Health Care Professionals’ Experiences Regarding Facilitators of and Barriers to Sustained Use of Social Robot Ivy for People With Intellectual Disabilities: Qualitative Interview Study

Abstract

BACKGROUND: Labor shortages in health care pose significant challenges to sustaining high-quality care for people with intellectual disabilities. Social robots show promise in supporting both people with intellectual disabilities and their health care professionals; yet, few are fully developed and embedded in productive care environments. Implementation of such technologies is inherently complex, requiring careful examination of facilitators and barriers influencing sustained use. OBJECTIVE: This research aimed to evaluate the value creation and implementation of social robots for people with intellectual disabilities and health care professionals, examining facilitators of and barriers to sustained use across 6 care organizations. METHODS: A qualitative field study was conducted involving 19 cases of robot implementation across 6 care organizations in the Netherlands; each case consisted of people with intellectual disabilities (clients) and the involved health care professionals. The study examined actual robot deployment in daily care practice between April 2023 and October 2023. Semistructured interviews were conducted with health care professionals after 2 months of implementation. Analysis followed a thematic approach guided by the nonadoption, abandonment, scale-up, spread, and sustainability framework and a model for tracing facilitators of and barriers to the adaptive implementation of the robot. Facilitators were classified as key drivers (complex), enablers (complicated), and minor benefits (simple), whereas barriers were categorized as deal-breakers (complex), obstacles (complicated), and minor hurdles (simple). The robots' sustained use (ie, robot use continuance at 2 months after implementation) served as a key indicator of success. RESULTS: After 2 months, robot use continued in 63% (12/19) of cases. For successful cases, the robot created distinct value among both clients (enhanced daily structure, improved emotional well-being through nonjudgmental interactions, and increased independence) and health care professionals (reduced workload through automation, improved quality of client interactions, and reduced emotional burden). Client characteristics (cognitive capabilities and care predictability), health care professional factors (available time and digital competency), contextual conditions (timing and connectivity), and organizational support (training and resources) influenced sustained use. Main implementation barriers included complex or unpredictable care needs, insufficient programming time, and contextual factors affecting care environments. CONCLUSIONS: The findings inform long-term care organizations on the implementation and value of the sustained use of social robots for both people with intellectual disabilities and their caregivers. Social robot Ivy demonstrates potential for supporting care delivery to people with intellectual disabilities when implemented under appropriate conditions. Success requires careful matching of robot capabilities with client needs, sufficient time and support for health care professionals, and stable care environments. Future research should examine longer-term sustainability and integrate direct client feedback.

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