Youth Perspectives on Generative AI and Its Use in Health Care

Introduction

Generative artificial intelligence (GAI) has become increasingly prevalent throughout health care, with GAI tools being applied to clinical decision support, medical documentation, patient-provider communication, and more [1,2]. GAI is unique in its widespread adoption by both the general public and technical professionals [3]. In particular, younger individuals are more likely to adopt GAI technologies [4]. In this nationwide qualitative survey, we characterized the attitudes of youth aged 14 to 24 years toward GAI technology. We then extracted potential implications of applying GAI to health care for adolescents and young adults, presenting our findings herein.

Methods

Ethical Considerations

This study was approved by the Institutional Review Board of the University of Michigan Medical School. Informed consent was obtained via the internet for all participants. All data were deidentified and protected by a National Institutes of Health Certificate of Confidentiality. Participants received US $1 per week for answering each week’s survey and a US $3 bonus if all questions were answered during the 8- to 12-week phase. US $5 was provided upon enrollment completion, which included a web-based demographic survey.

Study Design

Study participants were respondents of MyVoice—a nationwide text message survey that collects perspectives from youth aged 14 to 24 years. Five open-ended questions related to general GAI use were texted to participants in March 2024 (Multimedia Appendix 1) [5,6]. Using content analysis, 2 investigators reviewed responses by question, developed a codebook, and independently applied codes. Discrepancies were resolved via discussion. Code frequency and demographic data, including age, sex, ethnicity, zip code, and socioeconomic status (defined as “low” if respondents ever used the Supplemental Nutrition Assistance Program [SNAP]), were summarized by using descriptive statistics [5]. Zip codes were aggregated into the geographic regions outlined by the American Community Survey [5]. Themes identified in the survey responses, including those specific to health care, were coded across all questions. Participants’ responses could count toward multiple categories.

Results

Of 758 eligible youths, 624 (82.3%) responded to at least one question. On average, respondents were aged 20.3 (SD 2.6) years (Table 1). A majority (328/624, 52.6%) were female. About half (361/624, 57.9%) of respondents were White, 13.8% (86/624) were Black, and 13.6% (85/624) were Hispanic. Further, 25.7% (145/564) of respondents experienced low socioeconomic status (ie, current or previous use of the SNAP). Of 619 respondents (5 survey responses were excluded for being blank or nonsensical), 95.6% (592/619) endorsed prior knowledge of GAI, with 10% (62/619) sharing a positive opinion of GAI, 7.4% (46/619) expressing disapproval, and 82.6% (511/619) expressing neither; 31.3% (194/619) found GAI useful.

Survey response themes are summarized in Table 2. A majority of participants (474/619, 76.6%) endorsed use of GAI as a study aid, writing tool, or efficiency booster (Table 2). Among the 23.4% (145/619) of respondents who had not used GAI, frequently cited reasons included a lack of need or interest (46/145, 31.7%), ethical concerns (30/145, 20.7%), and authenticity concerns surrounding GAI (18/145, 12.4%). Notably, only 2.1% (10/474) expressed explicit dislike of GAI after use.

Across all survey responses, 10.6% (66/624) of respondents mentioned health applications, with 40.9% (27/66) citing specific health-related applications (eg, creating meal plans, designing exercise regimens, refining medical diagnoses, and improving health care systems) and 63.6% (42/66) expressing concerns. These concerns primarily focused on the need for human input in medical decision-making (12/42, 28.6%) and the importance of avoiding medical errors (8/42, 19%).

Discussion

Our study found that GAI adoption among American youth (77.2%) is high when compared to the general population (39.5%), which is consistent with previous research [7,8]. GAI use among adolescents and young adults ranged across many fields, including academics, health care, and daily efficiency. Despite the widespread GAI adoption among American youth, many remain uncomfortable with GAI use in health care settings; this sentiment’s prevalence among youth is similar to that among adult patients [9]. Respondents who discussed GAI in the context of health care primarily focused on concerns about medical decision-making and medical errors, highlighting the importance of transparency and disclosure when using GAI tools to treat adolescents and young adults.

Interestingly, the use of GAI platforms to address personal health concerns was not mentioned by participants in this study. This finding suggests that self-diagnosis is not currently a primary focus of youth who use GAI tools. Rather, youth more frequently voice concern with safeguarding medical processes against error and ensuring that human input is retained in medical decision-making.

In summary, youth remain wary of GAI applications in health care despite widespread GAI adoption for other use cases. Health care professionals can build trust and rapport with adolescents and young adults by acknowledging and addressing their concerns as GAI use becomes more prevalent in health care. Further research into meaningfully applying GAI to youth health is warranted to guide successful implementation of this novel technology.