A Nurse-Led Virtual Reality-Based Disaster Risk Reduction Program for Rural Adults: A Randomized Controlled Trial.

PURPOSE: To examine the effect of a nurse-led, 360-degree video-based virtual reality disaster risk reduction program (VR-b-DRRP) on disaster literacy, preparedness, and individual resilience among rural adults, who are often underprepared for disasters because of limited fixed infrastructure, distance from health services, and low health literacy. DESIGN: A randomized controlled trial with an intervention group and a control group (ClinicalTrials.gov: NCT06565962). METHODS: Sixty-four adults from a rural village were randomly allocated to either the intervention group (n = 32) or the control group (n = 32). Participants in the intervention group received the eight-week VR-based disaster risk reduction program (VR-b-DRRP), whereas those in the control group received a brochure-based disaster education program over the same eight-week period. Disaster literacy, the primary outcome, along with disaster preparedness and individual disaster resilience, was assessed at three time points: baseline, immediately following the intervention, and three months after its completion. All 64 randomized participants were included in the final analysis. FINDINGS: The two groups were similar before the program began (p > .05). After the program, the intervention group improved significantly more than the control group on all three measures, and these gains were still present three months later: disaster literacy (F = 46.53, p < .001, partial η2 = .600), disaster preparedness (F = 41.84, p < .001, partial η2 = .574), and individual disaster resilience (F = 38.26, p < .001, partial η2 = .552). Scores in the control group did not change significantly at any point. CONCLUSIONS: The nurse-led VR-b-DRRP significantly improved disaster literacy, preparedness, and resilience compared to a brochure-based program, and the improvements lasted for at least three months. CLINICAL RELEVANCE: Public health nurses can deliver portable VR disaster education to hard-to-reach rural communities, supporting efforts to reduce rural-urban preparedness inequalities.