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

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

Status
Completed
Phases
Unknown
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT07682220
Enrollment
1200
Registered
2026-07-02
Start date
2025-04-27
Completion date
2025-06-01
Last updated
2026-07-02

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

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

Keywords

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

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. 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.

Interventions

BEHAVIORALDefault 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.

Sponsors

Harbin Medical University
Lead SponsorOTHER

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Investigator)

Eligibility

Sex/Gender
ALL
Age
45 Years to 74 Years
Healthy volunteers
Yes

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.

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Who Accept the Cancer Screening AppointmentImmediately after the default option interventionThis 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.

Secondary

MeasureTime frameDescription
Acceptance Score of the Default Option Nudge in Public Health ServicesImmediately after the disclosure of the interventionThis 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.
Percentage of Participants Who Accept the Appointment After DisclosureImmediately after the disclosure of the interventionThis 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.
Participant Attitude Score Towards the Default Option NudgeImmediately after the disclosure of the interventionThis 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.
Self-Reported Score of the Nudge's Influence on Decision-MakingImmediately after the disclosure of the interventionThis 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.

Countries

China

Outcome results

None listed

Source: ClinicalTrials.gov · Data processed: Jul 3, 2026