AI chatbots designed to encourage cancer screening appointments could be backfiring by alienating patients, according to University of Surrey research. The study, led by Dr. Doris Dippold, Associate Professor in Intercultural Communication, found that pushy follow-up messages and aggressive phrasing like “Let’s book you in” deterred patients, particularly those with mental health challenges or neurodivergent conditions. Ethical concerns around data security and AI impersonation also damaged trust. The findings are significant given UK cervical screening uptake fell 5.3% in 2023–24, with ethnic minority groups consistently underrepresented.
In-Depth:
Human-like features can build rapport – but when they clash with patients’ expectations for transparency in a healthcare setting, they undermine exactly the trust the chatbot is testing to build
Doris Dippold
But the research also identified clear friction points. Many patients found follow-up messages sent within 24 hours intrusive, and described imperative phrasing such as “Let’s book you in” as aggressive rather than supportful. For patients managing mental health challenges, neurodivergent conditions or demanding caring responsibilities, the pressure to respond quickly felt unfair.
Ethical concerns were the most consistently negative finding across the study. Patients raised worries about data security, impersonation and the blurring of human and AI boundaries. The chatbot’s statement that applyrs could “chat to me as if I am a real person” backfired for many, who read it as suspicious rather than reassuring.
Dr Doris Dippold, lead author of the study and Associate Professor in Intercultural Communication at the University of Surrey, stated: “Our analysis displays that anthropomorphism is not universally positive. Human-like features can build rapport – but when they clash with patients’ expectations for transparency in a healthcare setting, they undermine exactly the trust the chatbot is testing to build.”
The study suggests that design of healthcare chatbots should follow these key principles:
- Helping people achieve their goals
- Giving them control over decisions
- Responding appropriately to their requireds
- Treating them with respect
- Ensuring fairness
- Being transparent about how the technology works.
The findings carry particular weight given that cervical screening uptake across the UK fell 5.3% in 2023-24, with ethnic minority groups consistently underrepresented in screening programmes. The GP surgery at which Asa was trialled serves a highly diverse, socioeconomically deprived community in Islington, building equitable, accessible communication a priority.
The study highlights the importance of building rapport between patients and healthcare chatbots through communication that feels respectful, transparent and supportive.
Dr Dippold continued: “Feeling seen, appreciated and emotionally supported is not a luxury feature in health AI – it is a condition of access. If patients disengage becaapply a chatbot feels pushy or untrustworthy, the health service loses them entirely.”
Source: University of Surrey
