搜索结果：Frontiers in reproductive health

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.

The rapid spread of health misinformation on online social networks (OSNs) during global crises such as the COVID-19 pandemic poses challenges to public health, social stability, and institutional trust. Centrality metrics have long been pivotal in understanding the dynamics of information flow, particularly in the context of health misinformation. However, the increasing complexity and dynamism of online networks, especially during crises, highlight the limitations of these traditional approaches. This study introduces and compares three novel centrality metrics: dynamic influence centrality (DIC), health misinformation vulnerability centrality (MVC), and propagation centrality (PC). These metrics incorporate temporal dynamics, susceptibility, and multilayered network interactions. Using the FibVID dataset, we compared traditional and novel metrics to identify influential nodes, propagation pathways, and misinformation influencers. Traditional metrics identified 29 influential nodes, while the new metrics uncovered 24 unique nodes, resulting in 42 combined nodes, an increase of 44.83%. Baseline interventions reduced health misinformation by 50%, while incorporating the new metrics

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

Precision health, increasingly supported by digital technologies, is a domain of research that broadens the paradigm of precision medicine, advancing everyday healthcare. This vision goes hand in hand with the groundbreaking advent of artificial intelligence (AI), which is reshaping the way we diagnose, treat, and monitor both clinical subjects and the general population. AI tools powered by machine learning have shown considerable improvements in a variety of healthcare domains. In particular, reinforcement learning (RL) holds great promise for sequential and dynamic problems such as dynamic treatment regimes and just-in-time adaptive interventions in digital health. In this work, we discuss the opportunity offered by AI, more specifically RL, to current trends in healthcare, providing a methodological survey of RL methods in the context of precision and digital health. Focusing on the area of adaptive interventions, we expand the methodological survey with illustrative case studies that used RL in real practice. This invited article has undergone anonymous review and is intended as a book chapter for the volume "Frontiers of Statistics and Data Science" edited by Subhashis Ghosha

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

Prognostics is concerned with predicting the future health of the equipment and any potential failures. With the advances in the Internet of Things (IoT), data-driven approaches for prognostics that leverage the power of machine learning models are gaining popularity. One of the most important categories of data-driven approaches relies on a predefined or learned health indicator to characterize the equipment condition up to the present time and make inference on how it is likely to evolve in the future. In these approaches, health indicator forecasting that constructs the health indicator curve over the lifespan using partially observed measurements (i.e., health indicator values within an initial period) plays a key role. Existing health indicator forecasting algorithms, such as the functional Empirical Bayesian approach, the regression-based formulation, a naive scenario matching based on the nearest neighbor, have certain limitations. In this paper, we propose a new `generative + scenario matching' algorithm for health indicator forecasting. The key idea behind the proposed approach is to first non-parametrically fit the underlying health indicator curve with a continuous Gauss

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.

This review underscores the vital role of interoperability in digital health, advocating for a standardized framework. It focuses on implementing a Fast Healthcare Interoperability Resources (FHIR) server, addressing technical, semantic, and process challenges. FHIR's adaptability ensures uniformity within Primary Care Health Information Systems, fostering interoperability. Patient data management complexities highlight the pivotal role of semantic interoperability in seamless patient care. FHIR standards enhance these efforts, offering multiple pathways for data search. The ADR-guided FHIR server implementation systematically addresses challenges related to patient identity, biometrics, and data security. The detailed development phases emphasize architecture, API integration, and security. The concluding stages incorporate forward-looking approaches, including HHIMS Synthetic Dataset testing. Envisioning FHIR integration as transformative, it anticipates a responsive healthcare environment aligned with the evolving digital health landscape, ensuring comprehensive, dynamic, and interconnected systems for efficient data exchange and access.

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

In this paper, we have discussed initial findings and results of our experiment to predict sexual and reproductive health vulnerabilities of migrants in a data-constrained environment. Notwithstanding the limited research and data about migrants and migration cities, we propose a solution that simultaneously focuses on data gathering from migrants, augmenting awareness of the migrants to reduce mishaps, and setting up a mechanism to present insights to the key stakeholders in migration to act upon. We have designed a webapp for the stakeholders involved in migration: migrants, who would participate in data gathering process and can also use the app for getting to know safety and awareness tips based on analysis of the data received; public health workers, who would have an access to the database of migrants on the app; policy makers, who would have a greater understanding of the ground reality, and of the patterns of migration through machine-learned analysis. Finally, we have experimented with different machine learning models on an artificially curated dataset. We have shown, through experiments, how machine learning can assist in predicting the migrants at risk and can also help

Promoting healthy lifestyle behaviors remains a major public health concern, particularly due to their crucial role in preventing chronic conditions such as cancer, heart disease, and type 2 diabetes. Mobile health applications present a promising avenue for low-cost, scalable health behavior change promotion. Researchers are increasingly exploring adaptive algorithms that personalize interventions to each person's unique context. However, in empirical studies, mobile health applications often suffer from small effect sizes and low adherence rates, particularly in comparison to human coaching. Tailoring advice to a person's unique goals, preferences, and life circumstances is a critical component of health coaching that has been underutilized in adaptive algorithms for mobile health interventions. To address this, we introduce a new Thompson sampling algorithm that can accommodate personalized reward functions (i.e., goals, preferences, and constraints), while also leveraging data sharing across individuals to more quickly be able to provide effective recommendations. We prove that our modification incurs only a constant penalty on cumulative regret while preserving the sample comp

Objective: To enhance health literacy and accessibility of health information for a diverse patient population by developing a patient-centered artificial intelligence (AI) solution using large language models (LLMs) and Fast Healthcare Interoperability Resources (FHIR) application programming interfaces (APIs). Materials and Methods: The research involved developing LLM on FHIR, an open-source mobile application allowing users to interact with their health records using LLMs. The app is built on Stanford's Spezi ecosystem and uses OpenAI's GPT-4. A pilot study was conducted with the SyntheticMass patient dataset and evaluated by medical experts to assess the app's effectiveness in increasing health literacy. The evaluation focused on the accuracy, relevance, and understandability of the LLM's responses to common patient questions. Results: LLM on FHIR demonstrated varying but generally high degrees of accuracy and relevance in providing understandable health information to patients. The app effectively translated medical data into patient-friendly language and was able to adapt its responses to different patient profiles. However, challenges included variability in LLM responses a

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

Although serious games have been increasingly used for mental health applications, few explicitly address coping with grief as a core mechanic and narrative experience for patients. Existing grief-related digital games often focus on clinical training for medical professionals rather than immersive storytelling and agency in emotional processing for the patient. In response, we designed Road to Acceptance, a VR game that presents grief through first-person narrative and gameplay. As the next phase of evaluation, we propose a workshop-based study with 12 licensed mental health professionals to assess the therapeutic impacts of the game and the alignment with best practices in grief education and interventions. This will inform iterative game design and patient evaluation methods, ensuring that the experience is clinically appropriate. Potential findings can contribute to the design principles of grief-related virtual reality experiences, bridging the gap between interactive media, mental health interventions, and immersive storytelling.

This study introduces an inverse behavioral optimization framework that integrates QALY-based health outcomes, ROI-driven incentives, and adaptive behavioral learning to quantify how policy design shapes national healthcare performance. Building on the FOSSIL (Flexible Optimization via Sample-Sensitive Importance Learning) paradigm, the model embeds a regret-minimizing behavioral weighting mechanism that enables dynamic learning from heterogeneous policy environments. It recovers latent behavioral sensitivities (efficiency, fairness, and temporal responsiveness T) from observed QALY-ROI trade-offs, providing an analytical bridge between individual incentive responses and aggregate system productivity. We formalize this mapping through the proposed System Impact Index (SII), which links behavioral elasticity to measurable macro-level efficiency and equity outcomes. Using OECD-WHO panel data, the framework empirically demonstrates that modern health systems operate near an efficiency-saturated frontier, where incremental fairness adjustments yield stabilizing but diminishing returns. Simulation and sensitivity analyses further show how small changes in behavioral parameters propagate

While Artificial Intelligence (AI) shows promise in healthcare applications, existing conversational systems often falter in complex and sensitive medical domains such as Sexual and Reproductive Health (SRH). These systems frequently struggle with hallucination and lack the specialized knowledge required, particularly for sensitive SRH topics. Furthermore, current AI approaches in healthcare tend to prioritize diagnostic capabilities over comprehensive patient care and education. Addressing these gaps, this work at the UNC School of Nursing introduces SARHAchat, a proof-of-concept Large Language Model (LLM)-based chatbot. SARHAchat is designed as a reliable, user-centered system integrating medical expertise with empathetic communication to enhance SRH care delivery. Our evaluation demonstrates SARHAchat's ability to provide accurate and contextually appropriate contraceptive counseling while maintaining a natural conversational flow. The demo is available at https://sarhachat.com/}{https://sarhachat.com/.

Sonification can provide valuable insights about data but most existing approaches are not designed to be controlled by the user in an interactive fashion. Interactions enable the designer of the sonification to more rapidly experiment with sound design and allow the sonification to be modified in real-time by interacting with various control parameters. In this paper, we describe two case studies of interactive sonification that utilize publicly available datasets that have been described recently in the International Conference on Auditory Display (ICAD). They are from the health and energy domains: electroencephalogram (EEG) alpha wave data and air pollutant data consisting of nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone. We show how these sonfications can be recreated to support interaction utilizing a general interactive sonification framework built using ChucK, Unity, and Chunity. In addition to supporting typical sonification methods that are common in existing sonification toolkits, our framework introduces novel methods such as supporting discrete events, interleaved playback of multiple data streams for comparison, and using frequency modulation (FM) synth

Imaging fluorescent disease biomarkers in tissues and skin is a non-invasive method to screen for health conditions. We report an automated process that combines intraoral fluorescent porphyrin biomarker imaging, clinical examinations and machine learning for correlation of systemic health conditions with periodontal disease. 1215 intraoral fluorescent images, from 284 consenting adults aged 18-90, were analyzed using a machine learning classifier that can segment periodontal inflammation. The classifier achieved an AUC of 0.677 with precision and recall of 0.271 and 0.429, respectively, indicating a learned association between disease signatures in collected images. Periodontal diseases were more prevalent among males (p=0.0012) and older subjects (p=0.0224) in the screened population. Physicians independently examined the collected images, assigning localized modified gingival indices (MGIs). MGIs and periodontal disease were then cross-correlated with responses to a medical history questionnaire, blood pressure and body mass index measurements, and optic nerve, tympanic membrane, neurological, and cardiac rhythm imaging examinations. Gingivitis and early periodontal disease were