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.