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Aim: To identify specific facial expressions associated with pain behaviors using the PainChek application in residents with dementia. Design: This is a secondary analysis from a study exploring the feasibility of PainChek to evaluate the effectiveness of a social robot (PARO) intervention on pain for residents with dementia from June to November 2021. Methods: Participants experienced PARO individually five days per week for 15 min (once or twice) per day for three consecutive weeks. The PainChek app assessed each resident's pain levels before and after each session. The association between nine facial expressions and the adjusted PainChek scores was analyzed using a linear mixed model. Results: A total of 1820 assessments were completed with 46 residents. Six facial expressions were significantly associated with a higher adjusted PainChek score. Horizontal mouth stretch showed the strongest association with the score, followed by brow lowering parting lips, wrinkling of the nose, raising of the upper lip and closing eyes. However, the presence of cheek raising, tightening of eyelids and pulling at the corner lip were not significantly associated with the score. Limitations of using the PainChek app were identified. Conclusion: Six specific facial expressions were associated with observational pain scores in residents with dementia. Results indicate that automated real‐time facial analysis is a promising approach to assessing pain in people with dementia. However, it requires further validation by human observers before it can be used for decision‐making in clinical practice. Impact: Pain is common in people with dementia, while assessing pain is challenging in this group. This study generated new evidence of facial expressions of pain in residents with dementia. Results will inform the development of valid artificial intelligence‐based algorithms that will support healthcare professionals in identifying pain in people with dementia in clinical situations. Reporting Method: The study adheres to the CONSORT reporting guidelines. Patient or Public Contribution: One resident with dementia and two family members of people with dementia were consulted and involved in the study design, where they provided advice on the protocol, information sheets and consent forms, and offered valuable insights to ensure research quality and relevance. Trial Registration: Australian and New Zealand Clinical Trials Registry number (ACTRN12621000837820). [ABSTRACT FROM AUTHOR]

Aim: This study aims to test the feasibility of the PainChek app to assess pain for people with dementia living in residential aged care facilities (RACFs). It will also identify the optimal dosage and efficacy of a social robot (personal assistant robot [PARO]) intervention on chronic pain for people with dementia. Design: This is a feasibility randomized controlled trial with three groups. Methods: Forty‐five residents living with dementia and chronic pain will be recruited from one RACF. The intervention consists of an individual 15‐min non‐facilitated session with a PARO robot twice a day (Group 1), a PARO robot once a day (Group 2), or a Plush‐Toy (non‐robotic PARO) once a day (Group 3) from Monday to Friday for 4 weeks. Participants will be followed at 4 and 8 weeks after baseline assessments. The primary outcome will be the feasibility of using the PainChek app to measure changes in pain levels before and after each session. Secondary outcomes include staff‐rated pain levels, neuropsychiatric symptoms, quality of life and changes in psychotropic and analgesic medication use. Participants, staff and family perceptions of using PARO and the PainChek app will be collected after the 4‐week intervention. Discussion: This study will test the use of the PainChek app and PARO to improve pain management for people with dementia. Results from this study will help determine its usefulness, feasibility and acceptability for pain management in people with dementia living in RACFs. Impact: As pain is a significant problem for people with dementia, this project will generate evidence on the use of the PainChek to measure the efficacy of a social robot intervention that has the potential to improve the quality of pain care in people with dementia. Trial Registration: Australian and New Zealand Clinical Trials Registry number (ACTRN12621000837820) date registered 30/06/2021. [ABSTRACT FROM AUTHOR]