The Danger in Easy Answers: Conceptualizing Subjective Processing Fluency for Healthcare Chatbot Information Presentation in an Inductive Reflexive Thematic Analysis of User Experience and Perceptions

The rapid advancement of AI technologies has introduced complex challenges for designers, particularly in understanding the theoretical foundations that guide AI design across different contexts. To bridge this gap, this study investigated the impact of communication style (conversational vs. informative) in a healthcare chatbot setting. Participants interacted with the chatbot and subsequently engaged in semi-structured interviews to discuss their perceptions and ideate future chatbot designs. Using inductive reflexive thematic analysis, we identified distinct user preferences for communication style and conceptualized how these preferences shaped users’ subjective processing fluency (i.e., the felt ease of processing health information) in healthcare chatbot interactions. Our findings reveal a key tension in AI design, where the preference for easy, concise interactions may risk prioritizing simplicity over deeper cognitive engagement, underscoring the need to balance ease of use with critical thinking for informed decision-making. The analysis contributes a theoretical framework centered on subjective processing fluency as a fundamental factor shaping user interactions with AI, and we argue that designing chatbots to maximize this fluency may give rise to a processing fluency bias that reduces users’ scrutiny of AI-generated information. These findings suggest that healthcare chatbots and other conversational agents should calibrate, rather than maximize, processing fluency, balancing ease of use with the preservation of users’ critical engagement with health information. This research emphasizes the importance for healthcare chatbots to align information presentation with users’ individual cognitive abilities. Future research should further explore how information presentation styles can optimize chatbot design to enhance user engagement while fostering accurate information consumption.