Table 2. Open in new tab Summary of...

Equity-relevant characteristics (contextual factors)

Availability outcomes

Accessibility outcomes

Acceptability outcomes

Health system factors

Can come with large upfront costs⁴^,²⁴^,²⁶^,²⁷^,^62–66

The costs and resources required to engage with XR programs could exclude some patient groups,²⁶^,³⁹^,⁶³^,⁶⁴ unless absorbed by relevant provider

No relevant data presented in the included reviews

Private space⁶⁷ and robust Wi-Fi networks or tethering³⁹^,⁶⁷^,⁶⁸ may be needed

Can require specialist staffing,⁴^,²⁶^,³⁵^,⁴⁹^,⁵³^,⁶⁴^,⁶⁵^,^68–70 but still demands relatively little of their time⁴¹^,⁴⁷^,⁷¹

Needs time to set up and/or deliver²⁷^,³⁵^,⁶⁸^,⁷²^,⁷³

Can interfere with clinical workflows²⁴^,³⁵^,⁶²^,⁷³ and present infection control risks⁴^,³⁵^,⁴⁹^,⁶⁴^,⁷⁴^,⁷⁵

Age

Safe and appropriate applications are not yet available for all age groups⁴^,⁶⁹

Eligibility criteria for XR interventions may exclude older patients with frailties⁷⁴

Tools can be unsuitable for young children⁴^,²⁵^,²⁸^,³²^,^64–67^,⁷³^,^76–78

Older adults may show poor acceptance and/or usability⁵^,²¹^,²⁴^,³⁰^,⁵¹^,⁶²^,⁶⁴^,⁷⁴

Older children and adults may be less engaged¹⁸^,²³^,⁵⁹^,^79–85

Gender

No relevant data presented in the included reviews

The perception and utilization of XR tools may vary between genders⁵^,¹⁸^,²⁷^,⁸⁶

Apps do not always tailor content to gender differences⁶⁸^,⁸⁷^,⁸⁸

Disabilities and health conditions

No relevant data presented in the included reviews

Some patients may be ineligible for XR use (eg, due to history of epilepsy or seizures)²⁴^,²⁷^,⁷⁴^,⁸⁹^,⁹⁰

Variability may relate to prior trauma⁵⁵^,⁹¹ or psychiatric conditions⁵⁵^,⁹²

May not be inclusive for all patients,⁹³^,⁹⁴ such as those with cognitive delays,¹⁷ alopecia,⁹⁵ injuries,²⁷^,⁴⁰^,⁶⁴ or glasses wearers³⁹

Sociocultural factors

No relevant data presented in the included reviews

Can exclude those with limited digital skills and experience³⁰^,⁶²^,⁷²^,⁷⁴^,⁹⁶

Can place added engagement demands/inconvenience onto patients⁴⁹^,⁷²^,⁷³^,⁹⁷^,⁹⁸

Time constraints may exclude some patients from taking up these interventions⁹⁷

Variability may relate to social factors⁵^,³³^,⁵⁹ and education levels³³^,⁴⁸^,⁵⁵

Content is not usually tailored for different cultures or ethnicities⁴^,²⁷^,⁴⁰^,⁸⁸

Apps may be rudimentary for patients who are “digital natives”⁶²

Adverse effects

No relevant data presented in the included reviews

Cybersickness may be more common in certain groups⁵²

Cybersickness and minor discomfort can be experienced²⁶^,³⁰^,³²^,³⁵^,⁴⁰^,⁵⁰^,⁵²^,⁶⁴^,⁷²^,⁷⁴^,⁷⁵^,⁷⁷^,⁷⁹^,⁸⁴^,⁸⁸^,⁹⁷^,^99–101

Equity-relevant characteristics (contextual factors)

Availability outcomes

Accessibility outcomes

Acceptability outcomes

Health system factors

Can come with large upfront costs⁴^,²⁴^,²⁶^,²⁷^,^62–66

The costs and resources required to engage with XR programs could exclude some patient groups,²⁶^,³⁹^,⁶³^,⁶⁴ unless absorbed by relevant provider

No relevant data presented in the included reviews

Private space⁶⁷ and robust Wi-Fi networks or tethering³⁹^,⁶⁷^,⁶⁸ may be needed

Can require specialist staffing,⁴^,²⁶^,³⁵^,⁴⁹^,⁵³^,⁶⁴^,⁶⁵^,^68–70 but still demands relatively little of their time⁴¹^,⁴⁷^,⁷¹

Needs time to set up and/or deliver²⁷^,³⁵^,⁶⁸^,⁷²^,⁷³

Can interfere with clinical workflows²⁴^,³⁵^,⁶²^,⁷³ and present infection control risks⁴^,³⁵^,⁴⁹^,⁶⁴^,⁷⁴^,⁷⁵

Age

Safe and appropriate applications are not yet available for all age groups⁴^,⁶⁹

Eligibility criteria for XR interventions may exclude older patients with frailties⁷⁴

Tools can be unsuitable for young children⁴^,²⁵^,²⁸^,³²^,^64–67^,⁷³^,^76–78

Older adults may show poor acceptance and/or usability⁵^,²¹^,²⁴^,³⁰^,⁵¹^,⁶²^,⁶⁴^,⁷⁴

Older children and adults may be less engaged¹⁸^,²³^,⁵⁹^,^79–85

Gender

No relevant data presented in the included reviews

The perception and utilization of XR tools may vary between genders⁵^,¹⁸^,²⁷^,⁸⁶

Apps do not always tailor content to gender differences⁶⁸^,⁸⁷^,⁸⁸

Disabilities and health conditions

No relevant data presented in the included reviews

Some patients may be ineligible for XR use (eg, due to history of epilepsy or seizures)²⁴^,²⁷^,⁷⁴^,⁸⁹^,⁹⁰

Variability may relate to prior trauma⁵⁵^,⁹¹ or psychiatric conditions⁵⁵^,⁹²

May not be inclusive for all patients,⁹³^,⁹⁴ such as those with cognitive delays,¹⁷ alopecia,⁹⁵ injuries,²⁷^,⁴⁰^,⁶⁴ or glasses wearers³⁹

Sociocultural factors

No relevant data presented in the included reviews

Can exclude those with limited digital skills and experience³⁰^,⁶²^,⁷²^,⁷⁴^,⁹⁶

Can place added engagement demands/inconvenience onto patients⁴⁹^,⁷²^,⁷³^,⁹⁷^,⁹⁸

Time constraints may exclude some patients from taking up these interventions⁹⁷

Variability may relate to social factors⁵^,³³^,⁵⁹ and education levels³³^,⁴⁸^,⁵⁵

Content is not usually tailored for different cultures or ethnicities⁴^,²⁷^,⁴⁰^,⁸⁸

Apps may be rudimentary for patients who are “digital natives”⁶²

Adverse effects

No relevant data presented in the included reviews

Cybersickness may be more common in certain groups⁵²

Cybersickness and minor discomfort can be experienced²⁶^,³⁰^,³²^,³⁵^,⁴⁰^,⁵⁰^,⁵²^,⁶⁴^,⁷²^,⁷⁴^,⁷⁵^,⁷⁷^,⁷⁹^,⁸⁴^,⁸⁸^,⁹⁷^,^99–101

Table 2.

Open in new tab

Summary of findings of XR-based health and procedural anxiety interventions: possible inequity-generating impacts (mechanisms) pertaining to the focal technology (context).

Equity-relevant characteristics (contextual factors)	Availability outcomes	Accessibility outcomes	Acceptability outcomes
*Health system factors*	Can come with large upfront costs⁴^,²⁴^,²⁶^,²⁷^,^62–66	The costs and resources required to engage with XR programs could exclude some patient groups,²⁶^,³⁹^,⁶³^,⁶⁴ unless absorbed by relevant provider	No relevant data presented in the included reviews
	Private space⁶⁷ and robust Wi-Fi networks or tethering³⁹^,⁶⁷^,⁶⁸ may be needed
	Can require specialist staffing,⁴^,²⁶^,³⁵^,⁴⁹^,⁵³^,⁶⁴^,⁶⁵^,^68–70 but still demands relatively little of their time⁴¹^,⁴⁷^,⁷¹
	Needs time to set up and/or deliver²⁷^,³⁵^,⁶⁸^,⁷²^,⁷³
	Can interfere with clinical workflows²⁴^,³⁵^,⁶²^,⁷³ and present infection control risks⁴^,³⁵^,⁴⁹^,⁶⁴^,⁷⁴^,⁷⁵
*Age*	Safe and appropriate applications are not yet available for all age groups⁴^,⁶⁹	Eligibility criteria for XR interventions may exclude older patients with frailties⁷⁴	Tools can be unsuitable for young children⁴^,²⁵^,²⁸^,³²^,^64–67^,⁷³^,^76–78
			Older adults may show poor acceptance and/or usability⁵^,²¹^,²⁴^,³⁰^,⁵¹^,⁶²^,⁶⁴^,⁷⁴
			Older children and adults may be less engaged¹⁸^,²³^,⁵⁹^,^79–85
*Gender*	No relevant data presented in the included reviews	No relevant data presented in the included reviews	The perception and utilization of XR tools may vary between genders⁵^,¹⁸^,²⁷^,⁸⁶
*Gender*	No relevant data presented in the included reviews	No relevant data presented in the included reviews	Apps do not always tailor content to gender differences⁶⁸^,⁸⁷^,⁸⁸
*Disabilities and health conditions*	No relevant data presented in the included reviews	Some patients may be ineligible for XR use (eg, due to history of epilepsy or seizures)²⁴^,²⁷^,⁷⁴^,⁸⁹^,⁹⁰	Variability may relate to prior trauma⁵⁵^,⁹¹ or psychiatric conditions⁵⁵^,⁹²
*Disabilities and health conditions*	No relevant data presented in the included reviews	May not be inclusive for all patients,⁹³^,⁹⁴ such as those with cognitive delays,¹⁷ alopecia,⁹⁵ injuries,²⁷^,⁴⁰^,⁶⁴ or glasses wearers³⁹
*Sociocultural factors*	No relevant data presented in the included reviews	Can exclude those with limited digital skills and experience³⁰^,⁶²^,⁷²^,⁷⁴^,⁹⁶	Can place added engagement demands/inconvenience onto patients⁴⁹^,⁷²^,⁷³^,⁹⁷^,⁹⁸
		Time constraints may exclude some patients from taking up these interventions⁹⁷	Variability may relate to social factors⁵^,³³^,⁵⁹ and education levels³³^,⁴⁸^,⁵⁵
			Content is not usually tailored for different cultures or ethnicities⁴^,²⁷^,⁴⁰^,⁸⁸
			Apps may be rudimentary for patients who are “digital natives”⁶²
*Adverse effects*	No relevant data presented in the included reviews	Cybersickness may be more common in certain groups⁵²	Cybersickness and minor discomfort can be experienced²⁶^,³⁰^,³²^,³⁵^,⁴⁰^,⁵⁰^,⁵²^,⁶⁴^,⁷²^,⁷⁴^,⁷⁵^,⁷⁷^,⁷⁹^,⁸⁴^,⁸⁸^,⁹⁷^,^99–101

Equity-relevant characteristics (contextual factors)	Availability outcomes	Accessibility outcomes	Acceptability outcomes
*Health system factors*	Can come with large upfront costs⁴^,²⁴^,²⁶^,²⁷^,^62–66	The costs and resources required to engage with XR programs could exclude some patient groups,²⁶^,³⁹^,⁶³^,⁶⁴ unless absorbed by relevant provider	No relevant data presented in the included reviews
	Private space⁶⁷ and robust Wi-Fi networks or tethering³⁹^,⁶⁷^,⁶⁸ may be needed
	Can require specialist staffing,⁴^,²⁶^,³⁵^,⁴⁹^,⁵³^,⁶⁴^,⁶⁵^,^68–70 but still demands relatively little of their time⁴¹^,⁴⁷^,⁷¹
	Needs time to set up and/or deliver²⁷^,³⁵^,⁶⁸^,⁷²^,⁷³
	Can interfere with clinical workflows²⁴^,³⁵^,⁶²^,⁷³ and present infection control risks⁴^,³⁵^,⁴⁹^,⁶⁴^,⁷⁴^,⁷⁵
*Age*	Safe and appropriate applications are not yet available for all age groups⁴^,⁶⁹	Eligibility criteria for XR interventions may exclude older patients with frailties⁷⁴	Tools can be unsuitable for young children⁴^,²⁵^,²⁸^,³²^,^64–67^,⁷³^,^76–78
			Older adults may show poor acceptance and/or usability⁵^,²¹^,²⁴^,³⁰^,⁵¹^,⁶²^,⁶⁴^,⁷⁴
			Older children and adults may be less engaged¹⁸^,²³^,⁵⁹^,^79–85
*Gender*	No relevant data presented in the included reviews	No relevant data presented in the included reviews	The perception and utilization of XR tools may vary between genders⁵^,¹⁸^,²⁷^,⁸⁶
*Gender*	No relevant data presented in the included reviews	No relevant data presented in the included reviews	Apps do not always tailor content to gender differences⁶⁸^,⁸⁷^,⁸⁸
*Disabilities and health conditions*	No relevant data presented in the included reviews	Some patients may be ineligible for XR use (eg, due to history of epilepsy or seizures)²⁴^,²⁷^,⁷⁴^,⁸⁹^,⁹⁰	Variability may relate to prior trauma⁵⁵^,⁹¹ or psychiatric conditions⁵⁵^,⁹²
*Disabilities and health conditions*	No relevant data presented in the included reviews	May not be inclusive for all patients,⁹³^,⁹⁴ such as those with cognitive delays,¹⁷ alopecia,⁹⁵ injuries,²⁷^,⁴⁰^,⁶⁴ or glasses wearers³⁹
*Sociocultural factors*	No relevant data presented in the included reviews	Can exclude those with limited digital skills and experience³⁰^,⁶²^,⁷²^,⁷⁴^,⁹⁶	Can place added engagement demands/inconvenience onto patients⁴⁹^,⁷²^,⁷³^,⁹⁷^,⁹⁸
		Time constraints may exclude some patients from taking up these interventions⁹⁷	Variability may relate to social factors⁵^,³³^,⁵⁹ and education levels³³^,⁴⁸^,⁵⁵
			Content is not usually tailored for different cultures or ethnicities⁴^,²⁷^,⁴⁰^,⁸⁸
			Apps may be rudimentary for patients who are “digital natives”⁶²
*Adverse effects*	No relevant data presented in the included reviews	Cybersickness may be more common in certain groups⁵²	Cybersickness and minor discomfort can be experienced²⁶^,³⁰^,³²^,³⁵^,⁴⁰^,⁵⁰^,⁵²^,⁶⁴^,⁷²^,⁷⁴^,⁷⁵^,⁷⁷^,⁷⁹^,⁸⁴^,⁸⁸^,⁹⁷^,^99–101

Abbreviation: XR, extended reality.

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