Conversational agents have been studied as tools to scaffold planning and self-reflection for productivity and well-being. While prior work has demonstrated positive outcomes, we still lack a clear understanding of what drives these results and how users behave and communicate with agents that act as coaches rather than assistants. Such understanding is critical for designing interactions in which agents foster meaningful behavioral change. We conducted a 14-day longitudinal study with 12 participants using a proactive agent that initiated regular check-ins to support daily planning and reflection. Our findings reveal diverse interaction patterns: participants accepted or negotiated suggestions, developed shared mental models, reported progress, and at times resisted or disengaged. We also identified problematic aspects of the agent’s behavior, including rigidity, premature turn-taking, and overpromising. Our work contributes to understanding how people interact with a proactive, coach-like agent and offers design considerations for facilitating effective behavioral change.

Autistic individuals sometimes disclose autism when asking LLMs for social advice, hoping for more personalized responses. However, they also recognize that these systems may reproduce stereotypes, raising uncertainty about the risks and benefits of disclosure. We conducted a mixed-methods study combining a large-scale LLM audit experiment with interviews involving 11 autistic participants. We developed a six-step pipeline operationalizing 12 documented autism stereotypes into decision-making scenarios framed as users requesting advice (e.g., “Should I do A or B?”). We generated 345,000 responses from six LLMs and measured how advice shifted when prompts disclosed autism versus when they did not. When autism was disclosed, LLMs disproportionately recommended avoiding stereotypically stressful situations, including social events, confrontations, new experiences, and romantic relationships. While some participants viewed this as affirming, others criticized it as infantilizing or undermining opportunities for growth. Our study illuminates how the intermingling of affirmation and stereotyping complicates the personalization of LLMs.1

In this paper, we describe a general-purpose dialogue management framework used to design SOPHIE (Standardized Online Patient for Healthcare Interaction Education). SOPHIE simulates a virtual standardized cancer patient that allows physicians to practice skills such as empathy and patient empowerment in end-of-life communication. To provide the user with an opportunity to practice these skills, SOPHIE must produce a natural, emotionally appropriate conversation, yet handle topic shifts and open-ended questions from the user. To accomplish this, our approach to dialogue management loosely followsschemas– explicit representations of thetypicalflows of dialogue in end-of-life communication – while also using flexible pattern-driven methods for interpretation and generation. We conduct a crowdsourced evaluation of conversations between medical students and SOPHIE. Our agent is judged to produce responses that are natural, emotionally appropriate, and consistent with her role as a cancer patient. Furthermore, it significantly outperforms an end-to-end neural model fine-tuned on a human standardized patient corpus, attesting to the advantages of a schema-guided approach in this domain. However, the system is currently limited in its ability to generate responses that are judged to demonstrate deep understanding of the user, suggesting that future work should place focus on integrating this framework with robust natural language understanding and commonsense reasoning methods.

Effective communication between a clinician and their patient is critical for delivering healthcare maximizing outcomes. Unfortunately, traditional communication training approaches that use human standardized patients and expert coaches are difficult to scale. Here, we present the development and validation of a scalable, easily accessible, digital tool known as the Standardized Online Patient for Health Interaction Education (SOPHIE) for practicing and receiving feedback on doctor-patient communication skills. SOPHIE was validated by conducting an experiment with 30 medical professionals. We found that participants who underwent SOPHIE condition performed significantly better than the control in overall communication, aggregate scores, empowering the patient, and showing empathy (p < 0.05 in all cases). The results presented in this paper provide early evidence of scalable and accessible virtual humans, chatbot technologies, and automated feedback generation being transformative for medical communication training by supplementing existing resources.

This paper explores the complexity of what constitutes the demographic features of race and how race is perceived. "Race" is composed of a variety of factors including skin tone, facial features, and accent. Isolating these interrelated race features is a difficult problem and failure to do so properly can easily invite confounding factors. Here we propose a novel method to isolate features of race by using AI-based technology and measure the impact these modifications have on an outcome variable of interest; i.e., perceived credibility. We used videos from a deception dataset for which the ground-truth is known and create three conditions: 1) a Black vs White CycleGAN image condition; 2) an original vs deepfake video condition; 3) an original vs deepfake still frame condition. We crowd-sourced 1736 responses to measure how credibility was influenced by changing the perceived race. We found that it is possible to alter perceived race through modifying demographically visual features alone. However, we did not find any statistically significant differences for credibility across our experiments based on these changes. Our findings help quantify intuitions from prior research that the relationship between racial perception and credibility is more complex than visual features alone. Our presented deepfake framework could be incorporated to precisely measure the impact of a wider range of demographic features (such as gender or age) due to the fine-grained isolation and control that was previously impossible in a lab setting.