JMIR Publications

Background:

Black men face a disproportionate burden of prostate cancer (CaP), often compounded by unmet psychosocial needs and challenges navigating social determinants of health (SDOH) at the point of prostate cancer diagnosis (PPCD). Traditional interventions are frequently not culturally tailored, emotionally engaging, or accessible, leaving gaps in support during this critical period.

Objective:

This study aimed to develop and assess the feasibility, acceptability, and usability of a culturally tailored, Artificial Intelligence (AI)-powered Virtual Reality Assistant (ViRA) for Black men at the PPCD, delivering psycho-oncology support, emotional guidance, and SDOH navigation.

Methods:

This cross-sectional study employed a mixed-methods, formative research approach to guide the co-design and alpha testing of the ViRA intervention. Four Black men with CaP were recruited using purposive sampling and were interviewed to obtain video-recorded data of their lived experiences and survivorship journey. ViRA was developed through structured planning, iterative prototyping of the survivors' narratives into AI-driven immersive virtual reality modules, with input from the survivors, the interdisciplinary team, and the community advisory board (CAB). Alpha testing included seven project team members (evaluating AI recommendation accuracy and platform functionality) and three Black CaP survivors (assessing usability, acceptability, and emotional engagement). Mixed-methods data collection included facilitator observations, structured interviews, and post-session focus groups. Qualitative data were thematically analyzed by two independent coders using NVivo to ensure rigor, trustworthiness, and credibility, while descriptive quantitative metrics assessed feasibility and usability using numbers and percentages.

Results:

PPCD ViRA therapy, consisting of 3D narrative videos, problem-solving psycho-oncology scripts, and SDOH navigation content, was developed using the survivor interviews, literature synthesis, existing web-based SDOH navigation resources, and CAB input. Alpha testing revealed high acceptability and emotional engagement with ViRA’s survivor-led narratives, psycho-oncology modules, and culturally resonant design (e.g., barbershop VR settings). Usability challenges included VR navigation for participants unfamiliar with technology and limitations in SDOH resource relevance. Participants suggested multiple delivery formats (VR, mobile, print), flexible timing of use, and enhanced localization of resources. Team member assessment confirmed AI recommendations were accurate and rapid, with minor refinements implemented to support user navigation.

Conclusions:

The study showed that ViRA is a critical, valuable, and convenient tool that can provide psycho-oncology support and information about CaP to men at the point of CaP diagnosis. The study further highlighted the feasibility, cultural acceptability, and potential to enhance the PPCD experience for Black men. Alpha testing identified key areas for refinement, including navigation support, SDOH resource curation, and flexible delivery formats. Future beta testing with a larger, diverse cohort will incorporate quantitative measures of psychological distress, health knowledge, and patient activation to validate the intervention. This study demonstrates the potential of immersive, AI-driven, culturally tailored digital tools to reduce disparities and improve emotional support in cancer care.

ClinicalTrial: