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Neil K. R. Sehgal

Publications and source records attributed to Neil K. R. Sehgal.

14 recordsLinked to original sources

AI-Assisted Submissions in Online Research Are Rare and Highly Concentrated but Routinely Approved

Online research platforms underpin much of what science claims about people, on the assumption that a human produced each response. Generative AI threatens that assumption by letting participants delegate responses to a chatbot, yet how often they do so remains unclear because prior estimates rely on self-report or automated detection rather than direct observation. We surveyed 2,500 workers on a high quality online research platform and directly observed AI assistance by linking donated ChatGPT histories to platform submission records of weekly ChatGPT users, covering 712,930 submissions across more than 127,000 studies. Although one in eight surveyed workers reported ever using AI on a study and 68% of observed workers had done so, assistance appeared in only 1% of submissions, with no detectable increase over more than 3 years. Assistance was often temporally localized within tasks and highly concentrated among workers, with 5% accounting for 64% of assisted submissions. Where assistance occurred, workers were virtually always paid, even when study instructions prohibited AI use, with overall approval rates similar to those for unassisted submissions. Half of assisted submissions involved bounded responses, outside the scope of the platform's LLM detector for open-ended responses. Taken together, our results do not support the view that AI assistance currently poses an existential threat to online research, but reveal limited payment consequences for prohibited use and gaps in platform safeguards, leaving platforms poorly prepared should that threat materialize.

cs.HC↗

"We Are Tired of Explaining": Communication Practice and AI Roleplay Training for Community Health Workers in Rural India

Community health workers (CHWs) in the Global South increasingly encounter AI-powered tools, yet the counseling work central to their role remains largely unsupported. We study communication practices among Accredited Social Health Activists (ASHAs) in rural Rajasthan, India, through simulated family-planning calls, semi-structured interviews, and an LLM chatbot roleplay design-probe with 20 participants. In calls, ASHAs often responded to social or material concerns by shifting to health-risk information, denying concerns, promising unspecified help, or listing medical solutions with limited explanation. A smaller set of responses instead engaged concerns, sought permission before involving family members, or left decisions with beneficiaries. We interpret these patterns through Motivational Interviewing, emphasizing restraint from correcting, persuading, or over-solving. Drawing across observed calls, interviews, and probe reactions, we derive design considerations for AI roleplay training: keep AI in a rehearsal role, provide descriptive rather than prescriptive feedback, and evaluate counseling process rather than agreement with prescribed responses.

cs.HC↗

Effects of Static and Conversational AI-Generated Messages on Colorectal Cancer Screening Intent: a Randomized Clinical Trial

Large language model chatbots show increasing promise in persuasive communication, but their clinical utility remains uncertain, particularly in settings where sustained conversations are difficult to scale. In a randomized clinical trial, 915 U.S. adults (ages 45-75) who had never completed colorectal cancer (CRC) screening were randomized to no-message control, expert-written patient materials, single AI-generated message, or motivational interviewing (MI) chatbot. 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). While AI interventions outperformed the no-message control for colonoscopy intent, neither showed improvement over expert materials. Notably, we did not detect a statistically significant difference between the longer, interactive chatbot and the simpler single AI message, despite participants spending 3 minutes more on average engaging with it. These findings suggest concise, demographically tailored AI messages may offer a scalable approach to increasing CRC screening intentions, although effects on completed screening remain unknown.

cs.CY↗

LLMs Mirror Country-Specific Gender Patterns If Asked, but Skew Male When Generating Media in Local Languages

Large language models (LLMs) are increasingly used to generate media, but whether their content perpetuates gender stereotypes is unknown: standard benchmarks rely on selection-based formats rather than long-form generation, and surveyed baselines for local gender associations are scarce outside the West. We collect gender associations for 22 occupational and domestic roles from 695 respondents across the United States, India, Kenya, and Nigeria, and evaluate eight LLMs under two regimes: direct questioning and media generation. Models track the surveyed associations under direct questioning but skew substantially more male under media generation in major local-language cells, consistent with the male bias documented in human-produced media. Outside the US, the shift is much smaller and non-significant under English prompting, so English-only or country-agnostic evaluation would miss this bias in the languages where these models are most deployed. Instruction prompting reduces the shift directionally, but trades off against alignment with the surveyed associations. Evaluating LLM gender bias for global deployment therefore requires generation-format testing, local-language prompting, and locally-collected human baselines.

cs.CL↗

Predictors of Loneliness in Older Adults Using Multimodal Analysis of Speech and Language

Loneliness is a critical public health issue among older adults, linked to higher risks of depression, cognitive decline, and mortality. Scalable, objective methods for its detection remain limited, particularly in natural conversational contexts. We analyzed speech and language markers of loneliness in 310 older adults using semi-structured telephone interviews to help understand how they process feeling lonely and how their language differs at different levels of feeling loneliness. Our multimodal framework combined linguistic features (psycholinguistic dictionaries, n-grams, and topic models) with acoustic features (pitch, tone, loudness) to examine associations with self-reported loneliness scores. Both predefined and data-driven methods captured patterns in verbal content and vocal delivery. Higher loneliness was associated with negations(r = 0.11), negative tone(r = 0.12), and conflict-related language. Lower loneliness was linked to social references(r = -0.18), motivational drives(r = -0.11), and emotional richness in speech(r = -0.12). We also found that the multimodal model (r = 0.298) outperforms the text-only and audio-only models. Findings suggest that loneliness manifests through both linguistic and acoustic cues, supporting the potential of speech-based analysis in psychological assessments and as an early indicator of emotional loneliness when used alongside existing assessments, rather than as standalone diagnostic tools.

cs.CL↗

Real-Time Deadlines Reveal Fragile Temporal Adaptation in LLM Strategic Dialogues

Large Language Models (LLMs) generate text token-by-token in discrete time, yet real-world communication, from therapy sessions to business negotiations, critically depends on continuous time constraints. We use simulated negotiations between paired agents under strict deadlines to study adaptation to real-time pressure. Agents either receive only the initial deadline or explicit remaining-time updates at each turn. Remaining-time feedback raises deal closure from 4% to 32% for GPT-5.1-chat-latest and increases offer acceptance more than sixfold. The same model achieves near-perfect closure under turn-based limits, showing that poor wall-clock performance is not simply due to insufficient negotiation competence. Across additional interface conditions, qualitative urgency cues can outperform numeric countdowns, repeated deadline reminders do not consistently reproduce their benefits, and directed time tracking can help or hurt depending on the model. Across additional negotiation scenarios and model configurations, we find real-time temporal adaptation is fragile, model-dependent, and sensitive to how temporal constraints are presented. Code available at https://github.com/sehgal-neil/llm-temporal-awareness

cs.AI↗

Different Demographic Cues Yield Inconsistent Conclusions About LLM Personalization and Bias

Demographic cue-based evaluation is widely used to study how large language models (LLMs) adapt their responses to signaled demographic attributes within and across groups. This approach typically relies on a single cue (e.g., names) as a proxy for group membership, implicitly treating different cues as interchangeable operationalizations of a single underlying identity-conditioned behavior. We test this assumption in realistic advice-seeking interactions spanning 14.8 million prompts, focusing on race and gender in a U.S. context. We find that cues for the same group induce only partially overlapping changes in model responses, yielding inconsistent conclusions about personalization, while bias conclusions are unstable, with both magnitude and direction of group differences varying across cues. We further show that these inconsistencies reflect differences in cue-group association strength and linguistic features bundled within cues that shape model responses. Together, our findings suggest that demographic conditioning in LLMs is not a cue-invariant category-level parameter but depends fundamentally on how identity is cued, reflecting responses to linguistic signals rather than stable demographic categories. We therefore call for multi-cue, mechanism-aware evaluations as a foundation for robust and interpretable claims about demographic variation in LLM responses.

cs.CL↗

Depression Symptoms and Relational Patterns in 187k ChatGPT Histories

Large language models are increasingly used as private, always-available conversational systems, but little is known about how people with depressive symptoms use them. Building on CSCW work on disclosure and peer support, we examine ChatGPT as an emerging informal support infrastructure: private, persistent, responsive, and available outside ordinary hours. We analyze 187,093 ChatGPT conversations from 766 participants who completed the PHQ-8, comparing those below the moderate-symptom threshold (score of 10) with those at or above it. Higher-PHQ participants used ChatGPT more for mental-health, interpersonal, loneliness, self-focused, and support-seeking conversations, with pronounced late-night and recurring month-level patterns. Their language contained more first-person singular pronouns and absolutist terms. They more often engaged ChatGPT in high-disclosure contexts, but professional redirection was not higher. Language-based prediction was modest and insufficient for screening (AUROC 0.591). We argue these histories should not be treated as clinical screening data but as evidence LLMs are increasingly used as informal support infrastructure.

cs.HC↗

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↗

Self-Reported Side Effects of Semaglutide and Tirzepatide in Online Communities

Social media can reveal patient experiences with glucagon-like peptide-1 receptor agonists (GLP-1 RAs) that extend beyond clinical trial data. We analyzed 410,198 Reddit posts (May 2019-June 2025) mentioning semaglutide or tirzepatide. A total of 67,008 users self-reported using these medications, and 43.5% described at least one side effect. Gastrointestinal symptoms predominated, including nausea (36.9%), fatigue (16.7%), vomiting (16.3%), constipation (15.3%), and diarrhea (12.6%). Notably, reproductive symptoms (e.g., menstrual irregularities) and temperature-related complaints (e.g., chills, hot flashes) emerged as unrecognized potential effects. These findings highlight patient concerns not well captured in current labeling or trials. Large-scale social media analysis can complement traditional pharmacovigilance by detecting emerging safety signals and expanding understanding of the real-world safety profile of GLP-1 RAs.

cs.SI↗

Designing Mental-Health Chatbots for Indian Adolescents: Mixed-Methods Evidence, a Boundary-Object Lens, and a Design-Tensions Framework

Mental health challenges among Indian adolescents are shaped by unique cultural and systemic barriers, including high social stigma and limited professional support. We report a mixed-methods study of Indian adolescents (survey n=362; interviews n=14) examining how they navigate mental-health challenges and engage with digital tools. Quantitative results highlight low self-stigma but significant social stigma, a preference for text over voice interactions, and low utilization of mental health apps but high smartphone access. Our qualitative findings reveal that while adolescents value privacy, emotional support, and localized content in mental health tools, existing chatbots lack personalization and cultural relevance. We contribute (1) a Design-Tensions framework; (2) an artifact-level probe; and (3) a boundary-objects account that specifies how chatbots mediate adolescents, peers, families, and services. This work advances culturally sensitive chatbot design by centering on underrepresented populations, addressing critical gaps in accessibility and support for adolescents in India.

cs.HC↗

PAL: Designing Conversational Agents as Scalable, Cooperative Patient Simulators for Palliative-Care Training

Effective communication in serious illness and palliative care is essential but often under-taught due to limited access to training resources like standardized patients. We present PAL (Palliative Assisted Learning-bot), a conversational system that simulates emotionally nuanced patient interactions and delivers structured feedback grounded in an existing empathy-based framework. PAL supports text and voice modalities and is designed to scaffold clinical skill-building through repeated, low-cost practice. Through a mixed-methods study with 17 U.S. medical trainees and clinicians, we explore user engagement with PAL, evaluate usability, and examine design tensions around modalities, emotional realism, and feedback delivery. Participants found PAL helpful for reflection and skill refinement, though some noted limitations in emotional authenticity and the adaptability of feedback. We contribute: (1) empirical evidence that large language models can support palliative communication training; (2) design insights for modality-aware, emotionally sensitive simulation tools; and (3) implications for systems that support emotional labor, cooperative learning, and AI-augmented training in high-stakes care settings.

cs.HC↗

Exploring Socio-Cultural Challenges and Opportunities in Designing Mental Health Chatbots for Adolescents in India

Mental health challenges among Indian adolescents are shaped by unique cultural and systemic barriers, including high social stigma and limited professional support. Through a mixed-methods study involving a survey of 278 adolescents and follow-up interviews with 12 participants, we explore how adolescents perceive mental health challenges and interact with digital tools. Quantitative results highlight low self-stigma but significant social stigma, a preference for text over voice interactions, and low utilization of mental health apps but high smartphone access. Our qualitative findings reveal that while adolescents value privacy, emotional support, and localized content in mental health tools, existing chatbots lack personalization and cultural relevance. These findings inform recommendations for culturally sensitive chatbot design that prioritizes anonymity, tailored support, and localized resources to better meet the needs of adolescents in India. This work advances culturally sensitive chatbot design by centering underrepresented populations, addressing critical gaps in accessibility and support for adolescents in India.

cs.CY↗

Race Discrimination in Internet Advertising: Evidence From a Field Experiment

We present the results of an experiment documenting racial bias on Meta's Advertising Platform in Brazil and the United States. We find that darker skin complexions are penalized, leading to real economic consequences. For every \$1,000 an advertiser spends on ads with models with light-skin complexions, that advertiser would have to spend \$1,159 to achieve the same level of engagement using photos of darker skin complexion models. Meta's budget optimization tool reinforces these viewer biases. When pictures of models with light and dark complexions are allocated a shared budget, Meta funnels roughly 64\% of the budget towards photos featuring lighter skin complexions.

cs.CY↗