Although virtual reality (VR) programs are being developed by marginalized groups’, a systemic power imbalance still exists. Marginalized groups have a place in digital wellbeing and can lead initiatives to access resources that they desire. To better support these efforts and mobilize knowledge among marginalized stakeholders, we conducted a scoping review of the use of VR for wellbeing. Adopting an equity lens that considers the experiences of intersectional marginalization, our aim was to identify VR programs, their targets, outcomes and equity-related facilitators and barriers. In May 2023, we conducted a comprehensive literature search of MEDLINE, PsycINFO, Embase and Web of Science databases and grey literature for virtual reality and marginalized populations. Eligible research articles since the inception of the databases were those that met our predefined criteria of VR, marginalized populations and wellbeing. We included 38 studies and charted preregistered variables using narrative synthesis, descriptive statistics, and a logic model. The populations were often intersectionally marginalized--primarily individuals with disabilities, underrepresented sexualities and genders, and marginalized older individuals in high-income countries on Turtle Island (North America). The most common race categories were Black or African American (26%) and European or White (53%), but other sociodemographic characteristics were underreported. VR offered diverse support, including social, mental, physical and cultural. We report program outcomes for several subgroups; though heterogeneous, most studies reported improved wellbeing outcomes. VR’s flexibility created informal, flexible spaces, with peer support that contributed to mental and social wellbeing. Several factors could hinder marginalized groups’ ability to access and participate, such as the lack of free programs, data and program ownership, and intersectional data analyses. This topic reflects a growing literature, with half of the publications being in 2022 or 2023. Many of these studies have limitations like small sample sizes and a lack of mixed-methods or practical significance analyses. Moving forward, researchers should apply more open-access and inclusive practices in their designs and recruitment processes to widen equitable access to marginalized stakeholders. Nevertheless, many marginalized populations created VR programs and benefited from them, contributing to a rebalancing of power over wellbeing.

Digital health technologies (DHTs) such as health apps are rapidly emerging as a major disruptor of health care. Yet there is no well-established process of decision making for selecting DHTs that are worthy of investing resources in their validation to determine whether they are ready (safe, effective, and not too costly) for health related use. We report here on an Ontario-based initiative to support such decision making. Specifically, we developed a decision-making algorithm that uses approved criteria including the strategic direction of the health research institute and the hospital, and availability of resources. The Council of Academic Hospitals of Ontario has adapted our approach for other hospitals. We hope that other healthcare organizations, in and beyond Ontario, will consider this and alternative approaches, and that research will be conducted to evaluate such approaches.