Virtual Reality-Based Health Promotion Education and Healthy Living Behaviors in Pregnant Women

This randomized controlled, open-label trial evaluated the effects of education based on Pender's Health Promotion Model, delivered through virtual reality or printed educational booklets, on healthy lifestyle behaviors in pregnant women. The study was conducted at two family health centers in Istanbul, Turkey, between April 2025 and February 2026. A total of 102 primigravida pregnant women at 12-16 weeks of gestation were randomly assigned in equal numbers to a virtual reality education group, a booklet-based education group, or a routine-care control group. Both intervention groups received three weekly educational sessions followed by five monthly motivational interviewing telephone calls, while the control group received routine prenatal care. Healthy lifestyle behaviors and depression, anxiety, and stress symptoms were assessed at baseline and at 36-38 weeks of gestation. Ninety-five participants completed the study and were included in the analyses.

Inclusion Criteria: * Pregnant women aged 18-35 years * Being at 12-16 weeks of gestation at enrollment * Being primigravida * Having no chronic disease or health condition affecting healthy lifestyle behaviors * Being able to communicate and provide informed consent Exclusion Criteria: * Having a high-risk pregnancy at enrollment, including gestational diabetes, preeclampsia, multiple pregnancy, or threatened preterm labor * Having a psychiatric disorder or communication impairment that could prevent participation * Having previously participated in a similar educational program