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Koda M, Horinouchi T, Oya N, Aki M, Iriki A, Yoshida K, Ogawa Y, Kuga H, Nakao T. Effectiveness of psychological first aid in infectious disease pandemics: An overview of systematic reviews. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e107. [PMID: 38868135 PMCID: PMC11114278 DOI: 10.1002/pcn5.107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 04/25/2023] [Accepted: 05/17/2023] [Indexed: 06/14/2024]
Abstract
There is insufficient research on the usefulness of psychological interventions, such as psychological first aid (PFA), during outbreaks. We searched for and critically appraised systematic reviews that examined the effectiveness of PFA during infectious disease outbreaks, such as the novel coronavirus disease (COVID-19). Systematic reviews that examined the efficacy of PFA in the severe acute respiratory syndrome, Middle East respiratory syndrome coronavirus, Ebola virus disease, and COVID-19 outbreaks were searched through PubMed on February 19, 2021. The three included systematic reviews were critically appraised and assessed using AMSTAR-2. One review's overall confidence in its findings was evaluated as "high," which suggested that PFA training had a favorable effect on healthcare personnel. Furthermore, the review also demonstrated that PFA was commonly used during outbreaks and could be delivered through multiple methods, such as a phone or video call. Although it was anticipated that PFA would improve subjective well-being, reports showed no evidence of reduced depression or insomnia. Future studies should examine additional numbers of PFA recipients and conduct quasi-experimental studies to better understand the effectiveness of PFA. Evidence on its effectiveness in infectious disease outbreaks is still lacking, along with research and evaluation methods. Quasi-experimental studies, such as comparisons with other psychological interventions, are required to better understand the effectiveness of PFA.
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Affiliation(s)
- Masahide Koda
- Co‐Learning Community Healthcare Re‐Innovation OfficeGraduate School of MedicineOkayamaJapan
| | - Toru Horinouchi
- Department of PsychiatryHokkaido University Graduate School of MedicineHokkaidoJapan
| | - Nozomu Oya
- Department of Psychiatry, Graduate School of Medical ScienceKyoto Prefectural University of MedicineKyotoJapan
| | - Morio Aki
- Department of Psychiatry, Graduate School of MedicineKyoto UniversityKyotoJapan
| | | | - Kazufumi Yoshida
- Department of Health Promotion and Human Behavior, Graduate School of Medicine/School of Public HealthKyoto UniversityKyotoJapan
| | - Yusuke Ogawa
- Department of Healthcare Epidemiology, School of Public Health in the Graduate School of MedicineKyoto UniversityKyotoJapan
| | - Hironori Kuga
- National Center for Cognitive Behavior Therapy and ResearchNational Center of Neurology and PsychiatryTokyoJapan
| | - Tomohiro Nakao
- Department of Neuropsychiatry, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
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Halliday EC, Holt V, Khan K, Ward F, Wheeler P, Sadler G. 'A lot of small things make a difference'. Mental health and strategies of coping during the COVID-19 pandemic. Health Expect 2021; 25:532-540. [PMID: 34939261 PMCID: PMC8957741 DOI: 10.1111/hex.13416] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 11/08/2021] [Accepted: 12/11/2021] [Indexed: 11/30/2022] Open
Abstract
Introduction The social and economic consequences of COVID‐19 have the potential to affect individuals and populations through different pathways (e.g., bereavement, loss of social interaction). Objective This study adopted a solicited diary method to understand how mental health was affected during England's first lockdown. We also considered the experiences of diary keeping during a pandemic from the perspective of public participants. Methods Fifteen adults older than 18 years of age were recruited from northwest England. Diarists completed semistructured online diaries for 8 weeks, which was combined with weekly calls. A focus group captured participants' experiences of diary keeping. Findings Four key factors influenced mental health, which fluctuated over time and in relation to diarists' situations. These concerned navigating virus risk, loss of social connections and control and constrictions of the domestic space. Diarists also enacted a range of strategies to cope with the pandemic. This included support from social networks, engagement with natural environments, establishing normality, finding meaning and taking affirmative action. Conclusion Use of diary methods provided insights into the lived experiences of the early months of a global pandemic. As well as contributing evidence on its mental health effects, diarists' accounts illuminated considerable resourcefulness and strategies of coping with positive effects for well‐being. While diary keeping can also have therapeutic benefits during adversity, ethical and practical issues need to be considered, which include the emotional nature of diary keeping. Public Contribution Members of the public were involved in interpretation of data as well as critiquing the overall diary method used in the study.
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Affiliation(s)
- Emma C Halliday
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Vivien Holt
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Koser Khan
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Fiona Ward
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Paula Wheeler
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
| | - Gill Sadler
- Division of Health Research, Faculty of Health & Medicine, Lancaster University, Lancaster, UK
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Peek L, Tobin J, van de Lindt JW, Andrews A. Getting Interdisciplinary Teams into the Field: Institutional Review Board Preapproval and Multi-Institution Authorization Agreements for Rapid Response Disaster Research. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:1204-1212. [PMID: 33960513 PMCID: PMC8360063 DOI: 10.1111/risa.13740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/16/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
This article describes an interdisciplinary community resilience research project and presents a case study that supports bringing researchers together before a disaster to develop plans, procedures, and preapproved Institutional Review Board (IRB) protocols. In addition, this article explains how researchers from various academic institutions and their federal agency partners can effectively collaborate by creating an IRB Authorization Agreement (IAA). Such preparations can support interdisciplinary rapid response disaster fieldwork that is timely, ethically informed, and scientifically rigorous. This fieldwork preplanning process can also advance interdisciplinary team formation and data collection efforts over the long term.
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Affiliation(s)
- Lori Peek
- Department of Sociology and Natural Hazards CenterUniversity of Colorado BoulderBoulderCOUSA
| | - Jennifer Tobin
- Natural Hazards CenterUniversity of Colorado BoulderBoulderCOUSA
| | - John W. van de Lindt
- Department of Civil and Environmental EngineeringColorado State UniversityFort CollinsCOUSA
| | - Anne Andrews
- Research Protections OfficeNational Institute of Standards and TechnologyGaithersburgMDUSA
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Bruno W, Haar RJ. A systematic literature review of the ethics of conducting research in the humanitarian setting. Confl Health 2020; 14:27. [PMID: 32489418 PMCID: PMC7245798 DOI: 10.1186/s13031-020-00282-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Research around humanitarian crises, aid delivery, and the impact of these crises on health and well-being has expanded dramatically. Ethical issues around these topics have recently received more attention. We conducted a systematic literature review to synthesize the lessons learned regarding the ethics of research in humanitarian crises. Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify articles regarding the ethics of research in humanitarian contexts between January 1, 1997 and September 1, 2019. We analyzed the articles to extract key themes and develop an agenda for future research. Results We identified 52 articles that matched our inclusion criteria. We categorized the article data into five categories of analysis: 32 were expert statements, 18 were case studies, 11 contained original research, eight were literature reviews and three were book chapters. All included articles were published in English. Using a step-wise qualitative analysis, we identified 10 major themes that encompassed these concepts and points. These major themes were: ethics review process (21 articles, [40.38%]); community engagement (15 articles [28.85%]); the dual imperative, or necessity that research be both academically sound and policy driven, clinical trials in the humanitarian setting (13 articles for each, [25.0%)]; informed consent (10 articles [19.23%]); cultural considerations (6 articles, [11.54%]); risks to researchers (5 articles, [9.62%]); child participation (4 articles [7.69%]); and finally mental health, and data ownership (2 articles for each [3.85%]). Conclusions Interest in the ethics of studying humanitarian crises has been dramatically increasing in recent years. While key concepts within all research settings such as beneficence, justice and respect for persons are crucially relevant, there are considerations unique to the humanitarian context. The particular vulnerabilities of conflict-affected populations, the contextual challenges of working in humanitarian settings, and the need for ensuring strong community engagement at all levels make this area of research particularly challenging. Humanitarian crises are prevalent throughout the globe, and studying them with the utmost ethical forethought is critical to maintaining sound research principles and ethical standards.
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Affiliation(s)
- William Bruno
- Department of Emergency Medicine, University of Southern California, Keck School of Medicine, Los Angeles, USA
| | - Rohini J Haar
- Division of Epidemiology and Biostatistics, School of Public Health, Research Fellow, Human Rights Center, School of Law, University of California at Berkeley, Berkeley, USA
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Khalid AF, Lavis JN, El-Jardali F, Vanstone M. Supporting the use of research evidence in decision-making in crisis zones in low- and middle-income countries: a critical interpretive synthesis. Health Res Policy Syst 2020; 18:21. [PMID: 32070370 PMCID: PMC7027202 DOI: 10.1186/s12961-020-0530-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Accepted: 01/21/2020] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Decision-makers in crisis zones are faced with the challenge of having to make health-related decisions under limited time and resource constraints and in light of the many factors that can influence their decisions, of which research evidence is just one. To address a key gap in the research literature about how best to support the use of research evidence in such situations, we conducted a critical interpretive synthesis approach to develop a conceptual framework that outlines the strategies that leverage the facilitators and address the barriers to evidence use in crisis zones. METHODS We systematically reviewed both empirical and non-empirical literature and used an interpretive analytic approach to synthesise the results and develop the conceptual framework. We used a 'compass' question to create a detailed search strategy and conducted electronic searches in CINAHL, EMBASE, MEDLINE, SSCI and Web of Science. A second reviewer was assigned to a representative sample of articles. We purposively sampled additional papers to fill in conceptual gaps. RESULTS We identified 21 eligible papers to be analysed and purposively sampled an additional 6 to fill conceptual gaps. The synthesis resulted in a conceptual framework that focuses on evidence use in crisis zones examined through the lens of four systems - political, health, international humanitarian aid and health research. Within each of the four systems, the framework identifies the most actionable strategies that leverage the facilitators and address the barriers to evidence use. CONCLUSIONS This study presents a new conceptual framework that outlines strategies that leverage the facilitators and address the barriers to evidence use in crisis zones within different systems. This study expands on the literature pertaining to evidence-informed decision-making.
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Affiliation(s)
- Ahmad Firas Khalid
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada.
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada.
| | - John N Lavis
- Health Policy PhD Program, McMaster University, Hamilton, ON, Canada
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- McMaster Health Forum, McMaster University, Hamilton, ON, Canada
- Department of Political Science, McMaster University, Hamilton, ON, Canada
| | - Fadi El-Jardali
- Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada
- Department of Health Management & Policy, American University of Beirut, Beirut, Lebanon
- enter for Systematic Review in Health Policy and Systems Research (SPARK), American University of Beirut, Beirut, Lebanon
- Knowledge to Policy (K2P) Center, American University of Beirut, Beirut, Lebanon
| | - Meredith Vanstone
- Centre for Health Economics and Policy Analysis, McMaster University, Hamilton, ON, Canada
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
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Horney JA, Casillas GA, Baker E, Stone KW, Kirsch KR, Camargo K, Wade TL, McDonald TJ. Comparing residential contamination in a Houston environmental justice neighborhood before and after Hurricane Harvey. PLoS One 2018; 13:e0192660. [PMID: 29420658 PMCID: PMC5805347 DOI: 10.1371/journal.pone.0192660] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 01/26/2018] [Indexed: 01/06/2023] Open
Abstract
Introduction Polycyclic aromatic hydrocarbons (PAHs) are complex environmental toxicants. Exposure to them has been linked to adverse health outcomes including cancer, as well as diseases of the skin, liver, and immune system. Based on an ongoing community engagement partnership with stakeholder groups and residents, we conducted a small longitudinal study to assess domestic exposure to PAHs among residents of Manchester, an environmental justice neighborhood located in the East End of Houston, TX. Methods In December, 2016, we used fiber wipes to collect samples of household dust from 25 homes in Manchester. Following Hurricane Harvey, in September 2017, we revisited 24 of the 25 homes to collect soil samples from the front yards of the same homes. Wipes and soil were analyzed for the presence of PAHs using gas chromatography–mass spectrometry (GC-MS) methods. Principal component analysis plots, heatmaps, and PAH ratios were used to compare pre- and post-Hurricane Harvey samples. Results While direct comparison is not possible, we present three methods for comparing PAHs found in pre-hurricane fiber wipes and post-hurricane soil samples. The methods demonstrate that the PAHs found before and after Hurricane Harvey are likely from similar sources and that those sources are most likely to be associated with combustion. We also found evidence of redistribution of PAHs due to extreme flooding associated with Hurricane Harvey. Discussion Residents of the Manchester neighborhood of Houston, TX, are exposed to a range of PAHs in household dust and outdoor soil. While it was not possible to compare directly, we were able to use several methods to assess detected concentrations, changes in site-specific PAH allocations, and PAH origination. Additional research is needed to identify specific sources of domestic PAH exposure in these communities and continued work involving community members and policy makers should aim to develop interventions to reduce domestic exposure to and prevent negative health outcomes from PAHs.
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Affiliation(s)
- Jennifer A. Horney
- Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas, United States of America
- Interdisciplinary Program in Toxicology, Texas A&M University, College Station, Texas, United States of America
- * E-mail:
| | - Gaston A. Casillas
- Interdisciplinary Program in Toxicology, Texas A&M University, College Station, Texas, United States of America
| | - Erin Baker
- Pacific Northwest National Laboratory, Richland, Washington, United States of America
| | - Kahler W. Stone
- Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas, United States of America
| | - Katie R. Kirsch
- Department of Epidemiology and Biostatistics, Texas A&M School of Public Health, College Station, Texas, United States of America
| | - Krisa Camargo
- Interdisciplinary Program in Toxicology, Texas A&M University, College Station, Texas, United States of America
- Geochemical and Environmental Research Group, Texas A&M University, College Station, Texas, United States of America
| | - Terry L. Wade
- Geochemical and Environmental Research Group, Texas A&M University, College Station, Texas, United States of America
| | - Thomas J. McDonald
- Department of Environmental and Occupational Health, Texas A&M School of Public Health, College Station, Texas, United States of America
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Packenham JP, Rosselli RT, Ramsey SK, Taylor HA, Fothergill A, Slutsman J, Miller A. Conducting Science in Disasters: Recommendations from the NIEHS Working Group for Special IRB Considerations in the Review of Disaster Related Research. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:094503. [PMID: 28949918 PMCID: PMC5915198 DOI: 10.1289/ehp2378] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 07/24/2017] [Indexed: 05/27/2023]
Abstract
SUMMARY Research involving human subjects after public health emergencies and disasters may pose ethical challenges. These challenges may include concerns about the vulnerability of prospective disaster research participants, increased research burden among disaster survivors approached by multiple research teams, and potentially reduced standards in the ethical review of research by institutional review boards (IRBs) due to the rush to enter the disaster field. The NIEHS Best Practices Working Group for Special IRB Considerations in the Review of Disaster Related Research was formed to identify and address ethical and regulatory challenges associated with the review of disaster research. The working group consists of a diverse collection of disaster research stakeholders across a broad spectrum of disciplines. The working group convened in July 2016 to identify recommendations that are instrumental in preparing IRBs to review protocols related to public health emergencies and disasters. The meeting included formative didactic presentations and facilitated breakout discussions using disaster-related case studies. Major thematic elements from these discussions were collected and documented into 15 working group recommendations, summarized in this article, that address topics such as IRB disaster preparedness activities, informed consent, vulnerable populations, confidentiality, participant burden, disaster research response integration and training, IRB roles/responsibilities, community engagement, and dissemination of disaster research results. https://doi.org/10.1289/EHP2378.
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Affiliation(s)
- Joan P Packenham
- Clinical Research Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS) , Research Triangle Park, North Carolina, USA
| | | | - Steve K Ramsey
- Social & Scientific Systems, Inc. , Durham, North Carolina, USA
| | - Holly A Taylor
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health , Baltimore, Maryland, USA
- Johns Hopkins Berman Institute of Bioethics , Baltimore, Maryland, USA
| | - Alice Fothergill
- Department of Sociology, University of Vermont , Burlington, Vermont, USA
| | - Julia Slutsman
- Office of Research Regulatory Affairs, Children's National Medical Center , Silver Spring, Maryland, USA
- Department of Pediatrics, George Washington University , School of Medicine and Health Sciences, Washington, DC, USA
| | - Aubrey Miller
- Office of the Director, NIEHS, NIH, DHHS , Research Triangle Park, North Carolina, USA
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Affleck W. The Inappropriate Use of Risk-Benefit Analysis in the Risk Assessment of Experimental Trauma-Focused Research. Account Res 2017; 24:384-406. [DOI: 10.1080/08989621.2017.1362557] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- William Affleck
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
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Familiar ethical issues amplified: how members of research ethics committees describe ethical distinctions between disaster and non-disaster research. BMC Med Ethics 2017; 18:44. [PMID: 28659166 PMCID: PMC5490228 DOI: 10.1186/s12910-017-0203-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 06/19/2017] [Indexed: 11/10/2022] Open
Abstract
Background The conduct of research in settings affected by disasters such as hurricanes, floods and earthquakes is challenging, particularly when infrastructures and resources were already limited pre-disaster. However, since post-disaster research is essential to the improvement of the humanitarian response, it is important that adequate research ethics oversight be available. Methods We aim to answer the following questions: 1) what do research ethics committee (REC) members who have reviewed research protocols to be conducted following disasters in low- and middle-income countries (LMICs) perceive as the key ethical concerns associated with disaster research?, and 2) in what ways do REC members understand these concerns to be distinct from those arising in research conducted in non-crisis situations? This qualitative study was developed using interpretative description methodology; 15 interviews were conducted with REC members. Results Four key ethical issues were identified as presenting distinctive considerations for disaster research to be implemented in LMICs, and were described by participants as familiar research ethics issues that were amplified in these contexts. First, REC members viewed disaster research as having strong social value due to its potential for improving disaster response, but also as requiring a higher level of justification compared to other research settings. Second, they identified vulnerability as an overarching concern for disaster research ethics, and a feature that required careful and critical appraisal when assessing protocols. They noted that research participants’ vulnerabilities frequently change in the aftermath of a disaster and often in unpredictable ways. Third, they identified concerns related to promoting and maintaining safety, confidentiality and data security in insecure or austere environments. Lastly, though REC members endorsed the need and usefulness of community engagement, they noted that there are significant challenges in a disaster setting over and above those typically encountered in global health research to achieve meaningful community engagement. Conclusion Disaster research presents distinctive ethical considerations that require attention to ensure that participants are protected. As RECs review disaster research protocols, they should address these concerns and consider how justification, vulnerability, security and confidentially, and community engagement are shaped by the realities of conducting research in a disaster.
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Chiumento A, Rahman A, Frith L, Snider L, Tol WA. Ethical standards for mental health and psychosocial support research in emergencies: review of literature and current debates. Global Health 2017; 13:8. [PMID: 28178981 PMCID: PMC5299703 DOI: 10.1186/s12992-017-0231-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 01/06/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research in emergencies is needed to understand the prevalence of mental health and psychosocial problems and strengthen the evidence base for interventions. All research - including operational needs assessments, programme monitoring and evaluation, and formal academic research - must be conducted ethically. While there is broad consensus on fundamental principles codified in research ethics guidelines, these do not address the ethical specificities of conducting mental health and psychosocial support (MHPSS) research with adults in emergencies. To address this gap, this paper presents a review of multidisciplinary literature to identify specific ethical principles applicable to MHPSS research in emergencies. DISCUSSION Fifty-nine sources meeting the literature review inclusion criteria were analysed following a thematic synthesis approach. There was consensus on the relevance of universal ethical research principles to MHPSS research in emergencies, including norms of participant informed consent and protection; ensuring benefit arises from research participation; researcher neutrality, accountability, and safety; and the duty to ensure research is well designed and accounts for contextual factors in emergency settings. We go onto discuss unresolved issues by highlighting six current debates relating to the application of ethics in emergency settings: (1) what constitutes fair benefits?; (2) how should informed consent be operationalised?; (3) is there a role for decision making capacity assessments?; (4) how do risk management approaches impact upon the construction of ethical research?; (5) how can ethical reflection best be achieved?, and (6) are ethical review boards sufficiently representative and equipped to judge the ethical and scientific merit of emergency MHPSS research? Underlying these debates is a systemic tension between procedural ethics and ethics in practice. In summary, underpinning the literature is a desire to ensure the protection of participants exposed to emergencies and in need of evidence-based MHPSS. However, there is a lack of agreement on how to contextualise guidelines and procedures to effectively maximise the perspectives of researchers, participants and ethical review boards. This is a tension that the field must address to strengthen ethical MHPSS research in emergencies.
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Affiliation(s)
- Anna Chiumento
- University of Liverpool, Institute of Psychology, Health and Society, 2nd Floor, Block B, Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL UK
| | - Atif Rahman
- University of Liverpool, Institute of Psychology, Health and Society, 2nd Floor, Block B, Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL UK
| | - Lucy Frith
- University of Liverpool, Institute of Psychology, Health and Society, 2nd Floor, Block B, Waterhouse Building, 1-5 Brownlow Street, Liverpool, L69 3GL UK
| | - Leslie Snider
- Independent Consultant, Peace in Practice, Amsterdam, The Netherlands
| | - Wietse A. Tol
- Johns Hopkins University, School of Public Health and The Peter C. Alderman Foundation, Baltimore, USA
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Mezinska S, Kakuk P, Mijaljica G, Waligóra M, O’Mathúna DP. Research in disaster settings: a systematic qualitative review of ethical guidelines. BMC Med Ethics 2016; 17:62. [PMID: 27769232 PMCID: PMC5073437 DOI: 10.1186/s12910-016-0148-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 10/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Conducting research during or in the aftermath of disasters poses many specific practical and ethical challenges. This is particularly the case with research involving human subjects. The extraordinary circumstances of research conducted in disaster settings require appropriate regulations to ensure the protection of human participants. The goal of this study is to systematically and qualitatively review the existing ethical guidelines for disaster research by using the constant comparative method (CCM). METHODS We performed a systematic qualitative review of disaster research ethics guidelines to collect and compare existing regulations. Guidelines were identified by a three-tiered search strategy: 1) searching databases (PubMed and Google Scholar), 2) an Internet search (Google), and 3) a search of the references in the included documents from the first two searches. We used the constant comparative method (CCM) for analysis of included guidelines. RESULTS Fourteen full text guidelines were included for analysis. The included guidelines covered the period 2000-2014. Qualitative analysis of the included guidelines revealed two core themes: vulnerability and research ethics committee review. Within each of the two core themes, various categories and subcategories were identified. CONCLUSIONS Some concepts and terms identified in analyzed guidelines are used in an inconsistent manner and applied in different contexts. Conceptual clarity is needed in this area as well as empirical evidence to support the statements and requirements included in analyzed guidelines.
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Affiliation(s)
| | - Péter Kakuk
- Department of Behavioural Sciences, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Goran Mijaljica
- Department of Medical Humanities, University of Split School of Medicine, Split, Croatia
| | - Marcin Waligóra
- Department of Philosophy and Bioethics, REMEDY, Research Ethics in Medicine Study Group, Jagiellonian University Medical College, Kraków, Poland
| | - Dónal P. O’Mathúna
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
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Hunt M, Tansey CM, Anderson J, Boulanger RF, Eckenwiler L, Pringle J, Schwartz L. The Challenge of Timely, Responsive and Rigorous Ethics Review of Disaster Research: Views of Research Ethics Committee Members. PLoS One 2016; 11:e0157142. [PMID: 27327165 PMCID: PMC4915681 DOI: 10.1371/journal.pone.0157142] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/25/2016] [Indexed: 11/22/2022] Open
Abstract
Background Research conducted following natural disasters such as earthquakes, floods or hurricanes is crucial for improving relief interventions. Such research, however, poses ethical, methodological and logistical challenges for researchers. Oversight of disaster research also poses challenges for research ethics committees (RECs), in part due to the rapid turnaround needed to initiate research after a disaster. Currently, there is limited knowledge available about how RECs respond to and appraise disaster research. To address this knowledge gap, we investigated the experiences of REC members who had reviewed disaster research conducted in low- or middle-income countries. Methods We used interpretive description methodology and conducted in-depth interviews with 15 respondents. Respondents were chairs, members, advisors, or coordinators from 13 RECs, including RECs affiliated with universities, governments, international organizations, a for-profit REC, and an ad hoc committee established during a disaster. Interviews were analyzed inductively using constant comparative techniques. Results Through this process, three elements were identified as characterizing effective and high-quality review: timeliness, responsiveness and rigorousness. To ensure timeliness, many RECs rely on adaptations of review procedures for urgent protocols. Respondents emphasized that responsive review requires awareness of and sensitivity to the particularities of disaster settings and disaster research. Rigorous review was linked with providing careful assessment of ethical considerations related to the research, as well as ensuring independence of the review process. Conclusion Both the frequency of disasters and the conduct of disaster research are on the rise. Ensuring effective and high quality review of disaster research is crucial, yet challenges, including time pressures for urgent protocols, exist for achieving this goal. Adapting standard REC procedures may be necessary. However, steps should be taken to ensure that ethics review of disaster research remains diligent and thorough.
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Affiliation(s)
- Matthew Hunt
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
- Center for Interdisciplinary Research in Rehabilitation, Montreal, Quebec, Canada
- Humanitarian Health Ethics Research Group, McGill University, Montreal, Quebec, Canada, McMaster University, Hamilton, Ontario, Canada
- * E-mail:
| | - Catherine M. Tansey
- Humanitarian Health Ethics Research Group, McGill University, Montreal, Quebec, Canada, McMaster University, Hamilton, Ontario, Canada
| | - James Anderson
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Ontario, Canada
| | - Renaud F. Boulanger
- Humanitarian Health Ethics Research Group, McGill University, Montreal, Quebec, Canada, McMaster University, Hamilton, Ontario, Canada
- Biomedical Ethics Unit, McGill University, Montreal, Quebec, Canada
| | - Lisa Eckenwiler
- Department of Philosophy & Department of Health Administration and Policy, George Mason University, Fairfax, Virginia, United States of America
| | - John Pringle
- Humanitarian Health Ethics Research Group, McGill University, Montreal, Quebec, Canada, McMaster University, Hamilton, Ontario, Canada
| | - Lisa Schwartz
- Humanitarian Health Ethics Research Group, McGill University, Montreal, Quebec, Canada, McMaster University, Hamilton, Ontario, Canada
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
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Pelcastre-Villafuerte BE, Domínguez-Esponda R, Vázquez TTG. La investigación social en salud en un contexto de violencia: una mirada desde la ética. SAUDE E SOCIEDADE 2015. [DOI: 10.1590/s0104-12902015130180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Durante el sexenio presidencial 2006-2012 inició una lucha contra el narcotráfico, la cual continuó con el actual presidente y sigue ocupando uno de los primeros lugares en la agenda política de México. Esta lucha ha movilizado las fuerzas de seguridad nacional y sus consecuencias han traspasado el ámbito político y trastocado a la sociedad en su conjunto. Éste es tan sólo uno de los escenarios que enfrenta el país, históricos conflictos comunitarios y una atmósfera de violencia generalizada alimentada por secuestros, homicidios y diversas clases de crímenes, lo acompañan. Este ensayo reflexiona sobre la forma en que la investigación social, concretamente la fase del trabajo que se realiza en campo, se ha visto también afectada por este contexto. El trabajo expone algunos obstáculos que las personas que realizan trabajo de campo (investigadores, estudiantes, entrevistadores y encuestadores) tienen que enfrentar. Analiza de qué manera este contexto está afectando la investigación social que se lleva a cabo, comprometiendo seriamente los resultados y reflexiona desde la ética de la investigación, señalando la falta de medidas de protección para el personal que participa en este tipo de estudios.
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Gaillard JC, Gomez C. Post-disaster research: Is there gold worth the rush? JAMBA (POTCHEFSTROOM, SOUTH AFRICA) 2015; 7:1-6. [PMID: 38633845 PMCID: PMC11021869 DOI: 10.4102/jamba.v7i1.120] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 02/11/2015] [Indexed: 04/19/2024]
Affiliation(s)
- JC Gaillard
- School of Environment, University of Auckland, New Zealand
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15
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O'Mathúna D. Research ethics in the context of humanitarian emergencies. J Evid Based Med 2015; 8:31-5. [PMID: 25594722 DOI: 10.1111/jebm.12136] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2014] [Accepted: 10/28/2014] [Indexed: 01/11/2023]
Abstract
Research is needed to make responses to disasters and humanitarian emergencies more evidence-based. Such research must also adhere to the generally accepted principles of research ethics. While research into health interventions used in disasters raises distinctive ethical concerns, seven ethical principles developed for clinical research are applied here to disaster research. Practical examples from disaster settings are used to demonstrate how these ethical principles can be applied. This reveals that research ethics needs to be seen as much more than a mechanism to obtain ethical approval for research. Research ethics involves ethical principles and governance frameworks, but must also consider the role of ethical virtues in research. Virtues are essential to ensure that researchers do what they believe is ethically right and resist what is unethical. Research ethics that truly protects participants and promotes respect needs to include training in ethical virtues to ensure disaster research is carried out to the highest ethical standards. This article is based on a presentation at the Evidence Aid Symposium on 20 September 2014, in Hyderabad, India.
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Affiliation(s)
- Dónal O'Mathúna
- School of Nursing & Human Sciences, Dublin City University, Glasnevin, Dublin 9, Ireland
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16
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Biddison LD, Berkowitz KA, Courtney B, De Jong CMJ, Devereaux AV, Kissoon N, Roxland BE, Sprung CL, Dichter JR, Christian MD, Powell T. Ethical considerations: care of the critically ill and injured during pandemics and disasters: CHEST consensus statement. Chest 2015; 146:e145S-55S. [PMID: 25144262 DOI: 10.1378/chest.14-0742] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Mass critical care entails time-sensitive decisions and changes in the standard of care that it is possible to deliver. These circumstances increase provider uncertainty as well as patients' vulnerability and may, therefore, jeopardize disciplined, ethical decision-making. Planning for pandemics and disasters should incorporate ethics guidance to support providers who may otherwise make ad hoc patient care decisions that overstep ethical boundaries. This article provides consensus-developed suggestions about ethical challenges in caring for the critically ill or injured during pandemics or disasters. The suggestions in this article are important for all of those involved in any pandemic or disaster with multiple critically ill or injured patients, including front-line clinicians, hospital administrators, and public health or government officials. METHODS We adapted the American College of Chest Physicians (CHEST) Guidelines Oversight Committee's methodology to develop suggestions. Twenty-four key questions were developed, and literature searches were conducted to identify evidence for suggestions. The detailed literature reviews produced 144 articles. Based on their expertise within this domain, panel members also supplemented the literature search with governmental publications, interdisciplinary workgroup consensus documents, and other information not retrieved through PubMed. The literature in this field is not suitable to support evidence-based recommendations. Therefore, the panel developed expert opinion-based suggestions using a modified Delphi process. RESULTS We report the suggestions that focus on five essential domains: triage and allocation, ethical concerns of patients and families, ethical responsibilities to providers, conduct of research, and international concerns. CONCLUSIONS Ethics issues permeate virtually all aspects of pandemic and disaster response. We have addressed some of the most pressing issues, focusing on five essential domains: triage and allocation, ethical concerns of patients and families, ethical responsibilities to providers, conduct of research, and international concerns. Our suggestions reflect the consensus of the Task Force. We recognize, however, that some suggestions, including those related to end-of-life care, may be controversial. We highlight the need for additional research and dialogue in articulating values to guide health-care decisions during disasters.
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Dieltjens T, Moonens I, Van Praet K, De Buck E, Vandekerckhove P. A systematic literature search on psychological first aid: lack of evidence to develop guidelines. PLoS One 2014; 9:e114714. [PMID: 25503520 PMCID: PMC4264843 DOI: 10.1371/journal.pone.0114714] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Accepted: 11/12/2014] [Indexed: 11/18/2022] Open
Abstract
Background Providing psychological first aid (PFA) is generally considered to be an important element in preliminary care of disaster victims. Using the best available scientific basis for courses and educational materials, the Belgian Red Cross-Flanders wants to ensure that its volunteers are trained in the best way possible. Objective To identify effective PFA practices, by systematically reviewing the evidence in existing guidelines, systematic reviews and individual studies. Methods Systematic literature searches in five bibliographic databases (MEDLINE, PsycINFO, The Cochrane Library, PILOTS and G-I-N) were conducted from inception to July 2013. Results Five practice guidelines were included which were found to vary in the development process (AGREE II score 20–53%) and evidence base used. None of them provides solid evidence concerning the effectiveness of PFA practices. Additionally, two systematic reviews of PFA were found, both noting a lack of studies on PFA. A complementary search for individual studies, using a more sensitive search strategy, identified 11 237 references of which 102 were included for further full-text examination, none of which ultimately provides solid evidence concerning the effectiveness of PFA practices. Conclusion The scientific literature on psychological first aid available to date, does not provide any evidence about the effectiveness of PFA interventions. Currently it is impossible to make evidence-based guidelines about which practices in psychosocial support are most effective to help disaster and trauma victims.
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Affiliation(s)
- Tessa Dieltjens
- Centre for Evidence-based Practice, Belgian Red Cross-Flanders , Mechelen, Belgium
- * E-mail:
| | - Inge Moonens
- Psychosocial Intervention Service, Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Koen Van Praet
- Psychosocial Intervention Service, Belgian Red Cross-Flanders, Mechelen, Belgium
| | - Emmy De Buck
- Centre for Evidence-based Practice, Belgian Red Cross-Flanders , Mechelen, Belgium
| | - Philippe Vandekerckhove
- Centre for Evidence-based Practice, Belgian Red Cross-Flanders , Mechelen, Belgium
- Department of Public Health and Primary Care, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium
- Faculty of Medicine, University of Ghent, Ghent, Belgium
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Hunt M, Schwartz L, Pringle J, Boulanger R, Nouvet E, O'Mathúna D. A research agenda for humanitarian health ethics. PLOS CURRENTS 2014; 6:ecurrents.dis.8b3c24217d80f3975618fc9d9228a144. [PMID: 25687273 PMCID: PMC4191921 DOI: 10.1371/currents.dis.8b3c24217d80f3975618fc9d9228a144] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
This paper maps key research questions for humanitarian health ethics: the ethical dimensions of healthcare provision and public health activities during international responses to situations of humanitarian crisis. Development of this research agenda was initiated at the Humanitarian Health Ethics Forum (HHE Forum) convened in Hamilton, Canada in November 2012. The HHE Forum identified priority avenues for advancing policy and practice for ethics in humanitarian health action. The main topic areas examined were: experiences and perceptions of humanitarian health ethics; training and professional development initiatives for humanitarian health ethics; ethics support for humanitarian health workers; impact of policies and project structures on humanitarian health ethics; and theoretical frameworks and ethics lenses. Key research questions for each topic area are presented, as well as proposed strategies for advancing this research agenda. Pursuing the research agenda will help strengthen the ethical foundations of humanitarian health action.
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Affiliation(s)
- Matthew Hunt
- Centre for Interdisciplinary Research in Rehabilitation McGill University
| | | | | | | | - Elysée Nouvet
- Humanitarian Healthcare Ethics research group McMaster University
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Kar-Purkayastha I, Clarke M, Murray V. DEALING WITH DISASTER DATABASES - WHAT CAN WE LEARN FROM HEALTH AND SYSTEMATIC REVIEWS?: Application in practice. PLOS CURRENTS 2011; 3:RRN1272. [PMID: 22033606 PMCID: PMC3201635 DOI: 10.1371/currents.rrn1272] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/07/2011] [Indexed: 12/22/2022]
Abstract
There is an increasing move towards facilitating the use of research findings in policy and practice relating to disaster risk reduction and response. One of the key issues is the quality of the evidence available to decision-makers. Disaster databases, as a key resource, represent a tremendous investment of effort and goodwill. However, their usefulness is limited by the variability in how they are compiled, differences in the output they produce, a general lack of comparability and standardization, and the fact that they might produce different results due to the ways they have been created or by chance. One possible solution to this, which has been applied successfully in evidence synthesis in health care is the systematic review. In this study we attempt to show how the systematic review process may be applied to information and data that is held in disaster databases. We demonstrate that systematic reviews of disaster databases can be achieved in a technical sense and the potential value of such reviews, but also discuss the practical difficulties that arise. Key words Systematic review, evidence, disaster database
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Affiliation(s)
- Ishani Kar-Purkayastha
- Specialist Registrar in Public Health & Clinical Toxicology, Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency; Director, All Ireland Hub for Trials Methodology Research; Evidence Aid and Head of Extreme Events and Health Protection Centre for Radiation, Chemicals and Environmental Hazards, Health Protection Agency, London UK
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