JMIR Publications

ABSTRACT

Background:

Recruiting participants for clinical trials poses challenges. Major barriers to participation include psychological factors (e.g., fear and mistrust) and logistical constraints (e.g., transportation, cost, and scheduling). Strategic design of clinical trial messaging can help overcome these barriers. While strategic communication can be done through various channels (e.g., recruitment ads), health care providers on the internet have been found to be key sources for communicating clinical trial information to U.S. adults in the social media era.

Objective:

Our study aims to examine how communication source (i.e., doctors and peers) and message framing of TikTok videos (i.e., psychological and logistical framing) influence clinical-trial-related attitudes, perceptions, and sign-up behaviors under the guidance of the integrated behavioral model.

Methods:

This study utilized a 2 (source: doctor vs. peer) x 2 (framing: psychological vs. logistical) between-subject factorial design online experiment targeting adults in the United States who had never participated in clinical trials (i.e., newcomers). A Qualtrics panel was used to recruit and compensate the study respondents (N=561). The main outcome measures included perceived source credibility, self-efficacy, attitude toward clinical trial participation, behavioral intention, and sign-up behavior. Structural equation modeling was employed to analyze the direct and indirect effects of message factors on the outcome variables. Source (doctor=1; peer=0) and framing (psychological=1; logistical=0) were dummy-coded.

Results:

Doctor-featured messages led to greater perceived source credibility (β=.31, P<.001), leading to greater self-efficacy (95% CI 0.13-0.30), which in turn enhanced behavioral intention (95% CI 0.12-0.29) and clinical trial sign-up behavior (95% CI 0.02-0.04). Logistical-barrier-framed messages led to greater self-efficacy (β= –.09, P=.02), resulting in higher intention to participate in clinical trials (95% CI –0.38- –0.03) and improved sign-up behavior (95% CI –.06- –.004). Logistical-barrier-framed messages were also directly associated with an increased likelihood of signing up for a clinical trial (β= –.08, P=.03). The model accounted for 21% of the variance in clinical trial sign-up behavior. Attitude did not significantly affect behavioral intention in the current study (β=.08, P=.14), and psychological- and logistical-barrier-framed messages did not significantly differ in attitudes toward clinical trial participation (β= –.03, P=.09).

Conclusions:

These findings advance our understanding of how people process popular message characteristics in short-form videos and lend practical guidance for communicators. We encourage medical professionals to consider short-form video sites (e.g., TikTok and Instagram Reels) as effective tools for discussing clinical trials and participation opportunities. Specifically, featuring doctors discussing efforts to reduce logistical barriers is recommended. Our measuring of actual behavior as an outcome is a rare and noteworthy contribution to this research.