{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:56:29Z","timestamp":1790866589396,"version":"4.1.0"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000001","name":"National Science Foundation","doi-asserted-by":"publisher","award":["2304278"],"award-info":[{"award-number":["2304278"]}],"id":[{"id":"10.13039\/100000001","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["CIN 13-413"],"award-info":[{"award-number":["CIN 13-413"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["K1 RX004813"],"award-info":[{"award-number":["K1 RX004813"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Digit. Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Veterans in rural and underserved communities face persistent care barriers from provider shortages, travel burdens, and the digital divide. Within the Department of Veterans Affairs (VA), the Clinical Resource Hub (CRH) National Telehealth Program delivers primary, mental health, specialty, surgical, and rehabilitative care into veterans\u2019 homes and rural clinics, while VA Immersive scales extended reality (XR) across the system. Embodied XR telehealth, where provider and patient meet as full-body avatars in a shared immersive environment, intersects these programs and introduces new design requirements. This study extends our embodied XR codesign series from physical rehabilitation to mental health and whole health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Stakeholders from VA, academia, and industry (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"IM1\">\n                          <mml:mi>N<\/mml:mi>\n                          <mml:mo>=<\/mml:mo>\n                          <mml:mn>30<\/mml:mn>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ), drawn from Boise and other participating CRHs, joined a 3-day codesign at the Boise VA Medical Center in June 2026, including shadowing telehealth workflows, a full-day workshop with five teams, and a half-day debrief with program leads. Seven usability task ratings, 164 four-axis ideas (Raise, Reduce, Eliminate, Create), 95 debrief proposals, 188 prioritization votes, and 19 discussion transcripts were analyzed through descriptive statistics and reflexive thematic analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Perceived task ease was high among a cohort with mixed VR experience across seven tasks (tutorial, joining a telehealth room, exercise completion, movement recording, environment and interactable customization, and spatial drawing), each above 4.1 of 5 on the Single Ease Question, led by customizing virtual environments (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"IM2\">\n                          <mml:mi>M<\/mml:mi>\n                          <mml:mo>=<\/mml:mo>\n                          <mml:mn>4.84<\/mml:mn>\n                          <mml:mo>\u00b1<\/mml:mo>\n                          <mml:mn>0.37<\/mml:mn>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      ). Stakeholders most endorsed minimalist defaults, onboarding resources, and out-of-the-box readiness, followed by embodiment with personalized environments, disability representation, and veteran identity markers. The debrief prioritized breathing and grounding, graded exposure, psychoeducation, and whole-health movement, delivered through headsets paired to an in-clinic tablet or monitored home deployment. Infrastructure compatibility, workforce fit, and governance emerged as pervasive constraints. Workshop satisfaction was high (\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"IM3\">\n                          <mml:mi>M<\/mml:mi>\n                          <mml:mo>=<\/mml:mo>\n                          <mml:mn>4.82<\/mml:mn>\n                          <mml:mo>\u00b1<\/mml:mo>\n                          <mml:mn>0.53<\/mml:mn>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      of 5) with 88% requesting follow-up; platform-specific ratings were favorable but lower and more variable (e.g., user-friendliness\n                      <jats:inline-formula>\n                        <mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"IM4\">\n                          <mml:mi>M<\/mml:mi>\n                          <mml:mo>=<\/mml:mo>\n                          <mml:mn>3.76<\/mml:mn>\n                          <mml:mo>\u00b1<\/mml:mo>\n                          <mml:mn>0.97<\/mml:mn>\n                        <\/mml:math>\n                      <\/jats:inline-formula>\n                      of 5).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>We propose candidate design principles for extending an embodied XR telehealth platform, built for physical rehabilitation, to mental health and whole health care for veterans, and discuss implications for platform design, piloting, and deployment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fdgth.2026.1952753","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T14:14:51Z","timestamp":1790864091000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Co-designing embodied extended reality telehealth for veteran mental health: from movement care to whole health"],"prefix":"10.3389","volume":"8","author":[{"given":"Aviv","family":"Elor","sequence":"first","affiliation":[{"name":"Immergo Labs, Inc.","place":["Mountain View, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maxim","family":"Kuznetsov","sequence":"additional","affiliation":[{"name":"Immergo Labs, Inc.","place":["Mountain View, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Kusumoto","sequence":"additional","affiliation":[{"name":"Immergo Labs, Inc.","place":["Mountain View, CA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jared","family":"Duval","sequence":"additional","affiliation":[{"name":"School of Informatics, Computing, and Cyber Systems, Northern Arizona University","place":["Flagstaff, AZ, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kedron","family":"Burnett","sequence":"additional","affiliation":[{"name":"VA Clinical Resource Hub National Telehealth Program, US Department of Veterans Affairs","place":["Boise, ID, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felicia","family":"Skelton","sequence":"additional","affiliation":[{"name":"Spinal Cord Injury Care Line, Michael E. 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