Aging Clinical Trial
Official title:
'Culture-Aware Robots and Environmental Sensor Systems for Elderly Support' (CARESSES) - Testing and Evaluation Phases
The aim of this study is to conduct and evaluate a controlled experimental trial aimed at exploring whether, to what extent and how a socially-assistive Pepper robot that operates on a unique CARESSES cultural competence solution can produce better health and well-being related outcomes among older adults residing in long stay care homes (and their informal carers) compared to a control socially-assistive Pepper robot with an alternative CARESSES solution, as well as care as usual.
The objective of the "Culture-Aware Robots and Environmental Sensor Systems for Elderly
Support' (CARESSES) project is to build culturally competent robots that are able to
re-configure their way of acting and speaking when offering a service to a person they are
assisting, and match his / her culture, customs and etiquette. This study will test and
evaluate robots that have been configured to provide a culturally-competent care to older
adults residing in care homes. It is hypothesised that by introducing robots, which are more
sensitive to the user's needs and able to adapt to his / her cultural background, the
CARESSES' innovative solution will offer a safe, reliable and intuitive system that fosters
independence and autonomy, improves quality of life of older adults, and also reduces
informal carer's burden. The methodology adopted to develop this culturally competent
solution is based on the principles of Transcultural Nursing, specifically on Hofstede's
Cultural dimensions theory (for describing general cultural characteristics at national
level) and on Papadopoulos, Tilki and Taylor's model of cultural competence.
At the heart of the CARESSES software is a cultural knowledge base (CKB) that stores all the
required information about the user and his / her cultural background. CKB was developed
using the guidelines provided by the experts in Transcultural Nursing, who identified through
field observations differences and similarities between individuals within three cultural
groups (i.e. White-English, Indian and Japanese) in order to avoid as much as possible
stereotyping and to provide suggestions regarding how likely culturally-specific behaviours
are valid for an individual belonging to the cultural group.
The study will employ a mixed method (qualitative and quantitative) single-blind, controlled
before-and-after experimental design with two testing sites (UK and Japan), in which
participants will either be purposefully allocated to an experimental arm (who will receive
and be assisted by the CARESSES robot), control arm 1 (who will receive and be assisted by
the control CARESSES robot) or control arm 2 (who will receive care as usual). Between and
within subjects comparisons will be used to evaluate whether and how the assistance of a
CARESSES Pepper robot improves health and well-being related outcomes among care home
residents and their informal carers. Eligible older adults from three cultural groups
(White-English, Indian and Japanese) will be recruited from the UK-based (White-English and
Indian cultural backgrounds only) and Japanese-based testing sites. Additionally, the
participants will be requested to nominate up to three informal carers of their choice who
will also be invited to take part in the study, but to a different degree. After the
recruitment, the participants from both sites will then be purposefully allocated to either
an experimental arm (UK site: n=10; Japan site: n=5) that will adopt the CARESSES robot, or
to a control arm 1 (UK site: n=10; Japan site: n=5) that will adopt the CARESSES control
robot, or to control arm 2 (UK site: n=10; Japan site n=5).
In the UK site, each of the arms will include five participants who primarily identify
themselves with the White-English culture, and five participants who primarily identify
themselves with the Indian culture. In the Japan site, three arms will only include
participants who primarily identify themselves with the Japanese culture. The participants
allocated to the control arm 2 will engage in testing first, followed by the control arm 1
and then the experimental arm. Testing will occur on two participants at any one time in the
UK site, and on one participant in the Japan site. Each participant will adopt a Pepper robot
over a period of two weeks.
Prior to commencing the full-scale study, a pre-trial feasibility pilot will be conducted
aimed at assessing the feasibility and acceptability of the screening, recruitment and
evaluation procedures, as well as identifying and tackling any technical issues associated
with the implementation of the CARESSES robot within a care home. One resident, who primarily
identifies himself / herself with the White-English culture and one informal carer will be
invited to take part in the pilot study. The evaluation procedure will take place in a
condensed format across one week (9 hours) rather than two weeks (18 hours) as during the
full-scale study.
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