Ideal Evaluation (actual research)

Problem statement and research questions

This project uses a Social Cognitive Engineering (SCE) approach to guide the design and research process. The SCE method provides a systematic approach to our study of robots for PwDs. The main goal of our application is to improve the well-being of the person with dementia (PwD) and of those living with them.

For the prototype that we have designed now, these are some research questions that we want to address.

1. Are the different stakeholders able to use our prototype smoothly?
2. Does the prototype allow the PwD greater autonomy in their day-to-day life?
3. Does the prototype improve the emotional state of the PwD and their relatives?

Method

As people with dementia have very specific situations (and because our prototype is built to deal with that aspect of customizability), we do not go for an identical experiment for all of them. Instead, the global setup is very similar, although Pepper is customized for the needs of every patient. Our evaluation can therefore be assimilated (with some reserve) to a within-subject evaluation. We also do pre-test and post-test.
Our main evaluation method is summative evaluation: we are trying to determine whether the robot has an impact and improves the frequency of "yes" in our yes-no driving questions.

Participants

The study will be conducted on approximately twenty people in the early stages of dementia. To avoid too much gender imbalance, there will be at least five men and five women. For the same reason, we hope to find at least five people around 50 or younger, although we expect most participants to be over 70 years old.
The participants will be selected based on a pool of PwD who live at home and need regular visits from an HCP. Only the volunteers will be kept for the experiment. The participants must have no experience of a Pepper robot helping with dementia.
As our experiment involves the PwD in their home environment, relatives and healthcare professionals (HCP) will also be involved in the process: although not being the targets of the experiment, they will contribute to obtaining the measurements and results.

Experimental design

Since dementia is unique to every person, it is very hard to conduct a global experiment with the same conditions for all participants. Every one of them may have different issues in their day-to-day life, while also not having the same living conditions (alone, living with husband, family, etc), this would require a different treatment. Furthermore, we want to record whether our prototype leads to an improvement in life quality. This can not be done through a short experiment, because the reliability of such an experiment would be very low.
This means we need to record the patient at home and measure over an extended period of time if their well-being and autonomy globally improved.

Tasks

The PwD will live their daily life, without Pepper in the beginning, then accompanied by Pepper, as if they were not under any experiment. The fact that they actually are will obviously affect their behavior. Yet, we hope that not being recorded and being under a non-invasive experiment will help them not to stress out and may make them live their life as normally as possible.
The tasks performed during the evaluation by Pepper, by the PwD, and by Pepper and the PwD together, will be decided in consultation with the HCP (and potentially the relatives) based on the needs of each patient.

Measures

We are planning to make behavioral and emotional measurements.
Behavioral measurements are the actions that the PwD is going to perform during the week, so it can be considered as subjective quantitative data. This will involve the relatives, the HCP, and the PwD themselves to quantify whether the use of Pepper did actually result in an increase in autonomy for the PwD.
Emotional measurements are more related to the state of mind, change of expression, and mood, so they can be considered as qualitative data. This can be measured by frequent talks with the PwD, either by the relatives or the HCP.
Measures will be done by oral discussions with the PwD, HCP, and relatives.

Procedure

The whole experiment process is 4 weeks long, although only weeks 1 and 4 are technically part of the experiment itself.
During week 1, the PwD, the HCP, and the relatives will be asked to pay increased attention. Behavioral and emotional data will be collected. This is a regular week for the PwD, i.e., in the usual situation, except that there is more attention dedicated to them.
During weeks 2 and 3, the PwD, the HCP, and the relatives will be introduced to Pepper, with the goal of getting used to it.
During week 4, which is the actual week of the experiment, attention will be spent trying to mirror week 1 as closely as possible. Behavioral and emotional data will be collected again.

Material

1. Consent form. To protect the privacy of participants and ensure the evaluation process goes smoothly, we will ask participants to sign a consent form, indicating they are willing to take part in the evaluation and the data gathered from the experiment will be analyzed by researchers.
2. Pepper robot. Our robot is programmed using Choregraphe. The robot will have the same behavior for every participant. However, the input data will be entered by the HCP(and potentially the relatives).

Results

Since each PwD has its own state of dementia and personal issues, it is very difficult to get uniform results, especially since they are collected orally.
Getting very nice, fully robust, and reliable results is merely a hope and a dream.
However, we can try to consider the main trends that we are interested in.
Thus, the results will be mainly focused on:
- How much autonomy did the PwD gain?
→ what did the HCP, relatives, and PwD report
→ how many tasks did they perform that they didn't do previously
→ did the relatives feel they had more time for themselves
- Did their emotional state improve?
→ feelings from the PwD themselves
→ reports from relatives and HCP
These results will most likely never be yes-no results, but more like clues or hints that show whether some things worked on not, which will be the point of our discussion.
NB: This part explains what we expect as a kind of result, it will be replaced by actual results after we perform an experiment with the class. There may also be interesting points we did not think about.

Discussion

• Reliability: Yes. One could replicate the same experiment with other patients.
• Validity: TBD.
• Biases: TBD.
• Scope: No. It would be very difficult to generalize the results since each prototype is built for a special patient. However, if the results conclude that the customized prototypes did improve the well-being of the people, then similar efforts to customize Pepper for more patients should produce similar effects.
• Ecological validity: Yes. Since we compare "without Pepper" (BEFORE) and "with Pepper" (AFTER) in a similar environment (i.e., for everything but Pepper), the results are not dependent on the environment.

Conclusions

Feasible evaluation (students)

Problem statement and research questions

This project uses a Social Cognitive Engineering (SCE) approach to guide the design and research process. The SCE method provides a systematic approach to our study of robots for PwDs. The main goal of our application is to improve the well-being of the person with dementia (PwD) and of those living with them.

For the prototype that we have designed now, these are some research questions that we want to address.

1. Are the different stakeholders able to use our prototype smoothly?
2. Does the prototype allow the PwD greater autonomy in their day-to-day life?
3. Does the prototype improve the emotional state of the PwD and their relatives?

Based on these questions and our evaluation setting, we can evaluate some of our claims from our Claim page. 

1. CL01: The PwD becomes aware of Pepper's presence.
   During the experiment, we can observe if this happens.
2. CL02: The PwD feels understood.
   In the questionnaire, there are questions related to this.
3. CL03: The PwD performs an activity step.
   We can verify this claim based on how far the participant went in the activity.
4. CL08: The PwD feels accomplished.
   After the activity is done, there are two specific questions related to accomplishment.
5. CL10: The PwD feels reassured.
   We can evaluate this from observing the participants, and from the affect questionnaire.
6. CL11: The PwD feels content.
   There is a question related to this in the questionnaire.

Method

In our situation, we recruit 20 students in our class to simulate the research. Since they are not real PwD, we ask them to act as if they were in home settings and we observe their behavior and expression. These data will also be reviewed after the evaluation to obtain the data and feedback.

Questionnaires

In order to collect qualitative data, we prepared two questionnaires to give to the participants: the affect assessment questionnaire and the system assessment questionnaire. All questionnaire questions are expressed in the form of statements and the participant can express one out of seven levels of agreement/disagreement from strongly disagree to strongly agree with the only exception being the additional remarks field at the end of the system assessment questionnaire.

Affect assessment

The affect assessment questionnaire asks the participant to describe their mood and feelings experienced during a task. The questionnaire is given two times: once before the experiments and once right after. The purpose of this questionnaire is to compare the feelings experienced by the participant before the interaction with Pepper and after to study how Pepper influences the participant's feelings. The questionnaire has six questions each designed to measure the level of a certain feeling experienced at the moment of filling the questionnaire. The six feelings we take into consideration are evaluated from the following statements:

1. I feel sad
2. I feel content
3. I feel calm
4. I feel tired
5. I feel nervous
6. I feel caring

System assessment

The system assessment questionnaire is given after the interaction with Pepper and its purpose is to assess the participant's experience with Pepper in more detail. The questionnaire has fourteen questions which are designed to answer research questions as described below:

1. I like gardening
2. I think Pepper made the task easier for me.
3. I would have known how to do the whole task without Pepper.
4. Pepper was easy to understand.
5. I enjoyed the task more than if I had had to do it alone.
6. I am pleased that Pepper reminded me to do the activity.
7. I feel like completing the task was a good accomplishment.
8. I feel like I accomplished it myself.
9. I felt in control of what I had to do.
10. I felt annoyed by Pepper.
11. I felt frustrated by the task.
12. I felt pressured by Pepper.
13. Pepper cared about helping me.
14. I would trust Pepper with more important activities.

Research questions:

1. To what extent did Pepper improve the task's experience? [Questions: 2,3,4,5,10,11,12]
2. To what extent did Pepper improve the participant's autonomy and perception of control? [Questions: 6, 8, 9]
3. To what extent did Pepper improve the participant's sense of accomplishment? [Questions: 7]
4. Did the participant perceive Pepper as a social agent? [Questions: 13, 14]
5. How was Pepper's ability to guide the participant through the task? [Questions: 4]

Question 1 is used to take into consideration the expected baseline enjoyment of the task for each participant. 

Participants

For this study, we simulate the real research by including 24 students from TU Delft. One third of them were female and two thirds male, so gender balance was decent. The students were not asked to roleplay someone with dementia, but simply to follow the experiment and do the activity.

Experimental design

Since our evaluating process is relatively short, we use within-subject, which means each participant goes through all conditions. In this way, our experiment tends to have more statistical power and less variability. Furthermore, every PwD may have different issues in their day-to-day life, while also not having the same living conditions (alone, living with husband, family, etc), thus would require a different treatment. But in our setting, we use the same setting for every participant.

Tasks

All participants will go through our designed testing process, which includes medication/meal/activity reminder and activity breakdown. 

Medication/meal/activity reminder: The robot will remind the patient of daily activities, through which we can see the effectiveness according to their reactions.
Activity breakdown: In this part, the robot will break down some complex tasks into a list of simple tasks and PwDs can follow the steps to accomplish complex tasks.

Measures

We are planning to make behavioural and emotional measurements.
Behavioral measurements are the actions that the PwD is going to perform during the week, so it can be considered as subjective quantitative data. This will involve the relatives, the HCP and the PwD themselves to quantify whether the use of Pepper did actually result in an increase in autonomy for the PwD.
Emotional measurements are more related to state of mind, change of expression and mood, so it can be considered as qualitative data. This can be measured by frequent talks with the PwD, either by the relatives or the HCP.
Measures will be done by oral discussions with the PwD, HCP and relatives.

Procedure

At the start of the evaluation, all participants will be gathered in the same room, together with the researchers and relatives. We will explain the whole evaluation process, provide simple instructions, explain that participation in the evaluations is voluntary, and participants are free to stop the evaluation at any time. Then, we will explain how the gathered data will be analyzed and help us to improve our prototype. All data will be kept private. We will also emphasize that if there is anything the participants dislike, they should let us know. The purpose of the study is to find out what they think of the prototype, and their honesty is greatly appreciated. Then, we will ask them to sign the consent form.
We will simulate a home setting, which is the most common scenario for PwDs. All PwDs are going to complete the evaluation separately.

Our robot will give corresponding prompts. For example, “It’s time to have lunch”, “Medicine time!”, “Today is your birthday. Happy Birthday!”.
We will record the reaction and behavior of participants after they heard the prompts.
To test the activity breakdown function, our robot will choose a relatively complex task to perform, such as making a paper plane, doing some exercise. Our robot will break it down into simple steps.
Record the reactions of participants and evaluate how is the activity accomplished.

Material

1. Consent form. To protect the privacy of participants and ensure the evaluation process goes smoothly, we will ask participants to sign a consent form, indicating they are willing to take part in the evaluation and the data gathered from the experiment will be analyzed by researchers.
2. Pepper robot. Our robot is programmed using Choregraphe. The robot will have the same behaviour for every participant. However, the input data will be entered by the HCP (and potentially the relatives).

Results

interactive version

Since each PwD has its own state of dementia and personal issues, it is very difficult to get uniform results, especially since they are collected orally.
Getting very nice, fully robust and reliable results, is merely a hope and a dream.
However, we can try to consider the main trends that we are interested in.
Thus, the results wil be mainly focused on:
- How much autonomy did the PwD gain?
→ what did the HCP, relatives and PwD report
→ how many tasks did they perform that they didn't do previously
→ did the relatives feel they had more time for themselves
- Did their emotional state improve?
→ feelings from the PwD themselves
→ reports from relatives and HCP
These results will most likely never be yes-no results, but more like clues or hints that show whether some things worked on not, which will be the point of our discussion.
NB: This part explains what we expect as kind of results, it will be replaced by actual results after we perform an experiment with the class. There may also be interesting points we did not think about.

Discussion

• Reliability: Yes. One could replicate the same experiment with other patients.
• Validity: TBD.
• Biases: TBD.
• Scope: No. It would be very difficult to generalize the results, since each prototype is built for a special patient. However, if the results conclude that the customized prototypes did improve the well-being of the people, then similar effort to customize Pepper for more patients should produce similar effects.
• Ecological validity: Yes. Since we compare "without Pepper" (BEFORE) and "with Pepper" (AFTER) in a similar environment (i.e., for everything but Pepper), the results are not dependent on the environment.

Conclusions