Olivier A. Blanson Henkemans

An online lifestyle diary with a persuasive computer assistant providing feedback on self-management

In accordance with the global trend, in The Netherlands approximately 45% of the population is overweight. Existing studies show that patient self-management can reduce these figures, but medical non-adherence is a persistent problem. eHealth can potentially increase adherence to self-management. Consequently, we designed a persuasive computer assistant and evaluated its influence on self-management, i.e., the use of an online lifestyle diary called DieetInzicht.nl. The assistant is represented by an animated iCat, which shows different facial expressions and provides cooperative feedback following principles from the motivational interviewing method. We conducted a randomized controlled trial with 118 overweight people over a period of four weeks and studied the difference between diary use with and without computer assistant feedback. Results show that the computer assistant contributed to filling in the diary more frequently, reduced the decline in motivation to perform self-management, lowered the (reported) BMI, and improved the ease of use. Furthermore, diary use increased knowledge of maintaining a healthy lifestyle. Finally, personal characteristics, i.e., locus of control, vocabulary, computer experience, age, gender, education level and initial BMI, explained the variance in the diary use and its outcome. Of the 118 participants 35 filled in the closing survey, covering motivation, BMI, lifestyle knowledge and ease of use, which implies that the findings based on these results are mainly representative for motivated participants. In general, this study shows that the Dieetinzicht eHealth service, including a personal computer assistant, is likely to support motivated overweight people and lifestyle related diseases to get a better insight in and adhere to their self-management.

Using a robot to personalise health education for children with diabetes type 1: A pilot study

OBJECTIVE Assess the effects of personalised robot behaviours on the enjoyment and motivation of children (8-12) with diabetes, and on their acquisition of health knowledge, in educational play. METHODS Children (N=5) played diabetes quizzes against a personal or neutral robot on three occasions: once at the clinic, twice at home. The personal robot asked them about their names, sports and favourite colours, referred to these data during the interaction, and engaged in small talk. Fun, motivation and diabetes knowledge was measured. Child-robot interaction was observed. RESULTS Children said the robot and quiz were fun, but this appreciation declined over time. With the personal robot, the children looked more at the robot and spoke more. The children mimicked the robot. Finally, an increase in knowledge about diabetes was observed. CONCLUSION The study provides strong indication for how a personal robot can help children to improve health literacy in an enjoyable way. Children mimic the robot. When the robot is personal, they follow suit. Our results are positive and establish a good foundation for further development and testing in a larger study. PRACTICE IMPLICATIONS Using a robot in health care could contribute to self-management in children and help them to cope with their illness.

Towards long-term social child-robot interaction: using multi-activity switching to engage young users

Social robots have the potential to provide support in a number of practical domains, such as learning and behaviour change. This potential is particularly relevant for children, who have proven receptive to interactions with social robots. To reach learning and therapeutic goals, a number of issues need to be investigated, notably the design of an effective child-robot interaction (cHRI) to ensure the child remains engaged in the relationship and that educational goals are met. Typically, current cHRI research experiments focus on a single type of interaction activity (e.g. a game). However, these can suffer from a lack of adaptation to the child, or from an increasingly repetitive nature of the activity and interaction. In this paper, we motivate and propose a practicable solution to this issue: an adaptive robot able to switch between multiple activities within single interactions. We describe a system that embodies this idea, and present a case study in which diabetic children collaboratively learn with the robot about various aspects of managing their condition. We demonstrate the ability of our system to induce a varied interaction and show the potential of this approach both as an educational tool and as a research method for long-term cHRI.

A remote social robot to motivate and support diabetic children in keeping a diary

Children with diabetes can benefit from keeping a diary, but seldom keep one. Within the European ALIZ-E project a robot companion is being developed that, among other things, will be able to support and motivate diabetic children to keep a diary. This paper discusses the study of a robot supporting the use of an online diary. Diabetic children kept an online diary for two weeks, both with and without remote support from the robot via webcam. The effect of the robot was studied on children’s use of the diary and their relationship with the robot. Results show that children shared significantly more personal experiences in their diaries when they were interacting with the robot. Furthermore, they greatly enjoyed working with the robot and came to see it as a helpful and supportive friend.Categories and Subject DescriptorsH.1.2 [User/Machine Systems]: Human factors; I.2.9 [Robotics]: Operator Interfaces; J.4 [Computer Applications]: Social and Behavioral Sciences.General TermsDesign, Experimentation, Human Factors, Verification.

Design and evaluation of a personal robot playing a self-management education game with children with diabetes type 1

Objective To assess the effects of a personal robot, providing diabetes self-management education in a clinical setting on the pleasure, engagement and motivation to play a diabetes quiz of children (7–12) with type 1 diabetes mellitus (T1DM), and on their acquisition of knowledge about their illness. Methods Children with T1DM (N = 27) participated in a randomized controlled trial (RCT) in which they played a diabetes mellitus self-management education (DMSE) game, namely a diabetes quiz, with a personal or neutral robot on three occasions at the clinic, or were allocated to a control group (care as usual). Personalised robot behaviour was based on the self-determination theory (SDT), focusing on the childrens needs for competence, relatedness and autonomy. The SDT determinants pleasure, motivation and diabetes knowledge were measured. Child-robot interaction was observed, including level of engagement. Results Results showed an increase in diabetes knowledge in children allocated to the robot groups and not in those allocated to the control group (P =.001). After three sessions, children working with the personal robot scored higher for determinants of SDT than children with the neutral robot (P = .02). They also found the robot to be more pleasurable (P =.04), they answered more quiz questions correctly (P =.02), and were more motivated to play a fourth time (P = .03). The analysis of audio/video recordings showed that in regard to engagement, children with the personal robot were more attentive to the robot, more social, and more positive (P < .05). Conclusion The study showed how a personal robot that plays DMSE games and applies STD based strategies (i.e., provides constructive feedback, acknowledges feelings and moods, encourages competition and builds a rapport) can help to improve health literacy in children in an pleasurable, engaging and motivating way. Using a robot in health care could contribute to self-management in children with a chronic disease and help them to cope with their illness.

Lost in persuasion: a multidisciplinary approach for developing usable, effective, and reproducible persuasive technology for health promotion

Despite its acknowledged benefits for health promotion, the full potential of persuasive technology is not (yet) reached in regard to usability, effectiveness, and reproducibility. It often lacks an effective combination of technical features and behavior change strategies. This paper presents a multidisciplinary approach, addressing both aspects. It builds on the frameworks of situated Cognitive Engineering and Intervention Mapping. The approach generates building blocks from theory originating from different relevant disciplines; it specifies change objectives and requirements, described in the context of use, for intervention (strategy) and interaction (technology); it evaluates process, effect and impact, whereby claims on interaction and intervention are validated. To cope with language barriers between developers from different disciplines, the approach is presented as a guideline, illustrated with a case study. This approach is expected to contribute to a sound design rationale, a broad reach and ongoing use of the technology, and larger results in regard to health promotion.

Child-robot interaction in the wild: field testing activities of the ALIZ-E project

A field study was conducted in which CRI activities developed by the ALIZ-E project were tested with the project’s primary user group: children with diabetes. This field study resulted in new insights in the modalities and roles a robot aimed at CRI in a healthcare setting might utilise, while in addition (re-)assessed some practises and technologies established within the project. Furthermore, it served as a means of strengthening the bonds with the project’s principal stakeholders. The study illustrates on the one hand the feasibility of the activities that were developed within the project, while on the other hand highlights the importance of engaging with primary users in an ongoing, incremental fashion.

The NAO goes to camp

ALIZ-E is a Europe-wide project focusing on long-term child-robot interaction, specifically as a means of educating diabetic children on their condition. This video showcases a recent field study at “SugarKidsClub”, a camp devoted to helping 7-12 year-olds handle type-1 diabetes. A wide range of CRI activities developed by ALIZ-E were employed, including a large “SandTray” touch table running a tile-sorting game and a “Handshake” touch-inducing activity designed to strengthen the child-robot bond. Apart from helping kids with their unfortunate affliction, the day at “SugarKidsClub” provided us a chance to use new technologies developed for the aforementioned activities as well as furthering our relationship with our primary stakeholders. This playful video highlights some of the footage taken that day within an entertaining story centered on Charlie, one of the NAO robots used for our field study with a pension for battery theft.