School of Journalism and Strategic Media, University of Arkansas, Fayetteville, AR, United States.
College of Journalism & Mass Communications, University of Nebraska-Lincoln, Lincoln, NE, United States.
J Med Internet Res. 2024 Aug 15;26:e49600. doi: 10.2196/49600.
Recruiting participants for clinical trials poses challenges. Major barriers to participation include psychological factors (eg, fear and mistrust) and logistical constraints (eg, transportation, cost, and scheduling). The strategic design of clinical trial messaging can help overcome these barriers. While strategic communication can be done through various channels (eg, recruitment advertisements), health care providers on the internet have been found to be key sources for communicating clinical trial information to US adults in the social media era.
This study aims to examine how communication source (ie, medical doctors and peers) and message framing of TikTok videos (ie, psychological and logistical framing) influence clinical trial-related attitudes, perceptions, and sign-up behaviors under the guidance of the integrated behavioral model.
This study used a 2 (source: doctor vs peer) × 2 (framing: psychological vs logistical) between-participant factorial design web-based experiment targeting adults in the United States who had never participated in clinical trials (ie, newcomers). A Qualtrics panel was used to recruit and compensate the study respondents (n=561). Participants viewed short-form videos with doctors or peers, using psychological or logistical framing. 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 used 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.
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 to -0.03) and improved sign-up behavior (95% CI -0.06 to -0.004). 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 this study (β=.08, P=.14), and psychological and logistical barrier-framed messages did not significantly differ in attitudes toward clinical trial participation (β=-.04, P=.09).
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 (eg, 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.
招募临床试验参与者面临挑战。参与的主要障碍包括心理因素（例如，恐惧和不信任）和后勤限制（例如，交通、费用和日程安排）。临床试验信息传递的策略设计有助于克服这些障碍。虽然可以通过各种渠道（例如，招募广告）进行策略性沟通，但在社交媒体时代，互联网上的医疗保健提供者已被发现是向美国成年人传达临床试验信息的关键来源。
本研究旨在检验在整合行为模型的指导下，信息源（即医生和同行）和 TikTok 视频的信息框架（即心理和后勤框架）如何影响与临床试验相关的态度、看法和注册行为。
本研究采用了一项针对从未参加过临床试验的美国成年人（即新手）的 2（来源：医生与同行）×2（框架：心理与后勤）的参与者间因子设计的网络实验。使用 Qualtrics 小组招募和补偿研究受访者（n=561）。参与者观看了由医生或同行使用心理或后勤框架制作的短视频。主要的测量指标包括感知的来源可信度、自我效能感、对临床试验参与的态度、行为意向和注册行为。结构方程模型用于分析信息因素对结果变量的直接和间接影响。来源（医生=1；同行=0）和框架（心理=1；后勤=0）采用哑变量编码。
医生特色的信息导致更高的感知来源可信度（β=.31，P<.001），从而导致更高的自我效能感（95%置信区间 0.13-0.30），进而增强了行为意向（95%置信区间 0.12-0.29）和临床试验注册行为（95%置信区间 0.02-0.04）。后勤障碍框架信息导致更高的自我效能感（β=-.09，P=.02），从而导致更高的临床试验参与意向（95%置信区间-0.38 至-0.03）和改善的注册行为（95%置信区间-0.06 至-0.004）。后勤障碍框架信息也与临床试验注册的可能性增加直接相关（β=-.08，P=.03）。该模型解释了临床试验注册行为 21%的变化。在这项研究中，态度并没有显著影响行为意向（β=.08，P=.14），心理和后勤障碍框架信息在临床试验参与态度方面没有显著差异（β=-.04，P=.09）。
这些发现增进了我们对人们如何处理短视频中流行信息特征的理解，并为传播者提供了实际指导。我们鼓励医疗专业人员将短视频网站（如 TikTok 和 Instagram Reels）视为讨论临床试验和参与机会的有效工具。具体来说，建议医生讨论减少后勤障碍的努力。我们将实际行为作为结果进行衡量，这是对该研究的一项罕见而有意义的贡献。
