# Designing Artificial Intelligence-Powered Health Care Assistants to Reach Vulnerable Populations: A Discrete Choice Experiment Among South African University Students

## TL;DR

This study explores what South African university students prefer in an AI health assistant, finding that language options and security are most important for engaging vulnerable populations.

## Contribution

The study introduces a discrete choice experiment to identify preferences for AI health assistants among South African university students, focusing on accessibility and inclusivity.

## Key findings

- Language, security, and personalized advice were the most important attributes for an AI health assistant.
- Participants strongly preferred being able to communicate in any South African language and receiving context-specific health information.
- Preferences were consistent across sex and socioeconomic status, emphasizing the importance of security and language options.

## Abstract

To understand what preferences are important to university students in South Africa when engaging with a hypothetical artificial intelligence-powered health care assistant (AIPHA) to access health information using a discrete choice experiment.

We conducted an unlabeled, forced choice discrete choice experiment among adult South African university students through Prolific, an online research platform, from June 26, 2024 to August 31, 2024. Each choice option described a hypothetical AIPHA using 8 attribute characteristics (cost, confidentiality, security, health care topics, language, persona, access, and services). Participants were presented with 10 choice sets each comprised of 2 choice options and asked to choose between the 2. A conditional logit model was used.

Three hundred participants were recruited and enrolled. Most participants were Black, born in South Africa, heterosexual, working for a wage, and had a mean age of 26.5 years (SD, 6.0). Language, security, and receiving personally tailored advice were the most important attributes for AIPHA. Participants strongly preferred the ability to communicate with the AIPHA in any South African language of their choosing instead of only English and receive information about health topics specific to their context including information on clinics geographically near them. The results were consistent when stratified by sex and socioeconomic status.

Participants had strong preferences for security and language, which is in line with previous studies where successful uptake and implementation of such health interventions clearly addressed these concerns. These results build the evidence base for how we might engage young adults in health care through technology effectively.