Goal versus duty? Persuading seniors to use generative AI-enabled medical applications

The integration of generative AI into healthcare presents a profound trust dilemma for older adults, a demographic highly sensitive to risk and algorithmic opacity. While existing literature primarily focuses on post-adoption AI interaction design, it largely overlooks the critical pre-adoption phase: how strategic marketing communication persuades vulnerable populations to engage with AI. Addressing this gap, this study investigates how marketing communication orientations: goal-oriented (emphasizing instrumental performance) versus duty-oriented (emphasizing safety and ethical governance) shape older adults’ trust and intention to adopt medical AI. Across three scenario-based experiments, we test a comprehensive behavioral model. Study 1 establishes a critical boundary condition, demonstrating that duty-oriented messaging significantly increases adoption intentions and trustworthiness in abstract, high-uncertainty preventive contexts, whereas this advantage diminishes in concrete, outcome-focused diagnostic and treatment settings. Studies 2 and 3 probe the underlying attributional mechanisms and individual differences by testing corporate motive attributions, AI literacy, and AI risk perception. Our findings reveal that duty-oriented framing enhances values-driven motive attributions, which in turn increase trust and adoption intentions among older adults. Furthermore, the persuasive advantage of duty-oriented communication is amplified for seniors with higher AI literacy. This study contributes to the digital innovation literature by shifting the paradigm from algorithmic interaction design to pre-adoption strategic framing and motive attribution. We provide actionable guidelines for practitioners to embed duty and normative transparency into their marketing to bridge the generative AI adoption gap for older adults.