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

Harbin Medical University1,200 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

DOUBLE

Enrollment

1,200

Conditions

Lung Neoplasms Stomach Neoplasms

Interventions

Default OptionsBEHAVIORAL

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.

Eligibility

Sex: ALLMin age: 45 YearsMax age: 74 YearsHealthy volunteers:

Medical Language ↔ Plain English

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.

Outcomes

Primary Outcomes

Percentage of Participants Who Accept the Cancer Screening Appointment

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.

Time frame: Immediately after the default option intervention

Secondary Outcomes

Participant Attitude Score Towards the Default Option Nudge

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.

Time frame: Immediately after the disclosure of the intervention

Self-Reported Score of the Nudge's Influence on Decision-Making

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.

Time frame: Immediately after the disclosure of the intervention

Acceptance Score of the Default Option Nudge in Public Health Services

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.

Time frame: Immediately after the disclosure of the intervention

Percentage of Participants Who Accept the Appointment After Disclosure

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.

Time frame: Immediately after the disclosure of the intervention

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

Overview

Conditions

Interventions

Eligibility

Locations (1)

Outcomes

Primary Outcomes

Secondary Outcomes