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| Name | Class |
|---|---|
| Brothers of Charity Services Galway Ireland | UNKNOWN |
| University College Hospital Galway | OTHER |
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Individuals with Intellectual disability face numerous barriers to cancer education, awareness and screening, including communication challenges, anxiety, and a lack of accessible educational resources. Traditional methods often fail to meet their unique learning needs, contributing to lower screening rates , delayed diagnoses and poorer outcomes..
Socially assistive robots, have demonstrated effectiveness in delivering interactive, engaging, and tailored education, helping individuals with cognitive impairments better understand medical procedures and the importance of preventive care.
The study investigators propose to conduct a pilot single arm clinical trial with a semi humanoid robot to deliver cancer awareness education to adults with intellectual disability attending a disability day service in Ireland .The semi humanoid robot will be programmed to engage in 2 way communication about the cancer related educational content that is uploaded on its system.
.Approximately 25 adults with ID will receive the robot led educational intervention addressing both breast and colorectal cancer awareness and screening. This a pragmatic pilot study to inform a future larger controlled clinical trial Our overall objective is to Improve breast and colorectal cancer awareness knowledge level among adults with ID receiving a robot-delivered education intervention
Individuals with intellectual disabilities (ID) face significant barriers in accessing healthcare education, including, challenges in understanding complex medical information and communicating with healthcare providers and anxiety1 Traditional methods of education delivery often fail to meet the unique learning needs of this population. Cancer screening is particularly affected by these barriers, leading to lower participation rates and delayed diagnoses 2 Socially assistive robots have demonstrated effectiveness in delivering interactive, engaging, and tailored education, helping individuals with cognitive impairments better understand medical procedures and the importance of preventive care. The integration of robotics in cancer awareness education offers a promising solution by providing an appealing and accessible learning experiences tailored to individuals with ID.
A number of studies have been conducted to investigate the use of social robots in healthcare learning .Findings demonstrate that technology which utilises artificial intelligence, speech recognition, and interactive displays enhance learning among individuals with cognitive impairments3 .A randomised controlled trial conducted in 2021 found the physical presence of the robot played a key role in engaging adults with ID and was valuable in learning as a facilitator of communication4.
Robots can simplify cancer awareness concepts using visual aids, step-by-step explanations, and gamification techniques to improve comprehension and retention. Additionally, research has shown that robots provide a non-judgmental and anxiety-free environment, making it easier for individuals with ID to engage with health education materials5,6.They also positively influence health behaviours and encourage proactive awareness participation7 Interactive robotic assistants have been shown to improve knowledge retention and promote adherence to medical recommendations among individuals with ID 8 Additionally it has also been demonstrated that social robots increase motivation in people with ASD when participating in educational activity9 By fostering independent learning and reducing healthcare disparities, robotics-based education represents a transformative approach to promoting cancer awareness screening and early detection.
'Breaking down Barriers' report10 (2023) is an assessment of the needs of disabled people in accessing cancer awareness services in Ireland. Recommendations to enhance cancer awareness in this population include person centred training and education using materials and assistive technologies to enhance delivery.
To this end the investigators plan to conduct a pilot a clinical trial to deliver Cancer Awareness and Prevention Education using the robot 'Pepper'. The trial will be conducted in collaboration with partners at the Brothers of Charity and colleagues at University of Galway, Galway University Hospital cancer services with support from the National Breast Cancer Research Institute ( NBCRI) ensuring co-design, implementation fidelity, and translation to routine care.
Cancer awareness resources already established by the National Cancer screening service will be utilised.
This pilot will assess feasibility, acceptability, and preliminary effectiveness of a robot-led education intervention to improve knowledge, reduce anxiety, and encourage participation in population-based cancer awareness programmes.
The project aligns with the Irish National Screening Service (NSS) programmes (e.g., Breast Check and Bowel Screen) and leverages accessible educational materials already established by NSS, adapted for delivery by Pepper.
Co-design workshops with adults with ID, caregivers, and Limelight staff will inform: content selection, accessible wording, imagery, session pacing, and anxiety supports. PPI contributors will review the easy-read materials and pilot the interaction flow on Pepper.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ARM A | Experimental | Each participant will receive at two ( or more if required) Pepper Robot sessions approx. 10-15 minutes delivered within a 2-week window, in small groups (2-5) or individually as needed. Breast cancer awareness and breast examination training will be delivered via pepper. Participants will use the breast examination mannequin and also the breast awareness shower card to enhance learning about performing self breast -examination Colorectal cancer awareness information and red flag symptoms will also be delivered via pepper |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Robot delivered Education | Other | Two Pepper Robot educational sessions , each approx. 10-15 minutes in duration delivered within a 2-week window, to small groups (2-5) or individually if needed, to people with intellectual disability Breast cancer awareness and breast examination training will be delivered via the robot pepper. Participants will use the breast examination mannequin and also the breast awareness shower card to enhance learning about performing self breast -examination Colorectal cancer awareness information and red flag symptoms will also be delivered via pepper |
| Measure | Description | Time Frame |
|---|---|---|
| Change in cancer awareness knowledge score range from pre- to post-intervention (immediate), | Easy-read Knowledge Questionnaire (breast & bowel awareness, 10-15 items each, pictorial supports, multiple choice/true-false. | Before enrolment and post intervention -immediately after the final education session |
| Measure | Description | Time Frame |
|---|---|---|
| Anxiety level related to checking for red flag symptoms (pre/post) using a 5-point visual faces scale validated/adapted for ID populations | Visual Faces Anxiety Scale (3 -point) will measure anxiety levels | At baseline and post intervention -immediately after the final education session |
| Intention to check for red flag symptoms (pre/post) on a 5-point pictorial Likert scale. |
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Inclusion Criteria:
Exclusion Criteria:
1 Severe sensory impairments that cannot be reasonably accommodated (e.g., profound hearing/vision loss without assistive solutions available for the session).
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Veronica McInerney, RN,PhD | Contact | +353 91494031 | veronica.mcinerney@universityofgalway.ie | |
| Aoife Lowery, MB,FRCS,PhD | Contact | +353 91 493033 | alowery@universityofgalway.ie |
| Name | Affiliation | Role |
|---|---|---|
| Veronica McInerney, RN,PhD | University of Galway | Principal Investigator |
| Aoife Lowery, MB,FRCS,PhD | University of Galway | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University Hospital Galway | Galway | H91 YR 71 | Ireland |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 24124776 | Background | Ortigosa Quiles JM, Garcia-Banda Garcia G, Chellew K, Ponsell Vicens E, Riquelme Marin A, Nicolas Carrasco MP. Identification of degrees of anxiety in children with three- and five-face facial scales. Psicothema. 2013;25(4):446-51. doi: 10.7334/psicothema2012.287. | |
| Background | 10. Cithambara k, Corby, D., & Hartnett, L ., Healy S., Joyce, D (2023). Breaking Down Barriers: An Assessment of the Needs of Disabled People in Accessing Population-Based Awareness Services in Ireland. 10.13140/RG.2.2.26735.82085. | ||
| Background | 9. Desideri, L., Negrini, M., Malavasi, M. et al. Using a Humanoid Robot as a Complement to Interventions for Children with Autism Spectrum Disorder: a Pilot Study. Adv Neurodev Disord 2, 273-285 (2018). https://doi.org/10.1007/s41252-018 | ||
| Background |
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Raw Anonymized Datasets: Coded data with Personal Health Information (PHI) removed will be shared.
Unending beginning after data analysis
data repository
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This is a single-arm, open-label, non-randomized pilot feasibility trial conducted at a single community site with support from Galway University Hospital Cancer Services and University of Galway Research team. Approximately 25 adults with ID will receive the robot ' Pepper'-led education intervention addressing both breast and colorectal cancer awareness. This a pragmatic pilot study to inform a future larger controlled clinical trial.
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|
Smiley face Likert scale (1-5) will measure assessment of intention to check for red flag symptoms and conduct self breast examinations (3) |
| At basline and post intervention -immediately after the final education session |
| Participant experience of the semi-humanoid robot to deliver the educational program via short structured questionnaire. | Participant Experience Smiley Face Survey will be used to assess the participants in using the semi humanoid robot Pepper to deliver cancer awareness education | At baseline and post intervention -immediately after the final education session |
| Participant acceptability of the semi-humanoid robot to deliver the educational program via short structured questionnaire. | Smiley Face Survey will be used to assess the participants acceptability in using the semi humanoid robot Pepper to deliver cancer awareness education. | At baseline and post intervention -immediately after the final education session |
| Participant reported usability of the semi-humanoid robot to deliver the educational program via short structured questionnaire. | Smiley Face Survey will be used to assess participants percieved usability of the semi humanoid robot Pepper to deliver cancer awareness education. | At baseline and post intervention -immediately after the final education session |
| The acceptability of using a robot assisted educational program | System Assessment for Staff and Professionals survey -6 point questionairre. | At end of study |
| The usability of a robot system for delivery of an educational program | System Usability Scale (SUS) | At end of study |
| 8. Feil-Seifer, D., & Matarić, M. J. (2011). Socially assistive robotics. IEEE Transactions on Autonomous Mental Development, 3(1), 88-103. |
| Background | 7. Papadopoulos, C., Koulouglioti, C., Ali, S., & Manthorpe, J. (2020). Promoting cancer awareness uptake for people with intellectual disabilities. BMC Public Health, 20(1), 1425 |
| Background | 6. Jordan A. Mann, Bruce A. MacDonald, I.-Han Kuo, Xingyan Li, Elizabeth Broadbent,People respond better to robots than computer tablets delivering healthcare instructions, Computers in Human Behavior, Volume 43,2015,Pages 112-117,ISSN 0747-5632,https://doi.org/10.1016/j.chb.2014.10.029 |
| Background | 5. Moyle, W., Jones, C., Cooke, M., O'Dwyer, S., Sung, B., & Drummond, S. (2017). Social robots helping people with dementia. Journal of Clinical Nursing, 26(23-24), 4765-4776 |
| Background | 4. Mitchell, A., Sitbon, L., Balasuriya, S.S., Koplick, S., Beaumont, C. (2021). Social Robots in Learning Experiences of Adults with Intellectual Disability: An Exploratory Study. In: Ardito, C., et al. Human-Computer Interaction - INTERACT 2021. INTERACT 2021. Lecture Notes in Computer Science(), vol 12932. Springer, Cham. https://doi.org/10.1007/978-3-030-85623-6_17 |
| 22577778 | Background | Scassellati B, Admoni H, Mataric M. Robots for use in autism research. Annu Rev Biomed Eng. 2012;14:275-94. doi: 10.1146/annurev-bioeng-071811-150036. Epub 2012 May 9. |
| Background | 2. Flynn, S., Hulbert-Williams, N. J., Bramwell, R., & Stevens-Gill, D. (2015). Beliefs about cancer and health behaviors among individuals with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 28(1), 36-45. |
| Background | 1. Tuffrey-Wijne, I., Curfs, L., Finlay, I., Hollins, S., & Bernal, J. (2018). Cancer care for people with intellectual disabilities. European Journal of Oncology Nursing, 35, 25-30. |
| ID | Term |
|---|---|
| D008607 | Intellectual Disability |
| D016504 | Breast Self-Examination |
| ID | Term |
|---|---|
| D019954 | Neurobehavioral Manifestations |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D016353 | Self-Examination |
| D015438 | Health Behavior |
| D001519 | Behavior |
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