Peer-reviewed article

Telepresence avatar use for children with cancer in schools: a study on barriers and facilitators.

Grabowski FC, Dördelmann J, Exner B, Frielitz FS · 9 Jul 2026

Abstract

Purpose Children with cancer often face psychosocial and educational challenges due to prolonged school absences. Telepresence avatars offer the possibility of maintaining virtual classroom participation. This study examines perceived barriers and facilitators to the implementation of telepresence avatars in schools from the perspectives of teachers and supplements these findings with parent perspectives. Methods A cross-sectional teacher survey was conducted, complemented by an exploratory qualitative parent-interview component. For the survey, 5,019 schools were contacted via e-mail. Teachers' perceptions were assessed via a quantitative questionnaire, including descriptive analyses and group comparisons based on experience with pediatric cancer and/or prior use of telepresence avatars. To illustrate implementation experiences from the family perspective, three parents of children with cancer who had used a telepresence avatar were interviewed. Results Teachers (N = 298) reported moderate technical and organizational barriers to telepresence avatar use. Significant differences in perceived barriers were observed across experience profiles, with the lowest overall barrier levels reported by teachers with combined experience in pediatric cancer and telepresence avatar use, and the highest levels among teachers without prior experience. Key facilitators included technical resources, organizational support, leadership endorsement, and training. The interviews with parents illustrated the potential role of telepresence avatars in maintaining academic and social participation during treatment, while also pointing to practical challenges such as technical instability, unclear responsibilities, and administrative procedures. Conclusion Telepresence avatars have the potential to support the social and academic participation of children with cancer during school absences. However, successful implementation seems to depend on contextual and organizational conditions rather than on the technology itself. Clinical trials register drks.de, Identifier: DRKS00036745 (registered on May 15, 2025).