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

NCT07682220 | Completed

• 1 other identifier: HMUIRB2025029PRE
• Study Type: interventional
• Target: 1,200
• Locations: 1 country
• Sites: 1

Brief Summary

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. 1.Does presenting a screening appointment as a default option increase the likelihood that high-risk individuals will choose to be screened?
2. 2.How do participants react, and what is their level of acceptance, when the nudge intervention is disclosed to them?
3. 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.
4. 4.Read a short educational text about lung or stomach cancer and its screening.
5. 5.Complete an online questionnaire.
6. 6.Make a decision regarding a simulated cancer screening appointment.
7. 7.Read a disclosure explaining the behavioral nudge strategy used during the study.
8. 8.Re-evaluate their screening decision and answer questions regarding their attitude toward the nudge.

Conditions

Lung Neoplasms; Stomach Neoplasms; Early Detection of Cancer; Patient Compliance

Keywords

Behavioral Economics; Nudge; Default Option; Screening Adherence; Disclosure Effect; Cancer Screening

Outcome Measures

Primary Outcomes (1)

• 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.

  Immediately after the default option intervention

Secondary Outcomes (4)

• Participant Attitude Score Towards the Default Option Nudge

  Immediately after the disclosure of the intervention

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

  Immediately after the disclosure of the intervention

• Acceptance Score of the Default Option Nudge in Public Health Services

  Immediately after the disclosure of the intervention

• Percentage of Participants Who Accept the Appointment After Disclosure

  Immediately after the disclosure of the intervention

Study Arms (4)

control group (lung cancer screening)

NO INTERVENTION

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?"

intervention group (lung cancer screening)

EXPERIMENTAL

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.

Behavioral: Default Options

control group (gastric cancer screening)

NO INTERVENTION

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?"

intervention group (gastric cancer screening)

EXPERIMENTAL

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.

Behavioral: Default Options

Interventions

Default Options BEHAVIORAL

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.

intervention group (gastric cancer screening); intervention group (lung cancer screening)

Eligibility Criteria

• Age: 45 Years - 74 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• 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.

You may not qualify if:

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

Sponsors & Collaborators

• Harbin Medical University: lead

Study Sites (1)

Harbin Medical University

Harbin, Heilongjiang, 150081, China

Location

MeSH Terms

Conditions

Lung Neoplasms; Stomach Neoplasms; Patient Compliance

Condition Hierarchy (Ancestors)

Respiratory Tract Neoplasms; Thoracic Neoplasms; Neoplasms by Site; Neoplasms; Lung Diseases; Respiratory Tract Diseases; Gastrointestinal Neoplasms; Digestive System Neoplasms; Digestive System Diseases; Gastrointestinal Diseases; Stomach Diseases; Patient Acceptance of Health Care; Treatment Adherence and Compliance; Health Behavior; Behavior

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Master

Study Record Dates

• First Submitted: June 23, 2026
• First Posted: July 2, 2026
• Study Start: April 27, 2025
• Primary Completion: June 1, 2025
• Study Completion: June 1, 2025
• Last Updated: July 2, 2026

Record last verified: 2026-06

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ICF
• Time Frame: Data will be available beginning 6 months and ending 36 months following the publication of the article.
• Access Criteria: Researchers who provide a methodologically sound proposal.

Locations

CN (1)