Collaborative knowledge generation and involvement of users is known to improve health promotion intervention development, but research about the roles and perspectives of users in the co-creation process is sparse. This research aimed to study how young people perceived their involvement in a co-creation process focussed on the development of a gamified virtual reality (VR) simulation—VR FestLab. The Living Lab methodology was applied to structure and guide the co-creation process. Living Lab participants were comprised of students, health promotion practitioners, researchers, and film and gaming experts who collaboratively designed and created the content and structure of the VR FestLab. Semi-structured interviews were conducted with nine students who participated in the Living Lab and represented young end users. Interviews were tape-recorded, transcribed and thematically analysed. Students described that they had influence on their tasks. They felt included and expressed that the collaboration with and feedback from peers and other stakeholders increased their self-efficacy and empowered them to take ownership and generate new ideas. Participants voiced that they lacked information about the final production of VR FestLab. Co-creation guided by the Living Lab methodology produced added value in terms of empowerment and increased self-efficacy for the students involved. Future Living Labs should plan for communication with participants about further development and implementation processes following ideation and prototyping phase.

Addressing the need for collaborative involvement in health intervention design requires application of processes that researchers and practitioners can apply confidently to actively involve end-users and wider stakeholder groups. Co-creation enables participation by focusing on empowering a range of stakeholders with opportunities to influence the final intervention design. While collaboration with users and stakeholders during intervention design processes are considered vital, clear articulation of procedures and considerations for various co-creation methodologies warrants further research attention. This paper is based on two case studies conducted in Australia and Denmark where researchers co-created virtual reality interventions in an alcohol prevention context. This paper explored and reflected on two co-creation methods–co-design and the Living Lab—and showcased the different processes and procedures of each approach. The study demonstrates that both approaches have merit, yet highlights tensions in distinguishing between the application of each of the respective steps undertaken in each of the processes. While a lot of similarities exist between approaches, differences are evident. Overall, it can be said that the Living Lab is broader in scope and processes applied within the Living Labs approach are more abstract. The co-design process that we applied in the first case study is described more granularly delivering a clear a step-by-step guide that practitioners can implement to co-design solutions that end-users value and that stakeholders support. An agenda to guide future research is outlined challenging researchers to identify the most effective co-creation approach.

This pilot study explores 31 Danish adolescent user experiences for the newly developed virtual party simulation app—Virtual Reality (VR) FestLab. The main objective of this study was to investigate usability for VR FestLab, which aims to improve alcohol resistance skills for Danish adolescents. A secondary objective was to understand gameplay experiences. The study is a mixed method study that draws on questionnaire data (n = 31) and focus group interviews (n = 10) of boarding school students participating in the pilot study. Descriptive statistics were used to examine quantitative data, and qualitative data were analyzed thematically. Quantitative findings indicated that gameplay experiences of the VR simulation were positive, and all User Experience Questionnaire (UEQ) items were answered positively. The focus group interviews showed that adolescents found the simulation to be realistic. Feedback indicated that the group pressure experienced in the simulation was regarded to be less than in real life. Adolescents had varying approaches to playing the VR simulation, they thought the quality of the simulation was good, and only a few users experienced technical difficulties. These initial study findings indicate that VR FestLab is a promising tool for the prevention of alcohol use among adolescents.