Aim: To evaluate the acceptance of three-dimensional virtual reality programs and to explore the factors influencing the acceptance of the programs among the institutionalized older adults. Design: A cross-sectional explanatory study. Methods: A total of 71 residents completed the program successfully. They were invited to join a 9-week program included eight activities related to horticultural therapy in a virtual environment. Data were collected by structured questionnaires from August 2018 to February 2019. Ten association hypotheses were derived from the literature review. Partial least squares structural equation modelling was used to examine the proposed hypotheses. Results: Program acceptance was defined as virtual reality practices and continuous usage intention. Frequency of practice was about 12 times during 9-week free-trial period, and the score of continuance usage intention was 13.06 (maximum value of 15). The findings indicated that virtual reality practices were significantly affected by presence and the presence was significantly affected by involvement and interactivity. Continuance usage intention was significantly affected by involvement; and involvement was significantly affected by interactivity. However, continuance usage intention was not significantly influenced by virtual reality practices. Conclusions: The findings supported that immersive three-dimensional virtual reality program was accepted by the institutionalized older adults. The acceptance, in terms of virtual reality practices and continuous usage intention, was influenced by different paths. The findings have a potential impact on the design of virtual reality technology for the care of institutionalized older adults. Impact: What problem did the study address? There were controversial findings about the acceptance of immersive 3D virtual reality program among older adults. What were the main findings? Interactivity advanced the sense of presence and, thus, resulted in a higher frequency of virtual reality practices. Interactivity enhanced perception of involvement, thus, contributing to an increased intention of continuous usage. Where and on whom will the research have an impact? The immersive 3D virtual reality program was appropriate for older adults, even for first time users or individuals aged over 80 years. The findings revealed new insights for developing immersive 3D virtual reality programs for the older adults.
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