Using Short-Form Videos to Get Clinical Trial Newcomers to Sign Up: Message-Testing Experiment.

BACKGROUND: 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. OBJECTIVE: 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. METHODS: 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. RESULTS: Doctor-featured messages led to greater perceived source credibility (ß=.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 (ß=-.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 (ß=-.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 (ß=.08, P=.14), and psychological and logistical barrier-framed messages did not significantly differ in attitudes toward clinical trial participation (ß=-.04, 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 (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.

"Addiction is Not a Choice." #narcansaveslives: Collective Voice in Harm Reduction on TikTok.

Using 100 videos posted to TikTok by harm reduction creators with the hashtags #narcansaveslives and #naloxonesaveslives, this study examines who is posting, what they are saying, and how they are explaining Narcan/naloxone to their followers. Incorporating the concept of reverse agenda setting, we examine how, through hashtags, TikTok creators can set the agenda for what is important to discuss in the harm reduction space. Findings demonstrate that harm reduction creators have developed a collective voice and created an affective public, attempting to educate others, shed stigma, and normalize the conversation around harm reduction. These creators are using TikTok to educate followers about the prevalence of opioid use, the availability of Narcan/naloxone, correcting misinformation, and discussing the reality of recovery. Echoing prior studies, this research illustrates how TikTok has become an essential resource for health questions, including opioid use. Practical implications are also discussed.

TikTok as a Source of Health Information and Misinformation for Young Women in the United States: Survey Study.

BACKGROUND: TikTok is one of the most-used and fastest-growing social media platforms in the world, and recent reports indicate that it has become an increasingly popular source of news and information in the United States. These trends have important implications for public health because an abundance of health information exists on the platform. Women are among the largest group of TikTok users in the United States and may be especially affected by the dissemination of health information on TikTok. Prior research has shown that women are not only more likely to look for information on the internet but are also more likely to have their health-related behaviors and perceptions affected by their involvement with social media. OBJECTIVE: We conducted a survey of young women in the United States to better understand their use of TikTok for health information as well as their perceptions of TikTok's health information and health communication sources. METHODS: A web-based survey of US women aged 18 to 29 years (N=1172) was conducted in April-May 2023. The sample was recruited from a Qualtrics research panel and 2 public universities in the United States. RESULTS: The results indicate that the majority of young women in the United States who have used TikTok have obtained health information from the platform either intentionally (672/1026, 65.5%) or unintentionally (948/1026, 92.4%). Age (959/1026, 93.47%; r=0.30; P<.001), education (959/1026, 93.47%; ρ=0.10; P=.001), and TikTok intensity (ie, participants' emotional connectedness to TikTok and TikTok's integration into their daily lives; 959/1026, 93.47%; r=0.32; P<.001) were positively correlated with overall credibility perceptions of the health information. Nearly the entire sample reported that they think that misinformation is prevalent on TikTok to at least some extent (1007/1026, 98.15%), but a third-person effect was found because the young women reported that they believe that other people are more susceptible to health misinformation on TikTok than they personally are (t1025=21.16; P<.001). Both health professionals and general users were common sources of health information on TikTok: 93.08% (955/1026) of the participants indicated that they had obtained health information from a health professional, and 93.86% (963/1026) indicated that they had obtained health information from a general user. The respondents showed greater preference for health information from health professionals (vs general users; t1025=23.75; P<.001); the respondents also reported obtaining health information from health professionals more often than from general users (t1025=8.13; P<.001), and they were more likely to act on health information from health professionals (vs general users; t1025=12.74; P<.001). CONCLUSIONS: The findings suggest that health professionals and health communication scholars need to proactively consider using TikTok as a platform for disseminating health information to young women because young women are obtaining health information from TikTok and prefer information from health professionals.

"Trust Me, I'm a Doctor." How TikTok Videos from Different Sources Influence Clinical Trial Participation.

This study experiments with TikTok videos to promote clinical trial participation. More specifically, it examines how short-form video sources (doctors vs. prior volunteers for clinical trials) influence perceived source credibility, self-efficacy, and behavioral intention to participate in clinical trials. Findings from this online experiment (N = 396) showed that doctor sources led to greater behavioral intention through enhancing source credibility compared to prior volunteer sources. Alternatively, prior volunteer sources increased behavioral intention via enhanced self-efficacy for participants with low trust in doctors. These findings contribute to the understanding of how short-form video sources act as heuristic cues, leading to persuasion outcomes. Overall, we recommend featuring doctors when using video-based messages to promote clinical trial participation. Also, this study emphasizes the need for health communication practitioners to consider prior volunteers as spokespersons when targeting populations with low baseline trust in doctors.

Exploring the Strategic Use of TikTok for Clinical Trial Recruitment: How audiences' Prior Short-Form Video Usage Influences Persuasive Effects.

Guided by the elaboration likelihood model and framing theory, this study explores the potential of short-form video platforms (e.g. TikTok), for targeted clinical trial recruitment. An online experiment compared doctor vs. peer-led videos addressing logistical or psychological barriers to participation, mimicking common TikTok communication tactics. Results indicate that high (vs. low) TikTok users are more persuaded by recruitment messages, and they exhibit stronger intentions to participate in clinical trials. Although doctor-sourced messages generate greater credibility and a more favorable message attitude, peer-sourced messages may be more effective in increasing participation intention. Lastly, doctor-sourced videos that address logistical barriers and peer-sourced videos that discuss psychological barriers result in higher self-efficacy for clinical trial participation. This study contributes to the growing body of research on new media's role in health communication and provides insights into how to strategically utilize TikTok and other short-form video platforms for clinical trial recruitment.

COVID-19 vaccination communication: Effects of vaccine conspiracy beliefs and message framing among black and white participants.

BACKGROUND: The importance of vaccination in combating the COVID-19 pandemic is widely acknowledged. The aim of this study was (1) to understand how one's vaccine conspiracy beliefs would influence their public health news processing, (2) to examine how specific public health news features (i.e., news frame) would influence message processing, and (3) to examine if there were any differences between Black and White participants in their message processing. METHODS: A nationwide online experiment (N = 821) with a 3 (vaccine conspiracy beliefs: high vs. moderate vs. low) × 2 (participants' race: Black vs. White) × 2 (news frames: gain vs. loss) mixed-factorial design was conducted in the United States. RESULTS: Participants' level of vaccine conspiracy beliefs was predictive of their responses to outcome measures. Additionally, Black participants reported higher perceived message effectiveness, more favorable attitudes toward the message, and higher vaccination intentions than White participants. Furthermore, health news that emphasized vaccination benefits produced more favorable attitudes than those emphasizing losses associated with non-vaccination, especially for White participants. Lastly, participants reported more favorable attitudes toward gain-framed health news regardless of their vaccine conspiracy beliefs. CONCLUSION: It is crucial for health officials to work to find effective media message strategies to combat COVID-19 vaccine conspiracy theories and misinformation. Furthermore, this study supports the significance of health organizations' ongoing efforts to tailor public health messaging to specific racial groups, as evidenced by considerable variations in perceptions among Black and White Americans.

Can Videos on TikTok Improve Pap Smear Attitudes and Intentions? Effects of Source and Autonomy Support in Short-Form Health Videos.

This study was designed to test the effects of two message features (source and level of autonomy support) that are commonly found in short-form social media (e.g. TikTok) videos about Pap tests. The source is defined as who is communicating the message, and autonomy support refers to providing an individual with the independence, respect, and choice to make their own decision. In an online experiment, 636 females aged 21-29 viewed TikTok videos about Pap tests varying in source (doctor vs. peer) and level of autonomy support (either using controlling language to demand getting a Pap test or being supportive of one's choice of whether they receive a Pap test) and then responded to outcomes measures including perceived source credibility, perceived message effectiveness, attitude toward the message, attitude toward Pap tests, intention to engage with the videos, and intention to get a Pap test. Doctors were perceived as more credible than peers, and doctor videos were perceived to be more effective than peer videos. Autonomy support interacted with source, such that autonomy-supportive videos delivered by a doctor improved attitude toward the messaging and attitude toward Pap tests. Regardless of the source, autonomy-supportive videos increased intention to engage with the content on social media. As Pap test rates have recently declined among young women in the United States and viewing of Pap test-related videos has skyrocketed on the TikTok platform, short-form social media sites like TikTok may be an effective health communication tool for health professionals.

Overcoming Black Americans' Psychological and Cognitive Barriers to Clinical Trial Participation: Effects of News Framing and Exemplars.

This study examines how news features (framing and the use of exemplars) can help overcome two common barriers (psychological and cognitive) impeding Black American participation in clinical trials. In an online experiment, Black participants (N = 390) viewed social media news posts varying in framing (focus on psychological vs. cognitive barriers) and use of an exemplar (present vs. absent and White vs. Black) and then responded to outcome measures including perceived message effectiveness, message attitudes, and intention to participate in clinical trials. The findings illustrate that including a racially matched (i.e. Black) exemplar improves attitudes toward clinical trial messages. Most notably, featuring a race-matched exemplar increases intention to participate in a trial when the messages discuss psychological barriers. These findings enhance our understanding of how messages can be better designed to increase Black American participation in clinical trials, thereby contributing to reducing health inequities and improving health outcomes.

Improving rural White men's attitudes toward clinical trial messaging and participation: effects of framing, exemplars and trust.

This study examined whether framing, exemplar presence and exemplar race in social media news posts influence rural White men's perceptions, attitudes and behavioral intentions toward clinical trial participation, and if so, how individual trust in doctors moderates the effects of these three factors. An experiment with a 2 within (framing: cognitive versus psychological barriers) × 2 within (exemplar: present versus absent) × 2 between (exemplar race: White versus Black) subjects mixed factorial design was conducted among rural White men (N = 208). Twelve social media news posts about clinical trial participation were created for the experiment. Results revealed that respondents had greater behavioral intentions to participate in clinical trials after seeing posts with exemplars present (versus absent). When news posts addressed cognitive barriers (e.g. lacking knowledge about the value of clinical trials), the presence of exemplars enhanced perceived self-efficacy to participate in clinical trials. Participants with lower trust in doctors reported more favorable attitudes to posts with exemplars, and the posts with Black exemplars were perceived as more effective (approaching statistical significance). When communicating about clinical trials to rural White men, health professionals should consider including exemplars and addressing cognitive barriers to participation.