Global rates of mental health concerns are rising, and there is increasing realization that existing models of mental health care will not adequately expand to meet the demand. With the emergence of large language models (LLMs) has come great optimism regarding their promise to create novel, large-scale solutions to support mental health. Despite their nascence, LLMs have already been applied to mental health related tasks. In this paper, we summarize the extant literature on efforts to use LLMs to provide mental health education, assessment, and intervention and highlight key opportunities for positive impact in each area. We then highlight risks associated with LLMs' application to mental health and encourage the adoption of strategies to mitigate these risks. The urgent need for mental health support must be balanced with responsible development, testing, and deployment of mental health LLMs. It is especially critical to ensure that mental health LLMs are fine-tuned for mental health, enhance mental health equity, and adhere to ethical standards and that people, including those with lived experience with mental health concerns, are involved in all stages from development through
Conversational Agents (CAs, chatbots) are systems with the ability to interact with users using natural human dialogue. While much of the research on CAs for sexual health has focused on adult populations, the insights from such research may not apply to CAs for youth. The study aimed to comprehensively evaluate the state-of-the-art research on sexual health CAs for youth. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we synthesized peer-reviewed studies specific to sexual health CAs designed for youth over the past 14 years. We found that most sexual health CAs were designed to adopt the persona of health professionals to provide general sexual and reproductive health information for youth. Text was the primary communication mode in all sexual health CAs, with half supporting multimedia output. Many sexual health CAs employed rule-based techniques to deliver pre-written expert knowledge on sexual health; yet most sexual health CAs did not have the safety features in place. While youth appreciated accessibility to non-judgmental and confidential conversations about sexual health topics, they perceived current sexual health CAs pro
Selecting the right monitoring level in Remote Patient Monitoring (RPM) systems for e-healthcare is crucial for balancing patient outcomes, various resources, and patient's quality of life. A prior work has used one-dimensional health representations, but patient health is inherently multidimensional and typically consists of many measurable physiological factors. In this paper, we introduce a multidimensional health state model within the RPM framework and use dynamic programming to study optimal monitoring strategies. Our analysis reveals that the optimal control is characterized by switching curves (for two-dimensional health states) or switching hyper-surfaces (in general): patients switch to intensive monitoring when health measurements cross a specific multidimensional surface. We further study how the optimal switching curve varies for different medical conditions and model parameters. This finding of the optimal control structure provides actionable insights for clinicians and aids in resource planning. The tunable modeling framework enhances the applicability and effectiveness of RPM services across various medical conditions.
Access to sexual and reproductive health information remains a challenge in many communities globally, due to cultural taboos and limited availability of healthcare providers. Public health organizations are increasingly turning to Large Language Models (LLMs) to improve access to timely and personalized information. However, recent HCI scholarship indicates that significant challenges remain in incorporating context awareness and mitigating bias in LLMs. In this paper, we study the development of a culturally-appropriate LLM-based chatbot for reproductive health with underserved women in urban India. Through user interactions, focus groups, and interviews with multiple stakeholders, we examine the chatbot's response to sensitive and highly contextual queries on reproductive health. Our findings reveal strengths and limitations of the system in capturing local context, and complexities around what constitutes "culture". Finally, we discuss how local context might be better integrated, and present a framework to inform the design of culturally-sensitive chatbots for community health.
Mobile health has the potential to revolutionize health care delivery and patient engagement. In this work, we discuss how integrating Artificial Intelligence into digital health applications-focused on supply chain, patient management, and capacity building, among other use cases-can improve the health system and public health performance. We present an Artificial Intelligence and Reinforcement Learning platform that allows the delivery of adaptive interventions whose impact can be optimized through experimentation and real-time monitoring. The system can integrate multiple data sources and digital health applications. The flexibility of this platform to connect to various mobile health applications and digital devices and send personalized recommendations based on past data and predictions can significantly improve the impact of digital tools on health system outcomes. The potential for resource-poor settings, where the impact of this approach on health outcomes could be more decisive, is discussed specifically. This framework is, however, similarly applicable to improving efficiency in health systems where scarcity is not an issue.
Large Language Models (LLMs) have been positioned as having the potential to expand access to health information in the Global South, yet their evaluation remains heavily dependent on benchmarks designed around Western norms. We present insights from a preliminary benchmarking exercise with a chatbot for sexual and reproductive health (SRH) for an underserved community in India. We evaluated using HealthBench, a benchmark for conversational health models by OpenAI. We extracted 637 SRH queries from the dataset and evaluated on the 330 single-turn conversations. Responses were evaluated using HealthBench's rubric-based automated grader, which rated responses consistently low. However, qualitative analysis by trained annotators and public health experts revealed that many responses were actually culturally appropriate and medically accurate. We highlight recurring issues, particularly a Western bias, such as for legal framing and norms (e.g., breastfeeding in public), diet assumptions (e.g., fish safe to eat during pregnancy), and costs (e.g., insurance models). Our findings demonstrate the limitations of current benchmarks in capturing the effectiveness of systems built for differen
The growing demand for home healthcare calls for tools that can support care delivery. In this study, we explore automatic health assessment from voice using real-world home care visit data, leveraging the diverse patient information it contains. First, we utilize Large Language Models (LLMs) to integrate Subjective, Objective, Assessment, and Plan (SOAP) notes derived from unstructured audio transcripts and structured vital signs into a holistic illness score that reflects a patient's overall health. This compact representation facilitates cross-visit health status comparisons and downstream analysis. Next, we design a multi-stage preprocessing pipeline to extract short speech segments from target speakers in home care recordings for acoustic analysis. We then employ an Audio Language Model (ALM) to produce plain-language descriptions of vocal biomarkers and examine their association with individuals' health status. Our experimental results benchmark both commercial and open-source LLMs in estimating illness scores, demonstrating their alignment with actual clinical outcomes, and revealing that SOAP notes are substantially more informative than vital signs. Building on the illness
YouTube has rapidly emerged as a predominant platform for content consumption, effectively displacing conventional media such as television and news outlets. A part of the enormous video stream uploaded to this platform includes health-related content, both from official public health organizations, and from any individual or group that can make an account. The quality of information available on YouTube is a critical point of public health safety, especially when concerning major interventions, such as vaccination. This study differentiates itself from previous efforts of auditing YouTube videos on this topic by conducting a systematic daily collection of posted videos mentioning vaccination for the duration of 3 months. We show that the competition for the public's attention is between public health messaging by institutions and individual educators on one side, and commentators on society and politics on the other, the latest contributing the most to the videos expressing stances against vaccination. Videos opposing vaccination are more likely to mention politicians and publication media such as podcasts, reports, and news analysis, on the other hand, videos in favor are more li
The Oregon Health Insurance Experiment (OHIE) offers a unique opportunity to examine the causal relationship between Medicaid coverage and happiness among low-income adults, using an experimental design. This study leverages data from comprehensive surveys conducted at 0 and 12 months post-treatment. Previous studies based on OHIE have shown that individuals receiving Medicaid exhibited a significant improvement in mental health compared to those who did not receive coverage. The primary objective is to explore how Medicaid coverage impacts happiness, specifically analyzing in which direction variations in healthcare spending significantly improve mental health: higher spending or lower spending after Medicaid. Utilizing instrumental variable (IV) regression, I conducted six separate regressions across subgroups categorized by expenditure levels and happiness ratings, and the results reveal distinct patterns. Enrolling in OHP has significantly decreased the probability of experiencing unhappiness, regardless of whether individuals had high or low medical spending. Additionally, it decreased the probability of being pretty happy and having high medical expenses, while increasing the
This research paper presents a meta-analysis of the multifaceted role of technology in mental health. The pervasive influence of technology on daily lives necessitates a deep understanding of its impact on mental health services. This study synthesizes literature covering Behavioral Intervention Technologies (BITs), digital mental health interventions during COVID-19, young men's attitudes toward mental health technologies, technology-based interventions for university students, and the applicability of mobile health technologies for individuals with serious mental illnesses. BITs are recognized for their potential to provide evidence-based interventions for mental health conditions, especially anxiety disorders. The COVID-19 pandemic acted as a catalyst for the adoption of digital mental health services, underscoring their crucial role in providing accessible and quality care; however, their efficacy needs to be reinforced by workforce training, high-quality evidence, and digital equity. A nuanced understanding of young men's attitudes toward mental health is imperative for devising effective online services. Technology-based interventions for university students are promising, al
Electronic Health Record (EHR) has become an essential tool in the healthcare ecosystem, providing authorized clinicians with patients' health-related information for better treatment. While most developed countries are taking advantage of EHRs to improve their healthcare system, it remains challenging in developing countries to support clinical decision-making and public health using a computerized patient healthcare information system. This paper proposes a novel EHR architecture suitable for developing countries--an architecture that fosters inclusion and provides solutions tailored to all social classes and socioeconomic statuses. Our architecture foresees an internet-free (offline) solution to allow medical transactions between healthcare organizations, and the storage of EHRs in geographically underserved and rural areas. Moreover, we discuss how artificial intelligence can leverage anonymous health-related information to enable better public health policy and surveillance.
Large Language Models (LLMs) hold promise in addressing complex medical problems. However, while most prior studies focus on improving accuracy and reasoning abilities, a significant bottleneck in developing effective healthcare agents lies in the readability of LLM-generated responses, specifically, their ability to answer public health problems clearly and simply to people without medical backgrounds. In this work, we introduce RephQA, a benchmark for evaluating the readability of LLMs in public health question answering (QA). It contains 533 expert-reviewed QA pairs from 27 sources across 13 topics, and includes a proxy multiple-choice task to assess informativeness, along with two readability metrics: Flesch-Kincaid grade level and professional score. Evaluation of 25 LLMs reveals that most fail to meet readability standards, highlighting a gap between reasoning and effective communication. To address this, we explore four readability-enhancing strategies-standard prompting, chain-of-thought prompting, Group Relative Policy Optimization (GRPO), and a token-adapted variant. Token-adapted GRPO achieves the best results, advancing the development of more practical and user-friendl
Mobile health apps are revolutionizing the healthcare ecosystem by improving communication, efficiency, and quality of service. In low- and middle-income countries, they also play a unique role as a source of information about health outcomes and behaviors of patients and healthcare workers, while providing a suitable channel to deliver both personalized and collective policy interventions. We propose a framework to study user engagement with mobile health, focusing on healthcare workers and digital health apps designed to support them in resource-poor settings. The behavioral logs produced by these apps can be transformed into daily time series characterizing each user's activity. We use probabilistic and survival analysis to build multiple personalized measures of meaningful engagement, which could serve to tailor content and digital interventions suiting each health worker's specific needs. Special attention is given to the problem of detecting churn, understood as a marker of complete disengagement. We discuss the application of our methods to the Indian and Ethiopian users of the Safe Delivery App, a capacity-building tool for skilled birth attendants. This work represents an
Culture moderates the way individuals perceive and express mental distress. Current understandings of mental health expressions on social media, however, are predominantly derived from WEIRD (Western, Educated, Industrialized, Rich, and Democratic) contexts. To address this gap, we examine mental health posts on Reddit made by individuals geolocated in India, to identify variations in social media language specific to the Indian context compared to users from Western nations. Our experiments reveal significant psychosocial variations in emotions and temporal orientation. This study demonstrates the potential of social media platforms for identifying cross-cultural differences in mental health expressions (e.g. seeking advice in India vs seeking support by Western users). Significant linguistic variations in online mental health-related language emphasize the importance of developing precision-targeted interventions that are culturally appropriate.
The COVID-19 pandemic has highlighted the dire necessity to improve public health literacy for societal resilience. YouTube, the largest video-sharing social media platform, provides a vast repository of user-generated health information in a multi-media-rich format which may be easier for the public to understand and use if major concerns about content quality and accuracy are addressed. This study develops an automated solution to identify, retrieve and shortlist medically relevant and understandable YouTube videos that domain experts can subsequently review and recommend for disseminating and educating the public on the COVID-19 pandemic and similar public health outbreaks. Our approach leverages domain knowledge from human experts and machine learning and natural language processing methods to provide a scalable, replicable, and generalizable approach that can also be applied to enhance the management of many health conditions.
In this paper, we present a comprehensive survey on the pervasive issue of medical misinformation in social networks from the perspective of information technology. The survey aims at providing a systematic review of related research and helping researchers and practitioners navigate through this fast-changing field. Specifically, we first present manual and automatic approaches for fact-checking. We then explore fake news detection methods, using content, propagation features, or source features, as well as mitigation approaches for countering the spread of misinformation. We also provide a detailed list of several datasets on health misinformation and of publicly available tools. We conclude the survey with a discussion on the open challenges and future research directions in the battle against health misinformation.
The impact of culture on how people express distress in online support communities is increasingly a topic of interest within Computer Supported Cooperative Work (CSCW) and Human-Computer Interaction (HCI). In the United States, distinct cultures have emerged from each of the two dominant political parties, forming a primary lens by which people navigate online and offline worlds. We examine whether partisan culture may play a role in how U.S. Republican and Democrat users of online mental health support communities express distress. We present a large-scale observational study of 2,184,356 posts from 8,916 statistically matched Republican, Democrat, and unaffiliated online support community members. We utilize methods from causal inference to statistically match partisan users along covariates that correspond with demographic attributes and platform use, in order to create comparable cohorts for analysis. We then leverage methods from natural language processing to understand how partisan expressions of distress compare between these sets of closely matched opposing partisans, and between closely matched partisans and typical support community members. Our data spans January 2013
Malaria can be prevented, diagnosed, and treated; however, every year, there are more than 200 million cases and 200.000 preventable deaths. Malaria remains a pressing public health concern in low- and middle-income countries, especially in sub-Saharan Africa. We describe how by means of mobile health applications, machine-learning-based adaptive interventions can strengthen malaria surveillance and treatment adherence, increase testing, measure provider skills and quality of care, improve public health by supporting front-line workers and patients (e.g., by capacity building and encouraging behavioral changes, like using bed nets), reduce test stockouts in pharmacies and clinics and informing public health for policy intervention.
Software engineering for digital health applications entails several challenges, including heterogeneous data acquisition, data standardization, software reuse, security, and privacy considerations. We explore these challenges and how our Stanford Spezi ecosystem addresses these challenges by providing a modular and standards-based open-source digital health ecosystem. Spezi enables developers to select and integrate modules according to their needs and facilitates an open-source community to democratize access to building digital health innovations.
Large AI models, or foundation models, are models recently emerging with massive scales both parameter-wise and data-wise, the magnitudes of which can reach beyond billions. Once pretrained, large AI models demonstrate impressive performance in various downstream tasks. A prime example is ChatGPT, whose capability has compelled people's imagination about the far-reaching influence that large AI models can have and their potential to transform different domains of our lives. In health informatics, the advent of large AI models has brought new paradigms for the design of methodologies. The scale of multi-modal data in the biomedical and health domain has been ever-expanding especially since the community embraced the era of deep learning, which provides the ground to develop, validate, and advance large AI models for breakthroughs in health-related areas. This article presents a comprehensive review of large AI models, from background to their applications. We identify seven key sectors in which large AI models are applicable and might have substantial influence, including 1) bioinformatics; 2) medical diagnosis; 3) medical imaging; 4) medical informatics; 5) medical education; 6) pu