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The goal of this clinical trial is to assess whether messages generated by a large language model (LLM), including both static and conversational formats, can increase colorectal cancer (CRC) screening intentions among U.S. adults aged 45-75 who have never completed CRC screening. The main questions it aims to answer are:
Do personalized, AI-generated messages increase the self-reported likelihood of completing a stool-based CRC screening test within 12 months?
Do they also increase intent to undergo colonoscopy screening within 12 months?
Researchers will compare four groups: (1) no message control, (2) expert-written patient education materials, (3) a single AI-generated persuasive message, and (4) a motivational interviewing-style AI chatbot. These comparisons will help assess whether a conversational format offers added benefit over static AI or expert-generated content.
Participants will:
Be randomly assigned to one of the four study arms
Spend at least 3 minutes reading or interacting with their assigned material
Complete pre- and post-intervention surveys assessing intent to receive CRC screening
Receive messages tailored to their self-reported demographics, including age, political ideology, gender, education, community setting (urban, rural, suburb), self-reported health, and the last time they saw their PCP
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| AI Motivational Interviewing Chatbot | Experimental | The motivational interviewing chatbot refers to a GPT-4.1 based chatbot that has been instructed to follow motivational interviewing principals to persuade participants to get screened for CRC. |
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| single GPT generated message | Experimental | The single GPT generated message is a single ~640 word persuasive message generated by GPT-4.1 where GPT-4.1 is provided with the same self-reported demographics. |
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| CRC JAMA patient page | Active Comparator | The 642 word JAMA Patient Page contains up to date information on screening guidelines for CRC directed at patients. |
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| No Message | No Intervention | Participants read a ~640 word fictional short story about a cat and dog. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| single GPT generated message | Behavioral | Participants receive a single ~640-word message generated by GPT-4.1. The message is tailored to participants' self-reported demographics (age, gender, political ideology, education, urbanicity, health status, and last PCP visit). The message provides persuasive content encouraging colorectal cancer screening, emphasizing stool and colonoscopy screening options. Participants are required to read the message for a minimum of 3 minutes. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Self-Reported Likelihood of Completing Stool Test Screening for Colorectal Cancer | Measured on a 0-100 scale, where 0 = "Extremely unlikely" and 100 = "Extremely likely." Assessed before and after the intervention. Change in score indicates difference in participant intention to complete a stool-based CRC screening test. | Immediately before and after the intervention (single session; same day) |
| Change in Self-Reported Likelihood of Completing Colonoscopy Screening for Colorectal Cancer | Measured on a 0-100 scale, where 0 = "Extremely unlikely" and 100 = "Extremely likely." Assessed before and after the intervention. Change in score reflects shift in participant intention to complete a colonoscopy within the next 12 months. | Immediately before and after the intervention (single session; same day) |
| Measure | Description | Time Frame |
|---|---|---|
| Perceived Empathy of the Intervention | Participants rate how empathetic they found the assigned message or chatbot interaction using a 5-point Likert scale. Higher values indicate greater perceived empathy. | Immediately after the intervention (single session) |
| Comfort Discussing CRC Screening with a Provider |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Participants are recruited online via Prolific | Philadelphia | Pennsylvania | 19104 | United States |
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| AI Chatbot | Behavioral | Participants engage in a multi-turn conversation with a GPT-4.1 chatbot trained to emulate motivational interviewing techniques. The chatbot personalizes its conversation based on each participant's demographics (age, gender, political ideology, education, urbanicity, health status, and last PCP visit). Conversations last at least 3 minutes and aim to increase participant motivation to complete colorectal cancer screening. |
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| Expert-Written Patient Materials | Behavioral | Participants read a 642-word expert-written educational summary from the Journal of the American Medical Association's Patient Page on colorectal cancer screening. The material is designed to provide objective information about screening options and guidelines recommended by the US Preventive Services Task Force. Participants are required to read the material for at least 3 minutes. |
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Measured on a 0-100 scale where 0 = "Not at all comfortable" and 100 = "Extremely comfortable." Assessed pre- and post-intervention to detect changes in self-reported comfort discussing colorectal cancer screening with a primary care provider. |
| Immediately before and after the intervention (single session; same day) |
| Perceived Message Effectiveness | Participants rate the persuasive effectiveness of the assigned content using a previously developed public health message effectiveness scale. | Immediately after the intervention (single session) |
| Change in Reasons for CRC Screening Hesitancy | Participants rate the importance of 13 pre-defined concerns about CRC screening on a 0-100 scale (e.g., cost, discomfort, necessity). Changes in ratings pre- to post-intervention reflect shifts in perceived barriers. | Immediately before and after the intervention (single session) |