Exploring the Use of Socially Assistive Robot Among Socially Isolated Korean American Older Adults

Purpose: Korean American immigrant older adults can experience increased social isolation and poorer behavioral health outcomes due to a combination of factors including limited English proficiency, health literacy, and a lack of familiarity with the US healthcare system. This pilot study explored whether a socially assistive robot (SAR) called “Hyodol” would have positive effects on Korean American immigrant older adults’ health behaviors and emotional well-being. The aims of the present study were: (1) to examine the preliminary effects of Hyodol on Korean American immigrant older adults’ medication adherence, depression, self-reported disability, and loneliness; and (2) to assess facilitators and barriers to users’ adoptability, considering factors like feasibility, compatibility, and user-friendliness, and recommendations for improvement.

Methods: A total of 45 Korean Americans (age 65+) in a large metropolitan area participated in the study, and each participant was provided a SAR named Hyodol for 4 months and interacted with it in ways that they saw appropriate. We used one-group pre- and post-test design to assess changes between baseline and follow-up in medication adherence (Medication Adherence Rating Scale, Chan et al., 2020), depressive symptoms (Patient Health Questionnaire-9, Kroenke et al., 2011), loneliness (University of California, Los Angeles Loneliness Scale, Russell et al., 1980), and disability (World Health Organization Disability Assessment Schedule, Saltychev et al., 2021). Additionally, we employed in-depth qualitative interviews to explore participants’ perceptions about the SAR.

Results: The majority of participants were women (73.3%), with an average age of 82.60 years (SD=6.36; range: 71-95). Over half of the participants were widowed (53.5%) and the majority (70.3%) were classified as low-income, living alone. On average, respondents spent 15.17 (SD=8.29) hours per day by themselves. At post-test, participants showed improved medication adherence, reduced depressive symptoms, and a slightly and statistically nonsignificant decrease in loneliness scores. Qualitative data suggested high adoptability of this particular SAR among the participants. Prevailing themes from qualitative interviews showed that these older adults enjoyed the companionship that the robot doll provided, alongside the personalized nudges aimed at promoting health behaviors. Many participants enjoyed pretending to have conversations, although Hyodol was not a chatbot and not designed for two-way conversations. Such personification becomes crucial in cultivating the sense of bonding with the SAR and mitigating loneliness and boredom for these socially isolated immigrants.

Conclusions and Implications: Synonymous with our findings from older adults in Korea, most Korean American older adult participants enjoyed having Hyodol as a conversational partner and ascribed human attributes to the SAR. This attribution of human qualities appears to have allowed the Hyodol SAR to remain usable even for those with limited digital literacy. The findings suggest that SARs that serve specific assistive functions such as medication reminding and health coaching for community dwelling older adults hold promise in enhancing their health behaviors and supplementing existing clinical interventions.