If robots can deliver food or play soccer, why not deploy them to help manage chronic illness? That's a question nurse scientist Cynthia Foronda, Ph.D., RN, CNE, CHSE, ANEF, FAAN, from the School of Nursing and Health Studies, is pursuing with an interprofessional research team and two grants from the University of Miami.
Asthma, a chronic lung disease affecting 1 in 12 U.S. school-age children, inflames and narrows the airways. Exacerbation episodes can lead to respiratory failure and even death, so managing the condition and preventing complications is key to improving outcomes. Yet there are significant barriers to effective asthma care. These barriers, include poor access to medications, non-adherence, linguistic diversity, and poor health literacy. Its these barriers, said Foronda, that can lead to dangerous situations for families with young asthma patients.
The responsibility for providing asthma education to families at the time of hospital discharge generally falls to nurses, but heavy workloads and time constraints can make thorough asthma education difficult if not impossible at those critical junctures.
"Research demonstrates that families of children with asthma often do not know how to respond during an asthma attack," said Foronda, assistant dean of innovation and clinical scholarship and a pediatric nurse by training. Often families of children with asthma leave the hospital after a critical incident without adequate training to prevent further complications. Frighteningly, research has shown that most patients don't even know the correct way to use their asthma inhalers, the device critical to administering medication in maintenance and in emergency situations.
That's where Artificially Intelligent Robot (AIR) Support for Pediatric Asthma Education comes in. "The purpose of this prevention study is to evaluate the design and usability of a newly developed asthma education protocol with the Human Support Robot (HSR) for children with asthma," shared Dr. Foronda, the principal investigator (PI).
The team includes AI and real-time robotics reasoning expert Ubbo Visser, Ph.D., the co-PI and an associate professor in the University's Computer Science Department; research assistant Katarzyna Pasternak, a computer science Ph.D. candidate interested in human-robot interaction and collaboration; and co-investigator Monica Cardenas, M.D., a pediatric pulmonologist with Miller School of Medicine.
Their proposed study earned a 2025–2026 Dean's Research Award from the School of Nursing and Health Studies in the amount of $32,295 as well as a competitive U-Link Chronic Diseases award from the University for the period from June 1, 2026, to May 31, 2027.
The awards recognize the team's commitment to high-impact interdisciplinary collaboration, outstanding research contributions, and the promise of their continued scholarly work. The Dean's Research Award requires that an extramural grant related to the research be submitted by June 2027. Indeed, the team has a stated goal of using pilot data collected from implementing and evaluating their novel educational intervention to support a future National Institutes of Health grant application.
The study builds on Dr. Foronda's past work of developing and testing educational technologies for caregivers of patients with asthma. The robots will be programmed to teach about inhaler use technique and reminders, as well as symptom monitoring, the kind of repetitive tasks, she explained, that "social robots are increasingly tested for in pediatric health contexts."
"In our previous study of 18 participants, we found that about half of family caregivers lacked basic knowledge regarding medications, and none of the parents had an asthma action plan," she said. "Clearly, there is a need for improved pediatric asthma education." In that study, the Asthma Academy, Foronda and her team identified major gaps in caregiver education and developed a unique curriculum to address them, using remotely conducted education sessions followed by individual telehealth visits. The intervention had a significant effect on improving caregivers' asthma knowledge and reducing caregivers' depressive symptoms, they found.
After studying the feasibility of using a social robot for pediatric asthma education with a small group of university students with backgrounds in computer science or nursing, they were able to refine the intervention for testing with health care providers and children.
While other early work has shown promise in using companion robots for asthma sufferers, what makes the work of this team unique is their plan to study the use of robots for educating children about asthma. "No study has tested an enabled social robot in pediatric asthma education, despite strong evidence of need," stated Dr. Foronda. "This project advances the field beyond prior feasibility studies. If successful, this pilot will validate the feasibility and effectiveness of robot-assisted asthma education and establish a scalable framework for AIR-supported pediatric health education with applications to other chronic conditions."
The Toyota Human Support Robot (HSR) they are using for this study is an autonomous robotic platform, capable of navigating in a known and unknown environment thanks to the onboard sensors and cameras, manipulating objects with its gripper-like hand, and interacting with the world via gestures, speech, and displaying videos and graphics. The robot's capacity to be programmed to speak numerous languages overcomes traditional communication and educational hurdles.
But Foronda is quick to emphasize this is not technology for technology's sake. "Effective educational interventions can empower patients and their caregivers to manage these chronic conditions successfully," she said.
The plan is to enroll 40 children with asthma ages 3 to 17 and a corresponding primary caregiver in the study. During the 15-minute robot-supported education session, the robot will deliver educational content addressing one or more of the following domains: the nature and clinical characteristics of asthma, correct use of the inhaler and spacer, implementation and utilization of an asthma action plan, and strategies to support adherence to prescribed medication.
Participants will be encouraged to pose questions during the session and given an opportunity to seek clarification or additional information. The study site is the UHealth Pediatric Pulmonary Clinic at Batchelor Children's Research Institute, where the researchers will coordinate with pulmonologists and nurse practitioners for referrals of children and families who use the clinic for care. Health care providers interested in the study can also observe a robotic educational session and evaluate acceptability of the robot.
"This project transforms asthma education by deploying an artificially intelligent social robot to deliver engaging, personalized, developmentally tailored learning that strengthens self-efficacy and correct inhaler technique," explained Cynthia Foronda. "If successful, this project will advance a scalable, AI-enabled model for pediatric chronic disease education."
