JMIR Publications

ABSTRACT

Background:

Socially assistive robots are increasingly being explored in health care, but evidence from real pediatric outpatient settings remains limited. In particular, little is known about how contextual support, human facilitation, and organizational conditions shape everyday human-robot interaction and practical acceptance in hospital environments

Objective:

This study aimed to examine how visitor engagement with a social robot differed across 3 implementation conditions in a pediatric outpatient hospital, how engagement differed between children and adults, and which socio-technical factors staff identified as enabling or constraining implementation.

Methods:

This convergent mixed methods pilot study was conducted at Tallinn Children’s Hospital. The quantitative strand consisted of structured behavioral observation across 3 field conditions, baseline, poster support, and staff facilitation, in which 675 visitors were recorded. The qualitative strand consisted of 4 small staff-group interviews with 12 health care professionals focused on use opportunities, barriers, and implementation needs. Quantitative data were analyzed descriptively, and qualitative data were analyzed using qualitative content analysis with deductive and inductive coding.

Results:

Observable engagement increased across the 3 conditions, from 3.1% in the baseline phase to 22.6% with poster support and 38.1% with staff facilitation. Children engaged more often than adults across all phases. Staff reported that acceptance depended less on novelty alone than on role clarity, visible usefulness, multilingual guidance, workflow fit, troubleshooting support, and clear organizational ownership. The robot was perceived as most useful for wayfinding, reducing uncertainty, engaging children during waiting, and supporting a calmer outpatient atmosphere.

Conclusions:

The findings support a socio-technical view of robot acceptance in pediatric health care. Meaningful uptake emerged through the interaction of robot affordances, local mediation, and organizational embedding rather than through technology alone. Public-facing, narrowly scoped functions, such as wayfinding, waiting-time support, parent guidance, and simple procedural information, appear to be the most feasible early use cases for social robots in pediatric hospitals.