LLMs for health: Perceived benefits, risks, intention to use AI chatbots, and willingness to self-disclose across sensitive health topics
Authors: Gwenn Beets, Anniek Jansen, Saar Hommes, Ruben D. Vromans, Leonie Westerbeek, Supraja Sankaran, Julia C. M. van Weert, Emiel J. Krahmer, +1 more
Organizations: Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands · Academic Collaborative Center for Digital Health and Mental Wellbeing, Department of Communication and Cognition, Tilburg School of Humanities and Digital Sciences, Tilburg University, Tilburg, The Netherlands · Amsterdam School of Communication Research (ASCoR), Department of Communication Science, University of Amsterdam, Amsterdam, The Netherlands
Abstract
AI chatbots are increasingly used for answering health-related questions. This study examines the role of topic type discussed with an AI chatbot and individual characteristics on perceived benefits and risks, intention to use an AI chatbot, and willingness to self-disclose health information. We conducted an online experiment with a 2 (topic type: physical versus psychological, between-subjects) x 2 (topic sensitivity: low versus high, within-subjects) mixed design among a Dutch representative sample (N = 1,388). Results showed that perceived benefits were positively associated with intention and willingness to self-disclose, while perceived risks were negatively associated. Moreover, participants reported higher usage intentions for low-sensitive topics compared to high-sensitive topics. Furthermore, perceptions, intention, and willingness to self-disclose varied by individual characteristics. Overall, our findings suggest that intentions to use AI chatbots and self-disclosure of health-related information are primarily related to perceived benefits and risks and to personal characteristics rather than to topic type.
AI healthcare chatbots are increasingly used to support health information seeking and self-management, yet their performance and impact on users remains to be studied. This study examines over 15,000 user reviews from 59 AI healthcare chatbot apps to explore how these systems function in everyday informational and emotional contexts. Topic modeling and interpretive analysis identify three recurring breakdowns: access barriers and service unreliability, user experience and interaction quality, and billing and customer support issues. Privacy and security concerns are associated with the most negative experiences. By framing AI healthcare chatbots as information infrastructures, our findings highlight how failures in access, usability, and trust affect users, offering actionable insights for designers, policymakers, and information professionals aiming to improve digital health systems.
Artificial intelligence (AI) is increasingly integrated into healthcare to support diagnostics, decision-making, and administrative processes. However, the successful implementation of AI depends not only on technical performance but also on public perceptions of its helpfulness, riskiness, and fairness. This study examines public perceptions of automated decision-making (ADM) in healthcare. Data were drawn from the first wave of an ongoing longitudinal survey panel. The final sample consisted of 3,915 respondents and was analyzed with structural equation modeling. Perceptions of ADM in healthcare as helpful, risky, and fair were treated as the dependent variables. AI literacy, familiarity with different forms of AI, confidence in clinicians' ability to distinguish AI- from human-generated content, use of conversational agents for health information, and use of traditional digital health information sources were included as exogenous. Greater familiarity with different forms of AI, higher confidence in the clinician's ability to recognize AI-generated content, and use of conversational agents for health information were associated with greater perceived helpfulness. Use of conversational agents was associated with lower perceived risk, whereas greater familiarity with AI and greater reliance on traditional health information sources were associated with higher perceived risk. Perceptions of ADM as fair were most strongly predicted by confidence in the clinician's ability, with additional small positive associations with AI familiarity, AI literacy, and use of conversational agents. Public perceptions of ADM in healthcare are shaped by technological familiarity, use of conversational agents, and confidence in human oversight. Overall, ADM's perceived helpfulness and fairness are driven more by trust in healthcare professionals than by trust in the technology itself.
Leonie Westerbeek, Ernesto de Leon, Julia C. M. van Weert
The growing role of AI-generated content and AI-enabled systems in public communication has led regulators to demand clear disclosure of content provenance and AI involvement. But the effects of such disclosures remain uncertain. We test two disclosure approaches in their impact on an AI chatbot's persuasive appeal. In a preregistered experiment, 1,500 UK adults held a short conversation with a persuasive chatbot about one of 60 policy issues. The chatbot was identical for everyone. We randomized the disclosure that people received: nothing (control), a prominent disclosure that they were interacting with an AI (T1), or that disclosure plus the chatbot's persuasive intent and instructions (T2). The chatbot shifted attitudes by 12.6 points on a 100-point scale in the control group. The AI-identity disclosure was practically equivalent to no disclosure, with a 13.1-point shift, whereas the additional intent disclosure cut the persuasive effect roughly in half to 6.3 points. It also made participants view the campaign's methods as less acceptable and support stronger penalties against it. For direct chatbot interactions, transparency about AI identity alone does not meaningfully impact its influence. While current rules emphasize what a system is, our results show why the regulation of persuasive AI must also address what the system is trying to do.