Patient trust in health education attributed to generative artificial intelligence versus a physician: a randomized survey study of pregnant and postpartum women

Objective To compare patient trust in educational health contentand the physician providing it, when authorship is attributed to a physician or generative artificial intelligence (AI). Materials and Methods In a preregistered randomized, parallel survey study, participants read a health education article. Individuals were randomized to 1 of 4 conditions, attributing authorship of an identical article to (1) a physician author, (2) generative AI, (3) a physician assisted by AI (hybrid authorship), or (4) no author. Pregnant or postpartum English-speaking US adults (n = 400) were recruited in August-October 2025 via an online survey panel. Eighty percent passed timing and attention checks. Participants rated article engagement, content trust, and trust in the (hypothetical) recommending physician with Likert-scales. Bonferroni corrections were applied to post hoc pairwise comparisons (α = 0.05). Results Among participants who correctly recalled authorship (n = 195), AI-only authorship was associated with lower trust in content (mean, 9.43 vs 11.11; P = .001) and the recommending physician (mean, 8.93 vs 10.84; P = .03) compared with physician-only authorship, while hybrid authorship did not differ significantly from physician-only authorship for either outcome (content: P = .08; physician: P > .99). Sensitivity analyses including all participants (n = 321) were generally consistent with the primary findings. Engagement did not differ significantly across conditions in the primary analytic sample. Discussion As generative AI becomes increasingly integrated into clinical care, how AI involvement and physician oversight are communicated to patients could have important implications for patient trust. Conclusion AI authorship was associated with reduced trust in patient-facing education despite identical, clinician-written content.