Acceptability and Usability of a Socially Assistive Robot Integrated With a Large Language Model for Enhanced Human-Robot Interaction in a Geriatric Care Institution: Mixed Methods Evaluation
Bibliographic record
Abstract
BACKGROUND: Socially assistive robots (SARs) hold promise for supporting older adults (OAs) in hospital settings by promoting social engagement, reducing loneliness, and enhancing emotional well-being. They may also assist health care professionals by delivering information, managing routines, and alleviating workload. However, their acceptability and usability remain major challenges, particularly in dynamic real-world care environments. OBJECTIVE: This study aimed to evaluate the acceptability and usability of a SAR in a geriatric day care hospital (DCH) and to identify key factors influencing its adoption by OAs and their informal caregivers. METHODS: Over the course of 1 year, 97 participants (n=65, 67%, OA patients and n=32, 33%, informal caregivers) took part in a mixed methods evaluation of ARI, a socially assistive humanoid robot developed by PAL Robotics. ARI was deployed in the waiting area of a geriatric day care robot in Paris (France), where it interacted with users through voice-based dialogue. After each session, participants completed 2 standardized assessments, the Acceptability E-scale (AES) and the System Usability Scale (SUS), administered orally to ensure accessibility. Open-ended qualitative feedback was also collected to capture subjective experiences and contextual perceptions. RESULTS: Acceptability scores significantly increased across waves (wave 1: mean 15.4/30, SD 5.81; wave 2: mean 20.9/30, SD 5.25; wave 3: mean 22.5/30, SD 4.23; P<.001). Usability scores also improved (wave 1: mean 47.9/100, SD 24.18; wave 2: mean 57.4/100, SD 22.46; wave 3: mean 69.3/100, SD 16.03; P<.001). A strong positive correlation was observed between acceptability and usability scores (r=0.664, P<.001). Qualitative findings indicated improved ease of use, clarity, and user satisfaction over time, particularly following the integration of a large language model (LLM) in wave 2, leading to more coherent, natural, and context-aware interactions. CONCLUSIONS: Successive system enhancements, most notably the integration of an LLM, led to measurable gains in usability and acceptability among patients and informal caregivers. These findings underscore the importance of iterative, user-centered design in deploying SARs in geriatric care environments. TRIAL REGISTRATION: Approved by the French national ethics committee (CPP Ouest II, IRB: 2021/20) as it did not involve randomization or clinical intervention.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.034 | 0.036 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".