Abstract
INTRODUCTION: Socially assistive robots (SARs) have shown promise in pediatric healthcare by helping children manage the stress and anxiety associated with medical procedures. However, limited research exists on the specific robot behaviors that are most effective in reducing negative emotions in children during stressful interventions. This study aimed to compare the effectiveness of two emotional support strategies provided by a SAR during a vaccination event: internal emotion regulation through a guided breathing exercise and external emotion regulation via motivational speech and physical comfort (hugging). Additionally, we compared the effects of active and passive participation in the two SAR interventions. METHODS: A field study was conducted during annual group vaccination days, involving 225 children aged 8-12 years. Emotional and behavioral outcomes, including anxiety, fear, trust, and willingness to engage with the robot, were measured using self-report questionnaires. RESULTS: Results indicated that while girls reported higher levels of fear and anxiety than boys, active participation in the SAR intervention led to greater reductions in fear and anxiety, particularly among girls. Additionally, active hugging enhanced both engagement and trust, with girls showing a stronger response to such a physical comfort intervention. DISCUSSION: These findings indicate that, within the constraints of this study, SAR interventions were associated with reduced negative emotions in children during vaccinations, with active participation and physical comfort being particularly impactful for emotional support. This study offers valuable insights into optimizing SAR interventions in pediatric healthcare.