Enablers and barriers to the implementation of socially assistive humanoid robots in health and social care: a systematic review

Objectives Socially assistive humanoid robots are considered a promising technology to tackle the challenges in health and social care posed by the growth of the ageing population. The purpose of our study was to explore the current evidence on barriers and enablers for the implementation of humanoid robots in health and social care. Design Systematic review of studies entailing hands-on interactions with a humanoid robot. Setting From April 2018 to June 2018, databases were searched using a combination of the same search terms for articles published during the last decade. Data collection was conducted by using the Rayyan software, a standardised predefined grid, and a risk of bias and a quality assessment tool. Participants Post-experimental data were collected and analysed for a total of 420 participants. Participants comprised: older adults (n=307) aged >= 60 years, with no or some degree of age-related cognitive impairment, residing either in residential care facilities or at their home; care home staff (n=106); and informal caregivers (n=7). Primary outcomes Identification of enablers and barriers to the implementation of socially assistive humanoid robots in health and social care, and consequent insights and impact. Future developments to inform further research. Results Twelve studies met the eligibility criteria and were included. None of the selected studies had an experimental design; hence overall quality was low, with high risks of biases. Several studies had no comparator, no baseline, small samples, and self-reported measures only. Within this limited evidence base, the enablers found were enjoyment, usability, personalisation and familiarisation. Barriers were related to technical problems, to the robots' limited capabilities and the negative preconceptions towards the use of robots in healthcare. Factors which produced mixed results were the robot's human-like attributes, previous experience with technology and views of formal and informal carers. Conclusions The available evidence related to implementation factors of socially assistive humanoid robots for older adults is limited, mainly focusing on aspects at individual level, and exploring acceptance of this technology. Investigation of elements linked to the environment, organisation, societal and cultural milieu, policy and legal framework is necessary. PROSPERO registration number CRD42018092866.