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

26 juin 2026 mis à jour par: 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.

Aperçu de l'étude

Statut

Complété

Les conditions

Intervention / Traitement

Type d'étude

Interventionnel

Inscription (Réel)

1200

Phase

  • N'est pas applicable

Contacts et emplacements

Cette section fournit les coordonnées de ceux qui mènent l'étude et des informations sur le lieu où cette étude est menée.

Lieux d'étude

  • Chine
    • Heilongjiang
      • Harbin, Heilongjiang, Chine, 150081
        • Harbin Medical University

Critères de participation

Les chercheurs recherchent des personnes qui correspondent à une certaine description, appelée critères d'éligibilité. Certains exemples de ces critères sont l'état de santé général d'une personne ou des traitements antérieurs.

Critère d'éligibilité

Âges éligibles pour étudier

  • Adulte
  • Adulte plus âgé

Accepte les volontaires sains

Oui

La description

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.

Plan d'étude

Cette section fournit des détails sur le plan d'étude, y compris la façon dont l'étude est conçue et ce que l'étude mesure.

Comment l'étude est-elle conçue ?

Détails de conception

  • Objectif principal: Recherche sur les services de santé
  • Répartition: Randomisé
  • Modèle interventionnel: Affectation parallèle
  • Masquage: Double

Armes et Interventions

Groupe de participants / Bras
Intervention / Traitement
Aucune intervention: 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?"
Expérimental: 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.
Comportemental: 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.
Aucune intervention: 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?"
Expérimental: 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.
Comportemental: 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.

Que mesure l'étude ?

Principaux critères de jugement

Mesure des résultats
Description de la mesure
Délai
Percentage of Participants Who Accept the Cancer Screening Appointment
Délai: 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

Mesures de résultats secondaires

Mesure des résultats
Description de la mesure
Délai
Participant Attitude Score Towards the Default Option Nudge
Délai: 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
Délai: 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
Délai: 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
Délai: 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

Collaborateurs et enquêteurs

C'est ici que vous trouverez les personnes et les organisations impliquées dans cette étude.

Parrainer

Harbin Medical University

Dates d'enregistrement des études

Ces dates suivent la progression des dossiers d'étude et des soumissions de résultats sommaires à ClinicalTrials.gov. Les dossiers d'étude et les résultats rapportés sont examinés par la Bibliothèque nationale de médecine (NLM) pour s'assurer qu'ils répondent à des normes de contrôle de qualité spécifiques avant d'être publiés sur le site Web public.

Dates principales de l'étude

Début de l'étude (Réel)

27 avril 2025

Achèvement primaire (Réel)

1 juin 2025

Achèvement de l'étude (Réel)

1 juin 2025

Dates d'inscription aux études

Première soumission

23 juin 2026

Première soumission répondant aux critères de contrôle qualité

26 juin 2026

Première publication (Réel)

2 juillet 2026

Mises à jour des dossiers d'étude

Dernière mise à jour publiée (Réel)

2 juillet 2026

Dernière mise à jour soumise répondant aux critères de contrôle qualité

26 juin 2026

Dernière vérification

1 juin 2026

Plus d'information

Termes liés à cette étude

Mots clés

Termes MeSH pertinents supplémentaires

Autres numéros d'identification d'étude

  • HMUIRB2025029PRE

Plan pour les données individuelles des participants (IPD)

Prévoyez-vous de partager les données individuelles des participants (DPI) ?

OUI

Description du régime IPD

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.

Délai de partage IPD

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

Critères d'accès au partage IPD

Researchers who provide a methodologically sound proposal.

Type d'informations de prise en charge du partage d'IPD

  • PROTOCOLE D'ÉTUDE
  • SÈVE
  • CIF

Informations sur les médicaments et les dispositifs, documents d'étude

Étudie un produit pharmaceutique réglementé par la FDA américaine

Non

Étudie un produit d'appareil réglementé par la FDA américaine

Non

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