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.