Trial Outcomes & Findings for Cognitive Behavioral Immersion: A Randomized Control Trial of Peer-Based Coaching in the Metaverse (NCT NCT06418997)

NCT ID: NCT06418997

Last Updated: 2026-09-03

Results Overview

The Patient Health Questionnaire is a 9-item self-report measure of depression symptom severity. Scores range from 0 to 27, with higher scale scores indicating greater depression symptom severity. Scale scores were assessed and are presented for post-intervention week 8.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

306 participants

Primary outcome timeframe

post-intervention week 8

Results posted on

2026-09-03

Participant Flow

Participants were recruited through posts on clinical trial registries, advertisements on social media apps, lab websites, and word of mouth. Participants were recruited from February 2024 to January 2025. The first intervention groups (8 weeks in duration) began in March 2024, and the final groups ended in March 2025 when the prespecified sample size was reached. Follow-up data (6 months in duration) were collected from May 2024 to September 2025.

Participant milestones

Participant milestones
Measure
CBI-Virtual Reality
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a virtual reality headset.
CBI-Flat Screen
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills and habits that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a flat-screen device, such as a computer.
Delayed-Access Control
Participants randomized to this arm asked not to attend CBI sessions for 8 weeks.
Overall Study
STARTED
102
102
102
Overall Study
COMPLETED
66
66
88
Overall Study
NOT COMPLETED
36
36
14

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Cognitive Behavioral Immersion: A Randomized Control Trial of Peer-Based Coaching in the Metaverse

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CBI-Virtual Reality
n=102 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a virtual reality headset.
CBI-Flat Screen
n=102 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills and habits that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a flat-screen device, such as a computer.
Delayed-Access Control
n=102 Participants
Participants randomized to this arm asked not to attend CBI sessions for 8 weeks.
Total
n=306 Participants
Total of all reporting groups
Age, Continuous
37.39 Years
STANDARD_DEVIATION 12.10 • n=136 Participants
37.65 Years
STANDARD_DEVIATION 13.38 • n=136 Participants
36.90 Years
STANDARD_DEVIATION 11.67 • n=272 Participants
37.31 Years
STANDARD_DEVIATION 12.34 • n=60 Participants
Sex/Gender, Customized
Female
71 Participants
n=136 Participants
64 Participants
n=136 Participants
74 Participants
n=272 Participants
209 Participants
n=60 Participants
Sex/Gender, Customized
Male
31 Participants
n=136 Participants
37 Participants
n=136 Participants
28 Participants
n=272 Participants
96 Participants
n=60 Participants
Sex/Gender, Customized
Not reported
0 Participants
n=136 Participants
1 Participants
n=136 Participants
0 Participants
n=272 Participants
1 Participants
n=60 Participants
Race/Ethnicity, Customized
Asian
12 Participants
n=136 Participants
27 Participants
n=136 Participants
23 Participants
n=272 Participants
62 Participants
n=60 Participants
Race/Ethnicity, Customized
Black
26 Participants
n=136 Participants
19 Participants
n=136 Participants
28 Participants
n=272 Participants
73 Participants
n=60 Participants
Race/Ethnicity, Customized
Hispanic
19 Participants
n=136 Participants
27 Participants
n=136 Participants
16 Participants
n=272 Participants
62 Participants
n=60 Participants
Race/Ethnicity, Customized
Native American
2 Participants
n=136 Participants
7 Participants
n=136 Participants
6 Participants
n=272 Participants
15 Participants
n=60 Participants
Race/Ethnicity, Customized
Pacific Islander
1 Participants
n=136 Participants
3 Participants
n=136 Participants
1 Participants
n=272 Participants
5 Participants
n=60 Participants
Race/Ethnicity, Customized
White
59 Participants
n=136 Participants
51 Participants
n=136 Participants
46 Participants
n=272 Participants
156 Participants
n=60 Participants
Race/Ethnicity, Customized
Other
3 Participants
n=136 Participants
2 Participants
n=136 Participants
6 Participants
n=272 Participants
11 Participants
n=60 Participants
Patient Health Questionnaire-9
16.86 scores on a scale
STANDARD_DEVIATION 5.00 • n=136 Participants
16.27 scores on a scale
STANDARD_DEVIATION 4.36 • n=136 Participants
15.93 scores on a scale
STANDARD_DEVIATION 4.96 • n=272 Participants
16.35 scores on a scale
STANDARD_DEVIATION 4.78 • n=60 Participants
Generalized Anxiety Disorder-7
13.10 scores on a scale
STANDARD_DEVIATION 4.85 • n=136 Participants
12.98 scores on a scale
STANDARD_DEVIATION 4.86 • n=136 Participants
13.18 scores on a scale
STANDARD_DEVIATION 5.06 • n=272 Participants
13.09 scores on a scale
STANDARD_DEVIATION 4.91 • n=60 Participants
World Health Organization Quality of Life - General scale
51.96 scores on a scale
STANDARD_DEVIATION 19.49 • n=136 Participants
55.88 scores on a scale
STANDARD_DEVIATION 22.02 • n=136 Participants
52.94 scores on a scale
STANDARD_DEVIATION 22.05 • n=272 Participants
53.59 scores on a scale
STANDARD_DEVIATION 21.22 • n=60 Participants

PRIMARY outcome

Timeframe: post-intervention week 8

Population: N=4 randomized to CBI-VR and N=16 randomized to CBI-FS completed 0 surveys during the intervention and follow-up periods, and therefore were not included in the primary analyses.

The Patient Health Questionnaire is a 9-item self-report measure of depression symptom severity. Scores range from 0 to 27, with higher scale scores indicating greater depression symptom severity. Scale scores were assessed and are presented for post-intervention week 8.

Outcome measures

Outcome measures
Measure
CBI-Virtual Reality
n=98 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a virtual reality headset.
CBI-Flat Screen
n=86 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills and habits that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a flat-screen device, such as a computer.
Delayed-Access Control
n=102 Participants
Participants randomized to this arm asked not to attend CBI sessions for 8 weeks.
Patient Health Questionnaire-9
8.94 scores on a scale
Standard Deviation 0.54
10.11 scores on a scale
Standard Deviation 0.57
11.25 scores on a scale
Standard Deviation 0.51

SECONDARY outcome

Timeframe: post-intervention week 8

Population: N=4 randomized to CBI-VR and N=16 randomized to CBI-FS completed 0 surveys during the intervention and follow-up periods, and therefore were not included in the primary analyses.

The Generalized Anxiety Disorder-7 is a 7-item self-report measure of anxiety symptom severity. Scores range from 0 to 21, with higher scale scores indicating greater anxiety symptom severity. Scale scores were assessed and are presented for post-intervention week 8.

Outcome measures

Outcome measures
Measure
CBI-Virtual Reality
n=98 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a virtual reality headset.
CBI-Flat Screen
n=86 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills and habits that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a flat-screen device, such as a computer.
Delayed-Access Control
n=102 Participants
Participants randomized to this arm asked not to attend CBI sessions for 8 weeks.
Generalized Anxiety Disorder-7
7.27 scores on a scale
Standard Deviation 0.51
8.73 scores on a scale
Standard Deviation 0.54
9.23 scores on a scale
Standard Deviation 0.48

SECONDARY outcome

Timeframe: post-intervention week 8

Population: N=4 randomized to CBI-VR and N=16 randomized to CBI-FS completed 0 surveys during the intervention and follow-up periods, and therefore were not included in the primary analyses.

The World Health Organization Quality of Life - General scale is a 1-item self-report scale of general quality of life. Scores on this scale range from 0 to 100. Higher scores on this scale reflect a higher general quality of life. Scale scores were assessed and are presented for post-intervention week 8.

Outcome measures

Outcome measures
Measure
CBI-Virtual Reality
n=98 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a virtual reality headset.
CBI-Flat Screen
n=86 Participants
Over 8 weekly 1-hour sessions, participants learn about the cognitive-behavioral model from trained peer coaches, develop cognitive-behavioral skills and habits that they can utilize in their daily lives (such as cognitive restructuring), and engage with a receptive community of peers. Participants randomized to this arm access these sessions using a flat-screen device, such as a computer.
Delayed-Access Control
n=102 Participants
Participants randomized to this arm asked not to attend CBI sessions for 8 weeks.
World Health Organization Quality of Life-General Scale
66.51 scores on a scale
Standard Deviation 1.52
64.43 scores on a scale
Standard Deviation 1.56
57.58 scores on a scale
Standard Deviation 1.38

Adverse Events

CBI-Virtual Reality

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

CBI-Flat Screen

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Delayed-Access Control

Serious events: 0 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Adverse event data not reported

Additional Information

Iony D. Ezawa

University of Southern California

Phone: n/a

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place