Hello Decker A, you can either have an ignition or fuel problem. The spark can be weak not permitting the engine to ignite the fuel,or you may have a fuel delivery problem. The coolant sensor the computer the temperature, when cold the computer is supposed to richen the mixture . You should check to see if you have a good hot spark,it should be blue and jump a gap off at least a 1/2 inch. If not the ignition coil ,cap and rotor will have to be inspected.Also check the battery voltage while the engine is being cranked,it should remain above 9.6v. If it is lower the electriclal sytem will have to be tested. To check the coolant sensor,the truck will have to be let sit over night and the coolant temp read with as scan tool,it should read close to the outside temperature. If this reading is off it will give you the hard starting condition you describe.
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