arXiv subjects

Alison Buttenheim

Publications and source records attributed to Alison Buttenheim.

2 recordsLinked to original sources

arXiv2025

Effect of Static vs. Conversational AI-Generated Messages on Colorectal Cancer Screening Intent: a Randomized Controlled Trial

Large language model (LLM) chatbots show increasing promise in persuasive communication. Yet their real-world utility remains uncertain, particularly in clinical settings where sustained conversations are difficult to scale. In a pre-registered randomized controlled trial, we enrolled 915 U.S. adults (ages 45-75) who had never completed colorectal cancer (CRC) screening. Participants were randomized to: (1) no message control, (2) expert-written patient materials, (3) single AI-generated message, or (4) a motivational interviewing chatbot. All participants were required to remain in their assigned condition for at least three minutes. Both AI arms tailored content using participant's self-reported demographics including age and gender. Both AI interventions significantly increased stool test intentions by over 12 points (12.9-13.8/100), compared to a 7.5 gain for expert materials (p<.001 for all comparisons). While the AI arms outperformed the no message control for colonoscopy intent, neither showed improvement xover expert materials. Notably, for both outcomes, the chatbot did not outperform the single AI message in boosting intent despite participants spending ~3.5 minutes more on average engaging with it. These findings suggest concise, demographically tailored AI messages may offer a more scalable and clinically viable path to health behavior change than more complex conversational agents and generic time intensive expert-written materials. Moreover, LLMs appear more persuasive for lesser-known and less-invasive screening approaches like stool testing, but may be less effective for entrenched preferences like colonoscopy. Future work should examine which facets of personalization drive behavior change, whether integrating structural supports can translate these modest intent gains into completed screenings, and which health behaviors are most responsive to AI-supported guidance.

cs.CY↗

arXiv2025

Large Language Model Chatbot Conversations vs Public Health Materials and Parental HPV Vaccination Intentions: A Randomized Clinical Trial

Health care systems are increasingly considering large language model (LLM)-based chatbots for vaccine communication, but evidence that they improve durable, behaviorally relevant outcomes beyond existing health materials is limited. This randomized clinical trial tested whether brief, multiturn LLM chatbot interactions increased parental intention to vaccinate children against human papillomavirus (HPV) compared with no intervention and government public health materials, and whether effects persisted. Parents in the US, Canada, and UK were recruited online from March 3 to May 25, 2025, with follow-up at 15 and 45 days. Eligible participants were adults with at least one HPV vaccine-eligible child who was unvaccinated or whose vaccination status was unknown. Participants were randomized to no-message control, country-matched government materials with at least 3 minutes of exposure, or a 3-minute GPT-4o chatbot interaction using either a default persuasive style or a shorter conversational style. The primary outcome was self-reported likelihood of vaccinating the child against HPV within 12 months, measured immediately after intervention on a 0-100 scale. Follow-up outcomes included vaccination intent and self-reported vaccination at 15 and 45 days. In total, 1297 participants were randomized (mean age 42.84 years; 72.1% female). Compared with no intervention, public health materials increased immediate vaccination intent (Cohen d = 0.53; 95% CI, 0.36-0.70), as did the default chatbot (d = 0.48; 95% CI, 0.30-0.65) and conversational chatbot (d = 0.33; 95% CI, 0.17-0.49). At 45 days, neither chatbot increased intent relative to controls, whereas public health materials maintained modest effects. No intervention increased self-reported vaccination uptake. Findings suggest well-designed public health materials may match or exceed short LLM chatbot conversations for HPV vaccine promotion.

cs.CY↗