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Default Option Nudging Intervention to Improve the Adherence Rates of Cancer Screening

26. Juni 2026 aktualisiert von: Zhisheng Zheng, Harbin Medical University

Default Option Nudging Intervention to Improve the Adherence Rates of Cancer Screening in High-risk Population: Randomized Controlled Trial and Intervention Disclosure Analysis

The goal of this clinical trial is to learn if a behavioral "nudge" strategy, specifically a default option, can improve screening participation in populations at high risk for lung and stomach cancer. The main questions it aims to answer are:

  1. Does presenting a screening appointment as a default option increase the likelihood that high-risk individuals will choose to be screened?
  2. How do participants react, and what is their level of acceptance, when the nudge intervention is disclosed to them?
  3. Does this transparency (disclosing the nudge) change their subsequent screening decisions? Researchers will compare a default option group to a standard control group to see if the nudge effectively increases screening adherence.

Participants will:

  1. Read a short educational text about lung or stomach cancer and its screening.
  2. Complete an online questionnaire.
  3. Make a decision regarding a simulated cancer screening appointment.
  4. Read a disclosure explaining the behavioral nudge strategy used during the study.
  5. Re-evaluate their screening decision and answer questions regarding their attitude toward the nudge.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Tatsächlich)

1200

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienorte

  • China
    • Heilongjiang
      • Harbin, Heilongjiang, China, 150081
        • Harbin Medical University

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Erwachsene
  • Älterer Erwachsener

Akzeptiert gesunde Freiwillige

Ja

Beschreibung

Inclusion Criteria:

  • High-risk population of lung cancer or gastric cancer.
  • Lung cancer high-risk definition (based on the 2024 Lung Cancer Screening and Early Diagnosis and Treatment Program organized by the National Health Commission of the PRC): Age ≥50 years and pack-years of smoking ≥20, including former smoking ≥20 pack-years, but smoking cessation less than 15 years (Note: Pack-years of smoking = number of packs smoked per day × number of years smoked).
  • Gastric cancer high-risk definition (based on the 2024 Gastric Cancer Screening and Early Diagnosis and Treatment Program organized by the National Health Commission of the PRC): Age ≥45 years old and living in areas with a high incidence of gastric cancer (Liaoning, Fujian, Gansu, Shandong, Jiangsu).
  • Ability to read and comprehend simplified Chinese.
  • The informed consent statement was read and confirmed.

Exclusion Criteria:

  • Reading impairment preventing independent questionnaire completion.
  • Failure to pass attention checks and logical consistency tests embedded within the questionnaire.

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Versorgungsforschung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Doppelt

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Kein Eingriff: control group (lung cancer screening)
Control group participants received neutral, informational content about lung cancer and screening. This content included lung cancer's status as a leading cause of cancer mortality, the challenges of late-stage diagnosis, and LDCT as the gold standard screening method. Participants were informed that high-risk individuals, particularly long-term smokers, require annual screening due to elevated cancer risk, with each participant explicitly told they qualified as high-risk due to their smoking history. Meanwhile, CanSPUC and its purpose were also shown to the participants. The screening participation question for controls was framed as: "We provide available time slots for free lung cancer screening. You can directly view available appointment times and make reservations according to your preference. Would you like to schedule lung cancer screening?"
Experimental: intervention group (lung cancer screening)
Intervention participants received the same neutral information plus a default option nudge. The critical modification involved reframing the screening participation measure as: "We have already scheduled a free lung cancer screening appointment for you, which you can attend at your convenience. If you do not wish to participate, please indicate below." We also default to "Yes, I would like to make an appointment for lung cancer screening and see the available hours for lung cancer screening" for this question.
Verhalten: Default Options
Participants in this arm are subjected to a behavioral "nudge" using a default option mechanism during a simulated online appointment process for cancer screening. Instead of being asked to actively schedule an appointment (an opt-in approach), the screening appointment is presented to them as pre-selected or pre-scheduled (an opt-out approach). Furthermore, to evaluate the ethical and behavioral impact of transparency, this intervention uniquely includes a "disclosure" phase: after the initial decision, participants are explicitly informed about the nudge strategy that was just applied to them, and their screening intention is immediately re-measured.
Kein Eingriff: control group (gastric cancer screening)
Control group participants received neutral, informational content about gastric cancer and screening. This content included gastric cancer's status as a cause of cancer mortality, the challenges of late-stage diagnosis, and endoscope as the gold standard screening method. Participants were informed that high-risk individuals require screening per 5 years, with each participant explicitly told they qualified as high-risk due to their living regions. Meanwhile, CanSPUC and its purpose were also shown to the participants. The screening participation question for controls was framed as: "We provide available time slots for free gastric cancer screening. You can directly view available appointment times and make reservations according to your preference. Would you like to schedule gastric cancer screening?"
Experimental: intervention group (gastric cancer screening)
Intervention participants received the same neutral information plus a default option nudge. The critical modification involved reframing the screening participation measure as: "We have already scheduled a free gastric cancer screening appointment for you, which you can attend at your convenience. If you do not wish to participate, please indicate below." We also default to "Yes, I would like to make an appointment for gastric cancer screening and see the available hours for lung cancer screening" for this question.
Verhalten: Default Options
Participants in this arm are subjected to a behavioral "nudge" using a default option mechanism during a simulated online appointment process for cancer screening. Instead of being asked to actively schedule an appointment (an opt-in approach), the screening appointment is presented to them as pre-selected or pre-scheduled (an opt-out approach). Furthermore, to evaluate the ethical and behavioral impact of transparency, this intervention uniquely includes a "disclosure" phase: after the initial decision, participants are explicitly informed about the nudge strategy that was just applied to them, and their screening intention is immediately re-measured.

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Percentage of Participants Who Accept the Cancer Screening Appointment
Zeitfenster: Immediately after the default option intervention
This outcome is assessed via a dichotomous choice (Yes/No) embedded in the simulated online scheduling system within the questionnaire. The value reported will be the percentage of participants who choose to accept and schedule the screening appointment.
Immediately after the default option intervention

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Participant Attitude Score Towards the Default Option Nudge
Zeitfenster: Immediately after the disclosure of the intervention
This measure is assessed via a self-reported questionnaire using a Likert scale. Scores range from 1 to 5, where 1 indicates a very negative attitude and 5 indicates a very positive attitude. Higher scores represent a better attitude towards the nudge strategy.
Immediately after the disclosure of the intervention
Self-Reported Score of the Nudge's Influence on Decision-Making
Zeitfenster: Immediately after the disclosure of the intervention
This measure is assessed via a self-reported questionnaire using a Likert scale. Scores range from 1 to 5, where 1 indicates no influence and 5 indicates extreme influence. Higher scores indicate that the participant felt the default option had a greater influence on their appointment decision.
Immediately after the disclosure of the intervention
Acceptance Score of the Default Option Nudge in Public Health Services
Zeitfenster: Immediately after the disclosure of the intervention
This measure is assessed via a self-reported questionnaire using a Likert scale. Scores range from 1 to 5, where 1 indicates completely unacceptable and 5 indicates completely acceptable. Higher scores indicate higher social acceptance and suitability of using such behavioral nudges in public health promotion.
Immediately after the disclosure of the intervention
Percentage of Participants Who Accept the Appointment After Disclosure
Zeitfenster: Immediately after the disclosure of the intervention
This outcome is assessed via a secondary dichotomous choice (Yes/No) presented after the participant reads the disclosure statement explaining the nudge. The value reported is the percentage of participants who choose to accept the screening at this final stage.
Immediately after the disclosure of the intervention

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Harbin Medical University

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

27. April 2025

Primärer Abschluss (Tatsächlich)

1. Juni 2025

Studienabschluss (Tatsächlich)

1. Juni 2025

Studienanmeldedaten

Zuerst eingereicht

23. Juni 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

26. Juni 2026

Zuerst gepostet (Tatsächlich)

2. Juli 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

2. Juli 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

26. Juni 2026

Zuletzt verifiziert

1. Juni 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Schlüsselwörter

Zusätzliche relevante MeSH-Bedingungen

Andere Studien-ID-Nummern

  • HMUIRB2025029PRE

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

All collected de-identified individual participant data (IPD) that underlie the results reported in the final publication. This includes demographic characteristics, group allocation, behavioral screening decisions, and responses related to attitudes toward the disclosure intervention.

IPD-Sharing-Zeitrahmen

Data will be available beginning 6 months and ending 36 months following the publication of the article.

IPD-Sharing-Zugriffskriterien

Researchers who provide a methodologically sound proposal.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL
  • SAFT
  • ICF

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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