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Sulaieva ON, Artamonova O, Dudin O, Semikov R, Urakov D, Zakharash Y, Kacharian A, Strilka V, Mykhalchuk I, Haidamak O, Serdyukova O, Kobyliak N. Ethical navigation of biobanking establishment in Ukraine: learning from the experience of developing countries. JOURNAL OF MEDICAL ETHICS 2023:jme-2023-109129. [PMID: 37945338 DOI: 10.1136/jme-2023-109129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023]
Abstract
Building a biobank network in developing countries is essential to foster genomic research and precision medicine for patients' benefit. However, there are serious barriers to establishing biobanks in low-income and middle-income countries (LMICs), including Ukraine. Here, we outline key barriers and essential milestones for the successful expansion of biobanks, genomic research and personalised medicine in Ukraine, drawing from the experience of other LMICs. A lack of legal and ethical governance in conjunction with limited awareness about biobanking and community distrust are the principal threats to establishing biobanks. The experiences of LMICs suggest that Ukraine urgently needs national guidelines covering ethical and legal aspects of biospecimen-related research. National guidelines must be consistent with international ethical recommendations for safeguarding participants' rights, welfare and privacy. Additionally, efforts to educate and engage physicians and patient communities are essential for achieving biobanking goals and benefits for precision medicine and future patients.
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Affiliation(s)
- Oksana N Sulaieva
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
- Doctorate in Bioethics, Neiswanger Institute for Bioethics, Loyola University Chicago, Chicago, Illinois, USA
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
| | | | - Oleksandr Dudin
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
| | - Rostyslav Semikov
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | - Dmytro Urakov
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
| | | | | | | | - Ivan Mykhalchuk
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | | | - Olena Serdyukova
- Ukrainian Association of Research Biobanks, Kyiv, Ukraine
- Audubon Bioscience, Kyiv, Ukraine
| | - Nazarii Kobyliak
- Department of Pathology, Medical Laboratory CSD, Kyiv, Ukraine
- Department of Endocrinology, Bogomolets National Medical University, Kyiv, Ukraine
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Maxwell L, Shreedhar P, Dauga D, McQuilton P, Terry RF, Denisiuk A, Molnar-Gabor F, Saxena A, Sansone SA. FAIR, ethical, and coordinated data sharing for COVID-19 response: a scoping review and cross-sectional survey of COVID-19 data sharing platforms and registries. Lancet Digit Health 2023; 5:e712-e736. [PMID: 37775189 PMCID: PMC10552001 DOI: 10.1016/s2589-7500(23)00129-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 04/27/2023] [Accepted: 07/05/2023] [Indexed: 10/01/2023]
Abstract
Data sharing is central to the rapid translation of research into advances in clinical medicine and public health practice. In the context of COVID-19, there has been a rush to share data marked by an explosion of population-specific and discipline-specific resources for collecting, curating, and disseminating participant-level data. We conducted a scoping review and cross-sectional survey to identify and describe COVID-19-related platforms and registries that harmonise and share participant-level clinical, omics (eg, genomic and metabolomic data), imaging data, and metadata. We assess how these initiatives map to the best practices for the ethical and equitable management of data and the findable, accessible, interoperable, and reusable (FAIR) principles for data resources. We review gaps and redundancies in COVID-19 data-sharing efforts and provide recommendations to build on existing synergies that align with frameworks for effective and equitable data reuse. We identified 44 COVID-19-related registries and 20 platforms from the scoping review. Data-sharing resources were concentrated in high-income countries and siloed by comorbidity, body system, and data type. Resources for harmonising and sharing clinical data were less likely to implement FAIR principles than those sharing omics or imaging data. Our findings are that more data sharing does not equate to better data sharing, and the semantic and technical interoperability of platforms and registries harmonising and sharing COVID-19-related participant-level data needs to improve to facilitate the global collaboration required to address the COVID-19 crisis.
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Affiliation(s)
- Lauren Maxwell
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany.
| | - Priya Shreedhar
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Peter McQuilton
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, Oxford, UK
| | - Robert F Terry
- TDR, the Special Programme for Research and Training in Tropical Diseases, WHO, Geneva, Switzerland
| | - Alisa Denisiuk
- Faculty of Chemistry, Georg-August-Universität Göttingen, Göttingen, Germany
| | | | | | - Susanna-Assunta Sansone
- Oxford e-Research Centre, Department of Engineering Science, University of Oxford, Oxford, UK
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Mthembu Z, Mogaka JJO, Chimbari MJ. Community engagement processes in low- and middle-income countries health research settings: a systematic review of the literature. BMC Health Serv Res 2023; 23:457. [PMID: 37158864 PMCID: PMC10169489 DOI: 10.1186/s12913-023-09466-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 04/27/2023] [Indexed: 05/10/2023] Open
Abstract
BACKGROUND Community Engagement is an important ethical imperative in research. Although substantial research emphasizes its real value and strategic importance, much of the available literature focuses primarily on the success of community participation, with little emphasis given to specific community engagement processes, mechanisms and strategies in relation to intended outcomes in research environments. The systematic literature review's objective was to explore the nature of community engagement processes, strategies and approaches in health research settings in low- and middle-income countries. METHODS The systematic literature review design was informed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched for peer-reviewed, English-language literature published between January 2011 and December 2021 through three databases on the internet (PubMed, Web of Science and Google Scholar). The terms "community engagement," "community involvement," "participation," "research settings," and "low- and middle-income countries" were merged in the search. RESULTS The majority of publications [8/10] were led by authors from low- and middle-income countries, with many of them, [9/10] failing to continuously include important aspects of study quality. Even though consultation and information sessions were less participatory, articles were most likely to describe community engagement in these types of events. The articles covered a wide range of health issues, but the majority were concerned with infectious diseases such as malaria, human immunodeficiency virus, and tuberculosis, followed by studies on the environment and broader health factors. Articles were largely under-theorized. CONCLUSIONS Despite the lack of theoretical underpinnings for various community engagement processes, strategies and approaches, community engagement in research settings was variable. Future studies should go deeper into community engagement theory, acknowledge the power dynamics underpin community engagement, and be more practical about the extent to which communities may participate.
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Affiliation(s)
- Zinhle Mthembu
- University of KwaZulu-Natal. College of Health Science, School of Nursing and Public Health, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041, South Africa.
- Faculty of Humanities and Social Sciences, Anthropology and Development Studies, University of Zululand, 1 Main Road, Vulindlela, KwaDlangezwa, 3886, South Africa.
| | - John J O Mogaka
- University of KwaZulu-Natal. College of Health Science, School of Nursing and Public Health, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041, South Africa
| | - Moses J Chimbari
- University of KwaZulu-Natal. College of Health Science, School of Nursing and Public Health, Howard College, 269 Mazisi Kunene Road, Berea, Durban, 4041, South Africa
- Great Zimbabwe University, Masvingo, P.O. Box 1234, Zimbabwe
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Evertsz N, Bull S, Pratt B. What constitutes equitable data sharing in global health research? A scoping review of the literature on low-income and middle-income country stakeholders' perspectives. BMJ Glob Health 2023; 8:bmjgh-2022-010157. [PMID: 36977523 PMCID: PMC10069505 DOI: 10.1136/bmjgh-2022-010157] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 02/23/2023] [Indexed: 03/30/2023] Open
Abstract
INTRODUCTION Despite growing consensus on the need for equitable data sharing, there has been very limited discussion about what this should entail in practice. As a matter of procedural fairness and epistemic justice, the perspectives of low-income and middle-income country (LMIC) stakeholders must inform concepts of equitable health research data sharing. This paper investigates published perspectives in relation to how equitable data sharing in global health research should be understood. METHODS We undertook a scoping review (2015 onwards) of the literature on LMIC stakeholders' experiences and perspectives of data sharing in global health research and thematically analysed the 26 articles included in the review. RESULTS We report LMIC stakeholders' published views on how current data sharing mandates may exacerbate inequities, what structural changes are required in order to create an environment conducive to equitable data sharing and what should comprise equitable data sharing in global health research. CONCLUSIONS In light of our findings, we conclude that data sharing under existing mandates to share data (with minimal restrictions) risks perpetuating a neocolonial dynamic. To achieve equitable data sharing, adopting best practices in data sharing is necessary but insufficient. Structural inequalities in global health research must also be addressed. It is thus imperative that the structural changes needed to ensure equitable data sharing are incorporated into the broader dialogue on global health research.
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Affiliation(s)
| | - Susan Bull
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Psychological Medicine, The University of Auckland, Auckland, New Zealand
| | - Bridget Pratt
- Queensland Bioethics Centre, Australian Catholic University, Banyo, Queensland, Australia
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Maxwell L, Chamorro JB, Leegstra LM, Laguna HS, Miranda Montoya MC. "How about me giving blood for the COVID vaccine and not being able to get vaccinated?" A cognitive interview study on understanding of and agreement with broad consent for future use of data and samples in Colombia and Nicaragua. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001253. [PMID: 37195974 DOI: 10.1371/journal.pgph.0001253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/28/2023] [Indexed: 05/19/2023]
Abstract
Broad consent for future use, wherein researchers ask participants for permission to share participant-level data and samples collected within the study for purposes loosely related to the study objectives, is central to enabling ethical data and sample reuse. Ensuring that participants understand broad consent-related language is key to maintaining trust in the study and public health research. We conducted 52 cognitive interviews to explore cohort research participants' and their parents' understanding of the broad consent-related language in the University of California at Berkeley template informed consent (IC) form for biomedical research. Participants and their parents were recruited from long-standing infectious disease cohort studies in Nicaragua and Colombia and interviewed during the COVID-19 pandemic. We conducted semi-structured interviews to assess participants' agreement with the key concepts in the IC after clarifying them through the cognitive interview. Participants did not understand abstract concepts, including collecting and reusing genetic data. Participants wanted to learn about incidental findings, future users and uses. Trust in the research team and the belief that sharing could lead to new vaccines or treatments were critical to participant support for data and sample sharing. Participants highlighted the importance of data and sample sharing for COVID-19 response and equitable access to vaccines and treatments developed through sharing. Our findings on participants' understanding of broad consent and preferences for data and sample sharing can help inform researchers and ethics review committees working to enable ethical and equitable data and sample sharing.
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Affiliation(s)
- Lauren Maxwell
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | | | - Luz Marina Leegstra
- Heidelberger Institut für Global Health, Universitätsklinikum Heidelberg, Heidelberg, Germany
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Cumyn A, Ménard JF, Barton A, Dault R, Lévesque F, Ethier JF. Patients and Members of the Public’s Wishes Regarding Transparency in the Context of Secondary Use of Health Data: A Scoping Review (Preprint). J Med Internet Res 2022; 25:e45002. [PMID: 37052967 PMCID: PMC10141314 DOI: 10.2196/45002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 02/09/2023] [Accepted: 03/03/2023] [Indexed: 03/06/2023] Open
Abstract
BACKGROUND Secondary use of health data has reached unequaled potential to improve health systems governance, knowledge, and clinical care. Transparency regarding this secondary use is frequently cited as necessary to address deficits in trust and conditional support and to increase patient awareness. OBJECTIVE We aimed to review the current published literature to identify different stakeholders' perspectives and recommendations on what information patients and members of the public want to learn about the secondary use of health data for research purposes and how and in which situations. METHODS Using PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines, we conducted a scoping review using Medline, CINAHL, PsycINFO, Scopus, Cochrane Library, and PubMed databases to locate a broad range of studies published in English or French until November 2022. We included articles reporting a stakeholder's perspective or recommendations of what information patients and members of the public want to learn about the secondary use of health data for research purposes and how or in which situations. Data were collected and analyzed with an iterative thematic approach using NVivo. RESULTS Overall, 178 articles were included in this scoping review. The type of information can be divided into generic and specific content. Generic content includes information on governance and regulatory frameworks, technical aspects, and scientific aims. Specific content includes updates on the use of one's data, return of results from individual tests, information on global results, information on data sharing, and how to access one's data. Recommendations on how to communicate the information focused on frequency, use of various supports, formats, and wording. Methods for communication generally favored broad approaches such as nationwide publicity campaigns, mainstream and social media for generic content, and mixed approaches for specific content including websites, patient portals, and face-to-face encounters. Content should be tailored to the individual as much as possible with regard to length, avoidance of technical terms, cultural competence, and level of detail. Finally, the review outlined 4 major situations where communication was deemed necessary: before a new use of data, when new test results became available, when global research results were released, and in the advent of a breach in confidentiality. CONCLUSIONS This review highlights how different types of information and approaches to communication efforts may serve as the basis for achieving greater transparency. Governing bodies could use the results: to elaborate or evaluate strategies to educate on the potential benefits; to provide some knowledge and control over data use as a form of reciprocity; and as a condition to engage citizens and build and maintain trust. Future work is needed to assess which strategies achieve the greatest outreach while striking a balance between meeting information needs and use of resources.
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Affiliation(s)
- Annabelle Cumyn
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-Frédéric Ménard
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Faculté de droit, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Adrien Barton
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Institut de recherche en informatique de Toulouse, Toulouse, France
| | - Roxanne Dault
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Frédérique Lévesque
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
| | - Jean-François Ethier
- Département de médecine, Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
- Groupe de recherche interdisciplinaire en informatique de la santé, Faculté des sciences/Faculté de médecine et des sciences de la santé, Université de Sherbrooke, Sherbrooke, QC, Canada
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Buchbinder M, Juengst E, Rennie S, Blue C, Rosen DL. Advancing a Data Justice Framework for Public Health Surveillance. AJOB Empir Bioeth 2022; 13:205-213. [PMID: 35442141 PMCID: PMC10777676 DOI: 10.1080/23294515.2022.2063997] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Bioethical debates about privacy, big data, and public health surveillance have not sufficiently engaged the perspectives of those being surveilled. The data justice framework suggests that big data applications have the potential to create disproportionate harm for socially marginalized groups. Using examples from our research on HIV surveillance for individuals incarcerated in jails, we analyze ethical issues in deploying big data in public health surveillance. METHODS We conducted qualitative, semi-structured interviews with 24 people living with HIV who had been previously incarcerated in county jails about their perspectives on and experiences with HIV surveillance, as part of a larger study to characterize ethical considerations in leveraging big data techniques to enhance continuity of care for incarcerated people living with HIV. RESULTS Most participants expressed support for the state health department tracking HIV testing results and viral load data. Several viewed HIV surveillance as a violation of privacy, and several had actively avoided contact from state public health outreach workers. Participants were most likely to express reservations about surveillance when they viewed the state's motives as self-interested. Perspectives highlight the mistrust that structurally vulnerable people may have in the state's capacity to act as an agent of welfare. Findings suggest that adopting a nuanced, context-sensitive view on surveillance is essential. CONCLUSIONS Establishing trustworthiness through interpersonal interactions with public health personnel is important to reversing historical legacies of harm to racial minorities and structurally vulnerable groups. Empowering stakeholders to participate in the design and implementation of data infrastructure and governance is critical for advancing a data justice agenda, and can offset privacy concerns. The next steps in advancing the data justice framework in public health surveillance will be to innovate ways to represent the voices of structurally vulnerable groups in the design and governance of big data initiatives.
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Affiliation(s)
- Mara Buchbinder
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Eric Juengst
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Stuart Rennie
- Department of Social Medicine, Center for Bioethics, UNC—Chapel Hill
| | - Colleen Blue
- Institute for Global Health and Infectious Diseases, UNC—Chapel Hill
| | - David L. Rosen
- Division of Infectious Diseases, Department of Medicine, UNC—Chapel Hill
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Chi PC, Owino EA, Jao I, Bejon P, Kapulu M, Marsh V, Kamuya D. Ethical considerations around volunteer payments in a malaria human infection study in Kenya: an embedded empirical ethics study. BMC Med Ethics 2022; 23:46. [PMID: 35443642 PMCID: PMC9019790 DOI: 10.1186/s12910-022-00783-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
Human Infection Studies (HIS) have emerged as an important research approach with the potential to fast track the global development of vaccines and treatments for infectious diseases, including in low resource settings. Given the high level of burdens involved in many HIS, particularly prolonged residency and biological sampling requirements, it can be challenging to identify levels of study payments that provide adequate compensation but avoid 'undue' levels of inducement to participate. Through this embedded ethics study, involving 97 healthy volunteers and other research stakeholders in a malaria HIS programme in Kenya, and using in-depth interviews, focus group discussions and observations during and after a malaria HIS, we give a grounded account of ethical issues emerging in relation to study payments in this setting. While careful community, national, international scientific and ethics review processes meant that risks of serious harm were highly unlikely, the levels of motivation to join HIS seen could raise concerns about study payments being too high. Particular value was placed on the reliability, rather than level, of study payment in this setting, where subsistence livelihoods are common. Study volunteers were generally clear about the study aims at the point of recruitment, and this knowledge was retained over a year later, although most reported experiencing more burdens than anticipated at enrolment. Strict study screening procedures, regular clinical and laboratory monitoring of volunteers, with prompt treatment with antimalarial at predetermined endpoints suggested that the risks of serious harm were highly unlikely. Ethical concerns emerged in relation to volunteers' attempts to conceal symptoms, hoping to prolong residency periods and increase study payments; and volunteers making decisions that compromised important family relationships and personal values. Our findings support an interpretation that, although study volunteers were keen to join the study to access cash payments, they also paid attention to other features of the study and the general clinical research landscape, including levels of risk associated with study participation. Overall, our analysis shows that the ethical concerns emerging from the study payments can be addressed through practical measures, hinged on reducing burdens and strengthening communication, raising important issues for research policy and planning.
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Affiliation(s)
- Primus Che Chi
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya.
| | - Esther Awuor Owino
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Irene Jao
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
| | - Philip Bejon
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University Oxford, Oxford, UK
| | - Melissa Kapulu
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University Oxford, Oxford, UK
| | - Vicki Marsh
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University Oxford, Oxford, UK
| | - Dorcas Kamuya
- Centre for Geographic Medicine Research (Coast), Kenya Medical Research Institute-Wellcome Trust Research Programme, Kilifi, Kenya
- Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University Oxford, Oxford, UK
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Sinnatwah JD, Kenneh H, Coker AA, Harmon-Gray WM, Zankah J, Day L, Hubbell E, Murphy MJ, Izzo M, Kong D, Sylwester P, Long Q, Bertozzi E, Skrip LA. Participatory Design and Process Testing to Optimize Utility, Usability, and Acceptability of a Mobile Game for Promoting Evidence-Driven Public Health Decision-Making in Resource-Constrained Settings. Front Digit Health 2022; 3:788557. [PMID: 35059686 PMCID: PMC8763845 DOI: 10.3389/fdgth.2021.788557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Innovative game-based training methods that leverage the ubiquity of cellphones and familiarity with phone-based interfaces have the potential to transform the training of public health practitioners in low-income countries such as Liberia. This article describes the design, development, and testing of a prototype of the Figure It Out mobile game. The prototype game uses a disease outbreak scenario to promote evidence-based decision-making in determining the causative agent and prescribing intervention measures to minimize epidemiological and logistical burdens in resource-limited settings. An initial prototype of the game developed by the US team was playtested and evaluated by focus groups with 20 University of Liberia Masters of Public Health (UL MPH) students. Results demonstrate that the learning objectives—improving search skills for identifying scientific evidence and considering evidence before decision-making during a public health emergency—were considered relevant and important in a setting that has repeatedly and recently experienced severe threats to public health. However, some of the game mechanics that were thought to enhance engagement such as trial-and-error and choose-your-own-path gameplay, were perceived by the target audience as distracting or too time-consuming, particularly in the context of a realistic emergency scenario. Gameplay metrics that mimicked real-world situations around lives lost, money spent, and time constraints during public health outbreaks were identified as relatable and necessary considerations. Our findings reflect cultural differences between the game development team and end users that have emphasized the need for end users to have an integral part of the design team; this formative evaluation has critically informed next steps in the iterative development process. Our multidisciplinary, cross-cultural and cross-national design team will be guided by Liberia-based public health students and faculty, as well as community members who represent our end user population in terms of experience and needs. These stakeholders will make key decisions regarding game objectives and mechanics, to be vetted and implemented by game design experts, epidemiologists, and software developers.
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Affiliation(s)
- James Douglas Sinnatwah
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia, Liberia
| | - Hajah Kenneh
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia, Liberia
| | - Alvan A. Coker
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia, Liberia
| | - Wahdae-Mai Harmon-Gray
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia, Liberia
- Ministry of Health, Monrovia, Liberia
| | - Joelyn Zankah
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia, Liberia
| | - Liam Day
- Department of Game Design and Development, Quinnipiac University, Hamden, CT, United States
| | - Emma Hubbell
- Department of Game Design and Development, Quinnipiac University, Hamden, CT, United States
| | - Michael J. Murphy
- Department of Game Design and Development, Quinnipiac University, Hamden, CT, United States
| | - Mandy Izzo
- Institute for Disease Modeling, Global Health, Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - David Kong
- Institute for Disease Modeling, Global Health, Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Peter Sylwester
- Institute for Disease Modeling, Global Health, Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Qinghua Long
- Institute for Disease Modeling, Global Health, Bill and Melinda Gates Foundation, Seattle, WA, United States
| | - Elena Bertozzi
- Department of Game Design and Development, Quinnipiac University, Hamden, CT, United States
- *Correspondence: Elena Bertozzi
| | - Laura A. Skrip
- School of Public Health, College of Health Sciences, University of Liberia, Monrovia, Liberia
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Shah SK, Gross M, Nebeker C. Optimizing Ethics Engagement in Research: Learning from the Ethical Complexities of Studying Opioid Use in Pregnancy. THE JOURNAL OF LAW, MEDICINE & ETHICS : A JOURNAL OF THE AMERICAN SOCIETY OF LAW, MEDICINE & ETHICS 2022; 50:339-347. [PMID: 35894577 DOI: 10.1017/jme.2022.61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Research on opioid use in pregnancy is critically important to understand how the opioid epidemic has affected a generation of children, but also raises significant ethical and legal challenges. Embedded ethicists can help to fill the gaps in ethics oversight for such research, but further guidance is needed to help strike the balance between integration and independence.
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Affiliation(s)
- Seema K Shah
- LURIE CHILDREN'S HOSPITAL AND DEPARTMENT OF PEDIATRICS, NORTHWESTERN UNIVERSITY, CHICAGO, ILLINOIS, USA
| | - Marielle Gross
- DEPARTMENT OF OBSTETRICS, GYNECOLOGY, AND REPRODUCTIVE SCIENCES, UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE, PITTSBURGH, PENNSYLVANIA, USA
| | - Camille Nebeker
- SCHOOL OF PUBLIC HEALTH AND UC SAN DIEGO RESEARCH ETHICS PROGRAM, UNIVERSITY OF CALIFORNIA, SAN DIEGO, LA JOLLA, CALIFORNIA, USA
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Marzouki A, Mellouli S, Daniel S. Understanding issues with stakeholders participation processes : A conceptual model of SPPs' dimensions of issues. GOVERNMENT INFORMATION QUARTERLY 2022. [DOI: 10.1016/j.giq.2022.101668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Chowdhury G, McLeod J, Lihoma P, Teferra S, Wato R. Promoting access to indigenous information in Africa: Challenges and requirements. INFORMATION DEVELOPMENT 2021. [DOI: 10.1177/02666669211048488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The United Nations Sustainable Development Goal SDG16.10 advocates for ensuring public access to information, yet knowledge access and sharing are some of the key challenges in many countries, especially in Africa. The African Union Agenda 2063 strongly recommends access to African indigenous, cultural information to promote sustainable development but how might this be achieved? This paper shares findings from a project - NetDiploma - that built an international multi-stakeholder network of experts, professionals and various user communities to mobilize and share knowledge to explore the requirements for promoting access to cultural heritage and government information held in memory institutions, such as archives, for everyone in Africa. It identifies the key enablers and challenges associated with the long-term goal of making African government, indigenous and cultural heritage information accessible online in the form of a Digital Public Library of Africa (DPLAf) and the research and development required to realise this vision.
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Affiliation(s)
| | | | | | | | - Richard Wato
- Kenya National Archives and Documentation Service
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13
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Molyneux S, Sukhtankar P, Thitiri J, Njeru R, Muraya K, Sanga G, Walson JL, Berkley J, Kelley M, Marsh V. Model for developing context-sensitive responses to vulnerability in research: managing ethical dilemmas faced by frontline research staff in Kenya. BMJ Glob Health 2021; 6:e004937. [PMID: 34244204 PMCID: PMC8268889 DOI: 10.1136/bmjgh-2021-004937] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 05/20/2021] [Indexed: 01/02/2023] Open
Abstract
Health research in low-resource settings often involves individuals and populations defined as 'vulnerable'. There is growing attention in the literature to the ethical dilemmas that frontline research staff face while conducting such research. However, there is little documented as to how research staff might support one another in identifying and handling these dilemmas in different contexts. Over the course of conducting empirical ethics research embedded in the Childhood Acute Illness & Nutrition Network, we developed an approach to examine and respond to the ethical issues and dilemmas faced by the study teams, particularly frontline staff. In this paper we describe the specific tools and approach we developed, which centred on regular cross-team ethics reflection sessions, and share lessons learnt. We suggest that all studies involving potentially vulnerable participants should incorporate activities and processes to support frontline staff in identifying, reflecting on and responding to ethical dilemmas, throughout studies. We outline the resources needed to do this and share piloted tools for further adaptation and evaluation. Such initiatives should complement and feed into-and certainly not in any way replace or substitute for-strong institutional ethics review, safeguarding and health and safety policies and processes, as well broader staff training and career support initiatives.
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Affiliation(s)
- Sassy Molyneux
- KEMRI-Wellcome Research Programme, Centre for Geographic Medicine Research Coast, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Priya Sukhtankar
- Department of Child Health, Gloucester Hospitals NHS Foundation Trust, Gloucester, UK
| | - Johnstone Thitiri
- KEMRI-Wellcome Research Programme, Centre for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Rita Njeru
- Ethox Centre and Wellcome Centre for Ethics & Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kui Muraya
- Kemri-Wellcome Trust, Centre for Geographic Medicine Research Coast, Nairobi, Kenya
| | - Gladys Sanga
- KEMRI-Wellcome Research Programme, Centre for Geographic Medicine Research Coast, Kilifi, Kenya
| | - Judd L Walson
- Department of Global Health, University of Washington, Seattle, Washington, USA
| | - James Berkley
- KEMRI-Wellcome Research Programme, Centre for Geographic Medicine Research Coast, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Maureen Kelley
- Ethox Centre and Wellcome Centre for Ethics & Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Vicki Marsh
- KEMRI-Wellcome Research Programme, Centre for Geographic Medicine Research Coast, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
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14
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African genetic diversity and adaptation inform a precision medicine agenda. Nat Rev Genet 2021; 22:284-306. [PMID: 33432191 DOI: 10.1038/s41576-020-00306-8] [Citation(s) in RCA: 64] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2020] [Indexed: 01/29/2023]
Abstract
The deep evolutionary history of African populations, since the emergence of modern humans more than 300,000 years ago, has resulted in high genetic diversity and considerable population structure. Selected genetic variants have increased in frequency due to environmental adaptation, but recent exposures to novel pathogens and changes in lifestyle render some of them with properties leading to present health liabilities. The unique discoverability potential from African genomic studies promises invaluable contributions to understanding the genomic and molecular basis of health and disease. Globally, African populations are understudied, and precision medicine approaches are largely based on data from European and Asian-ancestry populations, which limits the transferability of findings to the continent of Africa. Africa needs innovative precision medicine solutions based on African data that use knowledge and implementation strategies aligned to its climatic, cultural, economic and genomic diversity.
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15
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Hamdi Y, Zass L, Othman H, Radouani F, Allali I, Hanachi M, Okeke CJ, Chaouch M, Tendwa MB, Samtal C, Mohamed Sallam R, Alsayed N, Turkson M, Ahmed S, Benkahla A, Romdhane L, Souiai O, Tastan Bishop Ö, Ghedira K, Mohamed Fadlelmola F, Mulder N, Kamal Kassim S. Human OMICs and Computational Biology Research in Africa: Current Challenges and Prospects. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2021; 25:213-233. [PMID: 33794662 DOI: 10.1089/omi.2021.0004] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Following the publication of the first human genome, OMICs research, including genomics, transcriptomics, proteomics, and metagenomics, has been on the rise. OMICs studies revealed the complex genetic diversity among human populations and challenged our understandings of genotype-phenotype correlations. Africa, being the cradle of the first modern humans, is distinguished by a large genetic diversity within its populations and rich ethnolinguistic history. However, the available human OMICs tools and databases are not representative of this diversity, therefore creating significant gaps in biomedical research. African scientists, students, and publics are among the key contributors to OMICs systems science. This expert review examines the pressing issues in human OMICs research, education, and development in Africa, as seen through a lens of computational biology, public health relevant technology innovation, critically-informed science governance, and how best to harness OMICs data to benefit health and societies in Africa and beyond. We underscore the disparities between North and Sub-Saharan Africa at different levels. A harmonized African ethnolinguistic classification would help address annotation challenges associated with population diversity. Finally, building on the existing strategic research initiatives, such as the H3Africa and H3ABioNet Consortia, we highly recommend addressing large-scale multidisciplinary research challenges, strengthening research collaborations and knowledge transfer, and enhancing the ability of African researchers to influence and shape national and international research, policy, and funding agendas. This article and analysis contribute to a deeper understanding of past and current challenges in the African OMICs innovation ecosystem, while also offering foresight on future innovation trajectories.
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Affiliation(s)
- Yosr Hamdi
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia.,Laboratory of Human and Experimental Pathology, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Lyndon Zass
- Computational Biology Division, Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, CIDRI Africa Wellcome Trust Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Houcemeddine Othman
- Sydney Brenner Institute for Molecular Bioscience, University of the Witwatersrand, Johannesburg, South Africa
| | - Fouzia Radouani
- Chlamydiae and Mycoplasmas Laboratory, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Imane Allali
- Computational Biology Division, Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, CIDRI Africa Wellcome Trust Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Laboratory of Human Pathologies Biology, Department of Biology, Faculty of Sciences, and Genomic Center of Human Pathologies, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat, Morocco
| | - Mariem Hanachi
- Laboratory of Bioinformatics, Biomathematics and Biostatistics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia.,Faculty of Science of Bizerte, Zarzouna, University of Carthage, Tunis, Tunisia
| | - Chiamaka Jessica Okeke
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda, South Africa
| | - Melek Chaouch
- Laboratory of Bioinformatics, Biomathematics and Biostatistics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Maureen Bilinga Tendwa
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda, South Africa
| | - Chaimae Samtal
- Laboratory of Biotechnology, Environment, Agri-food and Health, Faculty of Sciences Dhar El Mahraz-Sidi Mohammed Ben Abdellah University, Fez, Morocco.,University of Mohamed Premier, Oujda, Morocco
| | - Reem Mohamed Sallam
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt.,Department of Basic Medical Sciences, Faculty of Medicine, Galala University, Suez, Egypt
| | - Nihad Alsayed
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Michael Turkson
- The National Institute for Mathematical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samah Ahmed
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Alia Benkahla
- Laboratory of Bioinformatics, Biomathematics and Biostatistics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Lilia Romdhane
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia.,Faculty of Science of Bizerte, Zarzouna, University of Carthage, Tunis, Tunisia
| | - Oussema Souiai
- Laboratory of Bioinformatics, Biomathematics and Biostatistics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Özlem Tastan Bishop
- Research Unit in Bioinformatics (RUBi), Department of Biochemistry and Microbiology, Rhodes University, Makhanda, South Africa
| | - Kais Ghedira
- Laboratory of Bioinformatics, Biomathematics and Biostatistics, Institut Pasteur de Tunis, Université Tunis El Manar, Tunis, Tunisia
| | - Faisal Mohamed Fadlelmola
- Centre for Bioinformatics and Systems Biology, Faculty of Science, University of Khartoum, Khartoum, Sudan
| | - Nicola Mulder
- Computational Biology Division, Department of Integrative Biomedical Sciences, Institute of Infectious Disease and Molecular Medicine, CIDRI Africa Wellcome Trust Centre, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Samar Kamal Kassim
- Department of Medical Biochemistry and Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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16
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Matandika L, Ngóngóla RT, Mita K, Manda-Taylor L, Gooding K, Mwale D, Masiye F, Mfutso-Bengo J. A qualitative study exploring stakeholder perspectives on the use of biological samples for future unspecified research in Malawi. BMC Med Ethics 2020; 21:61. [PMID: 32689995 PMCID: PMC7372640 DOI: 10.1186/s12910-020-00503-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is growing interest in the collection, storage and reuse of biological samples for future research. Storage and future use of biological samples raise ethical concerns and questions about approaches that safeguard the interests of participants. The situation is further complicated in Africa where there is a general lack of governing ethical frameworks that could guide the research community on appropriate approaches for sample storage and use. Furthermore, there is limited empirical data to guide development of such frameworks. A qualitative study to address this gap was conducted with key stakeholders in Malawi to understand their experiences and perspectives regarding storage and usage of samples for future research. METHODS This study conducted 13 in-depth interviews with ethics committee members, regulators and researchers, and five focus group discussions with community representatives and clinical trial participants in Malawi. Interviews and focus group discussions were audio-recorded, transcribed verbatim, and thematically analysed. RESULTS On the current regulatory guidelines that governs the collection, storage and reuse of samples in Malawi, participants highlighted their different understanding of it, with some indicating that it prohibited the reuse and sharing of samples, while others believed it permitted. Views on the informed consent model used in Malawi, some stakeholders expressed that the current model limited options for sample contributors regarding future use. Researchers supported storing samples for future use in order to maximize their value and reduce research costs. However, they expressed concern over the exportation of samples highlighting that it could lead to misuse and would not support the development of research capacity within Malawi. They recommended use of broad consent or tiered consent and establishment of biobanks to address these concerns. CONCLUSIONS Study findings highlighted the need for a review of the current regulatory guideline and the development of infrastructure to support the use of stored biological samples for future use among the research community in Malawi. At the moment, there are ethical and practical concerns arising from the collection, storage and secondary use of biological samples make it hard to reconcile scientific progress and the protection of participants.
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Affiliation(s)
- Limbanazo Matandika
- Centre for Bioethics in Eastern and Southern Africa, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi.
| | - Ruby Tionenji Ngóngóla
- Centre for Bioethics in Eastern and Southern Africa, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Khama Mita
- Centre for Bioethics in Eastern and Southern Africa, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi.,College of Medicine Research Ethics Committee, University of Malawi, Blantyre, Malawi
| | - Lucinda Manda-Taylor
- Centre for Bioethics in Eastern and Southern Africa, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | | | - Daniel Mwale
- John Hopkins- One Community Project, Blantyre, Malawi
| | - Francis Masiye
- Centre for Bioethics in Eastern and Southern Africa, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi.,The Centre for Medical Ethics and Law (Department of Medicine), Stellenbosch University, Tygerberg Campus, Cape Town, South Africa.,Directorate of Postgraduate Studies, Research and Outreach, Malawi University of Science and Technology, P.O Box 5196, Limbe, Malawi
| | - Joseph Mfutso-Bengo
- Centre for Bioethics in Eastern and Southern Africa, College of Medicine, University of Malawi, Private Bag 360, Chichiri, Blantyre 3, Malawi
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17
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Howe N, Giles E, Newbury-Birch D, McColl E. Systematic review of participants' attitudes towards data sharing: a thematic synthesis. J Health Serv Res Policy 2019; 23:123-133. [PMID: 29653503 DOI: 10.1177/1355819617751555] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Objectives Data sharing is well established in biological research, but evidence on sharing of clinical trial or public health research study data remains limited, in particular studies of research participants' perspectives of data sharing. This study systematically reviewed international evidence of research participants' attitudes towards the sharing of data for secondary research use. Methods Systematic search of seven databases, and author-, citation- and bibliography-follow up to identify studies examining research participants' attitudes towards data sharing. Studies were thematically analysed using NVivo v10 to identify recurring themes. Results Nine studies were eligible for inclusion. Thematic analysis identified four key themes: (1) benefits of data sharing, including benefit to participants or immediate community, benefits to the public and benefits to science or research; (2) fears and harms, such as fear of exploitation, stigmatization or repercussions, alongside concerns about confidentiality and misuse of data; (3) data sharing processes, in particular the role of consent in the process; and (4) the relationship between participants and research such as trust in different types of research or organization and the relationship with the original research team. Conclusions The available literature on attitudes towards sharing data from clinical trials or public health interventions remains scant. This study has identified four themes regarding research participants' attitudes and preferences, which should be considered by policy makers, and explored with further research.
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Affiliation(s)
- Nicola Howe
- 1 Database Manager, Newcastle Clinical Trials Unit, 5994 Newcastle University , Newcastle University, UK
| | - Emma Giles
- 2 Senior Research Lecturer in Public Health, School of Health and Social Care, Teesside University, UK
| | - Dorothy Newbury-Birch
- 3 Professor of Alcohol and Public Health Research, School of Health and Social Care, Teesside University, UK
| | - Elaine McColl
- 4 Professor of Health Service Research, Institute of Health and Society, 5994 Newcastle University , Newcastle University, UK
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18
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Mweemba O, Musuku J, Mayosi BM, Parker M, Rutakumwa R, Seeley J, Tindana P, De Vries J. Use of broad consent and related procedures in genomics research: Perspectives from research participants in the Genetics of Rheumatic Heart Disease (RHDGen) study in a University Teaching Hospital in Zambia. Glob Bioeth 2019; 31:184-199. [PMID: 33343192 PMCID: PMC7734073 DOI: 10.1080/11287462.2019.1592868] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The use of broad consent for genomics research raises important ethical questions for the conduct of genomics research, including relating to its acceptability to research participants and comprehension of difficult scientific concepts. To explore these and other challenges, we conducted a study using qualitative methods with participants enrolled in an H3Africa Rheumatic Heart Disease genomics study (the RHDGen network) in Zambia to explore their views on broad consent, sample and data sharing and secondary use. In-depth interviews were conducted with RHDGen participants (n = 18), study staff (n = 5) and with individuals who refused to participate (n = 3). In general, broad consent was seen to be reasonable if reasons for storing the samples for future research use were disclosed. Some felt that broad consent should be restricted by specifying planned future studies and that secondary research should ideally relate to original disease for which samples were collected. A few participants felt that broad consent would delay the return of research results to participants. This study echoes findings in other similar studies in other parts of the continent that suggested that broad consent could be an acceptable consent model in Africa if careful thought is given to restrictions on re-use.
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Affiliation(s)
- Oliver Mweemba
- Department of Health Promotion and Education, University of Zambia, Lusaka, Zambia
| | - John Musuku
- Children Hospital, University Teaching Hospitals, Lusaka, Zambia
| | - Bongani M Mayosi
- Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Michael Parker
- Wellcome Centre for Ethics and Humanities (Ethox), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rwamahe Rutakumwa
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda
| | - Janet Seeley
- Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit, Entebbe, Uganda.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Jantina De Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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19
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Yakubu A, Tindana P, Matimba A, Littler K, Munung NS, Madden E, Staunton C, De Vries J. Model framework for governance of genomic research and biobanking in Africa - a content description. AAS Open Res 2018; 1:13. [PMID: 30714023 PMCID: PMC6354903 DOI: 10.12688/aasopenres.12844.2] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/21/2018] [Indexed: 12/17/2022] Open
Abstract
Genomic research and biobanking are expanding globally, with a promise to fast-track the research needed to improve approaches to disease treatment and prevention through scientific collaborations such as the Human Heredity and Health in Africa (H3Africa) initiative. Integral to this type of research is the availability of samples and data for research. The need for broad access brings along a host of ethical concerns, including those related to privacy and confidentiality, as well as fairness and equity in access and capacity to utilise these samples between scientists from the high income and low income countries. Addressing these concerns while promoting genomic research, especially in Africa, requires the implementation of a sound governance framework. In this paper, we describe the contents of a Framework for Best Practice for Genomics Research and biobanking in Africa that was developed, under the auspices of the H3Africa initiative. This framework is broad enough to be used and adapted by African countries to facilitate the development of country-specific guidelines and to help improve the conduct and governance of genomics research.
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Affiliation(s)
- Aminu Yakubu
- Department of Health Planning, Research & Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Alice Matimba
- Wellcome Genome Campus Advanced Courses and Scientific Conferences, Cambridge, UK
| | | | | | - Ebony Madden
- Division of Genomic Medicine, National Human Genome Research Institute, National Institutes of Health, Rockville, MD, USA
| | | | - Jantina De Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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20
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Yakubu A, Tindana P, Matimba A, Littler K, Munung NS, Madden E, Staunton C, De Vries J. Model framework for governance of genomic research and biobanking in Africa - a content description. AAS Open Res 2018; 1:13. [PMID: 30714023 DOI: 10.12688/aasopenres.12844.1] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Genomic research and biobanking are expanding globally, with a promise to fast-track the research needed to improve approaches to disease treatment and prevention through scientific collaborations such as the Human Heredity and Health in Africa (H3Africa) initiative. Integral to this type of research is the availability of samples and data for research. The need for broad access brings along a host of ethical concerns, including those related to privacy and confidentiality, as well as fairness and equity in access and capacity to utilise these samples between scientists from the high income and low income countries. Addressing these concerns while promoting genomic research, especially in Africa, requires the implementation of a sound governance framework. In this paper, we describe the contents of a Framework for Best Practice for Genomics Research and biobanking in Africa that was developed, under the auspices of the H3Africa initiative. This framework is broad enough to be used and adapted by African countries to facilitate the development of country-specific guidelines and to help improve the conduct and governance of genomics research.
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Affiliation(s)
- Aminu Yakubu
- Department of Health Planning, Research & Statistics, Federal Ministry of Health, Abuja, Nigeria
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Alice Matimba
- Wellcome Genome Campus Advanced Courses and Scientific Conferences, Cambridge, UK
| | | | | | - Ebony Madden
- Division of Genomic Medicine, National Human Genome Research Institute, National Institutes of Health, Rockville, MD, USA
| | | | - Jantina De Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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21
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Cheah PY, Jatupornpimol N, Hanboonkunupakarn B, Khirikoekkong N, Jittamala P, Pukrittayakamee S, Day NPJ, Parker M, Bull S. Challenges arising when seeking broad consent for health research data sharing: a qualitative study of perspectives in Thailand. BMC Med Ethics 2018; 19:86. [PMID: 30404642 PMCID: PMC6223036 DOI: 10.1186/s12910-018-0326-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 10/25/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Research funders, regulatory agencies, and journals are increasingly expecting that individual-level data from health research will be shared. Broad consent to such sharing is considered appropriate, feasible and acceptable in low- and middle-income settings, but to date limited empirical research has been conducted to inform the design of such processes. We examined stakeholder perspectives about how best to seek broad consent to sharing data from the Mahidol Oxford Tropical Medicine Research Unit, which implemented a data sharing policy and broad consent to data sharing in January 2016. METHODS Between February and August 2017 qualitative data were collected at two sites, Bangkok and the Thai-Myanmar border town of Mae Sot. We conducted eighteen semi-structured interviews. We also conducted four focus group discussions with a total of nineteen people. Descriptive and thematic coding informed analysis of aspects of data sharing that are considered most important to inform participants about, and the best ways to explain complex and abstract topics relating to data sharing. RESULTS The findings demonstrated that clinical trial participants prioritise information about the potential benefits and harms of data sharing. Stakeholders made multiple suggestions for clarifying information provided about data sharing on such topics. There was significant variation amongst stakeholders' perspectives about how much information should be provided about data sharing, and it was clear that effective information provision should be responsive to the study, the study population, the individual research participant and the research context. CONCLUSIONS Effectively communicating about data sharing with research participants is challenging in practice, highlighting the importance of robust and effective data sharing governance in this context. Broad consent should incorporate effective and efficient explanations of data sharing to promote informed decision-making, without impeding research participants' understandings of key aspects of the research from which data will be shared. Further work is required to refine both the development of core information about data sharing to be provided to all research participants, and appropriate solutions for context specific-challenges arising when explaining data sharing.
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Affiliation(s)
- Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK. .,The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Nattapat Jatupornpimol
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Borimas Hanboonkunupakarn
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Napat Khirikoekkong
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Shoklo Malaria Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Podjanee Jittamala
- Department of Tropical Hygiene, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Sasithon Pukrittayakamee
- Department of Clinical Tropical Medicine, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Nicholas P J Day
- Mahidol Oxford Tropical Medicine Research Unit (MORU), Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Old Road Campus, Roosevelt Drive, Oxford, OX3 7FZ, UK
| | - Michael Parker
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Susan Bull
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK.,Wellcome Centre for Ethics and Humanities, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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22
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Serwadda D, Ndebele P, Grabowski MK, Bajunirwe F, Wanyenze RK. Open data sharing and the Global South-Who benefits? Science 2018; 359:642-643. [PMID: 29439233 DOI: 10.1126/science.aap8395] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Affiliation(s)
- David Serwadda
- Makerere University School of Public Health, Kampala, Uganda. .,Rakai Health Sciences Program, Kalisizo, Uganda
| | - Paul Ndebele
- Medical Research Council of Zimbabwe, Harare, Zimbabwe
| | - M Kate Grabowski
- Rakai Health Sciences Program, Kalisizo, Uganda.,Department of Pathology, Johns Hopkins University, Baltimore, MD, USA
| | - Francis Bajunirwe
- Department of Community Health, Mbarara University for Science and Technology, Mbarara, Uganda
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Mendy M, Lawlor RT, van Kappel AL, Riegman PHJ, Betsou F, Cohen OD, Henderson MK. Biospecimens and Biobanking in Global Health. Clin Lab Med 2018; 38:183-207. [PMID: 29412882 DOI: 10.1016/j.cll.2017.10.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biobanks provide a critical infrastructure to support research in human health. Biospecimens and their accompanying data are increasingly needed to support biomedical research and clinical care. The original text was initially published in the Handbook for Cancer Research in Africa. The value of this publication is great as it underlines the importance of biobanks in Africa as a key resource to increase quality scientific research and participate in global health research. Therefore, a revision to extend these principles to other low resource contexts, to include updated material and references and add the topic of biobank sustainability were relevant.
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Affiliation(s)
- Maimuna Mendy
- Laboratory Services and Biobank Group, International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon 69372, France
| | - Rita T Lawlor
- ARC-Net Applied Research on Cancer Centre, University of Verona, Piazzale LA Scuro 10, Verona 37134, Italy
| | | | - Peter H J Riegman
- Department of Pathology, Tissue Bank, Erasmus MC, Dr Molewaterplein 40, Rotterdam 3015, The Netherlands
| | - Fay Betsou
- Integrated BioBank of Luxembourg, 6 rue Nicolas Ernest Barble, Luxembourg L-1210, Luxembourg
| | - Oliver D Cohen
- AGEIS EA 7407 Laboratory, Medical School of Grenoble, Joseph Fourier University, Domaine de la Merci, La Tronche 38700, France
| | - Marianne K Henderson
- Center for Global Health, National Cancer Institute, NIH, DHHS, 9609 Medical Center Drive, Room 3W534, Bethesda, MD 20892, USA.
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Leyden KM, Slevin A, Grey T, Hynes M, Frisbaek F, Silke R. Public and Stakeholder Engagement and the Built Environment: a Review. Curr Environ Health Rep 2017; 4:267-277. [DOI: 10.1007/s40572-017-0159-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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de Vries J, Munung SN, Matimba A, McCurdy S, Ouwe Missi Oukem-Boyer O, Staunton C, Yakubu A, Tindana P. Regulation of genomic and biobanking research in Africa: a content analysis of ethics guidelines, policies and procedures from 22 African countries. BMC Med Ethics 2017; 18:8. [PMID: 28153006 PMCID: PMC5289015 DOI: 10.1186/s12910-016-0165-6] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 12/29/2016] [Indexed: 11/17/2022] Open
Abstract
Background The introduction of genomics and biobanking methodologies to the African research context has also introduced novel ways of doing science, based on values of sharing and reuse of data and samples. This shift raises ethical challenges that need to be considered when research is reviewed by ethics committees, relating for instance to broad consent, the feedback of individual genetic findings, and regulation of secondary sample access and use. Yet existing ethics guidelines and regulations in Africa do not successfully regulate research based on sharing, causing confusion about what is allowed, where and when. Methods In order to understand better the ethics regulatory landscape around genomic research and biobanking, we conducted a comprehensive analysis of existing ethics guidelines, policies and other similar sources. We sourced 30 ethics regulatory documents from 22 African countries. We used software that assists with qualitative data analysis to conduct a thematic analysis of these documents. Results Surprisingly considering how contentious broad consent is in Africa, we found that most countries allow the use of this consent model, with its use banned in only three of the countries we investigated. In a likely response to fears about exploitation, the export of samples outside of the continent is strictly regulated, sometimes in conjunction with regulations around international collaboration. We also found that whilst an essential and critical component of ensuring ethical best practice in genomics research relates to the governance framework that accompanies sample and data sharing, this was most sparingly covered in the guidelines. Conclusions There is a need for ethics guidelines in African countries to be adapted to the changing science policy landscape, which increasingly supports principles of openness, storage, sharing and secondary use. Current guidelines are not pertinent to the ethical challenges that such a new orientation raises, and therefore fail to provide accurate guidance to ethics committees and researchers.
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Affiliation(s)
- Jantina de Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
| | - Syntia Nchangwi Munung
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Alice Matimba
- Department of Clinical Pharmacology, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Sheryl McCurdy
- Center for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, USA
| | | | | | - Aminu Yakubu
- National Health Research Ethics Committee, Federal Ministry of Health, Abuja, Nigeria
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
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Pisani E, Aaby P, Breugelmans JG, Carr D, Groves T, Helinski M, Kamuya D, Kern S, Littler K, Marsh V, Mboup S, Merson L, Sankoh O, Serafini M, Schneider M, Schoenenberger V, Guerin PJ. Beyond open data: realising the health benefits of sharing data. BMJ 2016; 355:i5295. [PMID: 27758792 PMCID: PMC6616027 DOI: 10.1136/bmj.i5295] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | | | | | | | | | - Michelle Helinski
- European and Developing Countries Clinical Trials Partnership, The Hague, Netherlands
| | - Dorcas Kamuya
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Steven Kern
- Bill and Melinda Gates Foundation, Seattle, Washington, USA
| | | | - Vicki Marsh
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | | | - Laura Merson
- Infectious Diseases Data Observatory, University of Oxford, Oxford, UK
| | | | | | | | - Vreni Schoenenberger
- International Federation of Pharmaceutical Manufacturers and Associations, Geneva
| | - Philippe J Guerin
- Infectious Diseases Data Observatory, University of Oxford, Oxford, UK
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Hate K, Meherally S, Shah More N, Jayaraman A, Bull S, Parker M, Osrin D. Sweat, Skepticism, and Uncharted Territory: A Qualitative Study of Opinions on Data Sharing Among Public Health Researchers and Research Participants in Mumbai, India. J Empir Res Hum Res Ethics 2016; 10:239-50. [PMID: 26297746 PMCID: PMC4547203 DOI: 10.1177/1556264615592383] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Efforts to internalize data sharing in research practice have been driven largely by developing international norms that have not incorporated opinions from researchers in low- and middle-income countries. We sought to identify the issues around ethical data sharing in the context of research involving women and children in urban India. We interviewed researchers, managers, and research participants associated with a Mumbai non-governmental organization, as well as researchers from other organizations and members of ethics committees. We conducted 22 individual semi-structured interviews and involved 44 research participants in focus group discussions. We used framework analysis to examine ideas about data and data sharing in general; its potential benefits or harms, barriers, obligations, and governance; and the requirements for consent. Both researchers and participants were generally in favor of data sharing, although limited experience amplified their reservations. We identified three themes: concerns that the work of data producers may not receive appropriate acknowledgment, skepticism about the process of sharing, and the fact that the terrain of data sharing was essentially uncharted and confusing. To increase data sharing in India, we need to provide guidelines, protocols, and examples of good practice in terms of consent, data preparation, screening of applications, and what individuals and organizations can expect in terms of validation, acknowledgment, and authorship.
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Affiliation(s)
- Ketaki Hate
- Society for Nutrition, Education and Health Action, Mumbai, India
| | - Sanna Meherally
- Society for Nutrition, Education and Health Action, Mumbai, India
| | - Neena Shah More
- Society for Nutrition, Education and Health Action, Mumbai, India
| | - Anuja Jayaraman
- Society for Nutrition, Education and Health Action, Mumbai, India
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Cheah PY, Tangseefa D, Somsaman A, Chunsuttiwat T, Nosten F, Day NPJ, Bull S, Parker M. Perceived Benefits, Harms, and Views About How to Share Data Responsibly: A Qualitative Study of Experiences With and Attitudes Toward Data Sharing Among Research Staff and Community Representatives in Thailand. J Empir Res Hum Res Ethics 2016; 10:278-89. [PMID: 26297749 PMCID: PMC4547202 DOI: 10.1177/1556264615592388] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The Thailand Major Overseas Programme coordinates large multi-center studies in tropical medicine and generates vast amounts of data. As the data sharing movement gains momentum, we wanted to understand attitudes and experiences of relevant stakeholders about what constitutes good data sharing practice. We conducted 15 interviews and three focus groups discussions involving 25 participants and found that they generally saw data sharing as something positive. Data sharing was viewed as a means to contribute to scientific progress and lead to better quality analysis, better use of resources, greater accountability, and more outputs. However, there were also important reservations including potential harms to research participants, their communities, and the researchers themselves. Given these concerns, several areas for discussion were identified: data standardization, appropriate consent models, and governance.
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Affiliation(s)
| | | | | | | | - François Nosten
- Mahidol University, Bangkok, Thailand University of Oxford, UK
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29
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Abstract
This issue of the Journal of Empirical Research on Human Research Ethics highlights the ethical issues that arise when researchers conducting projects in low- and middle-income countries seek to share the data they produce. Although sharing data is considered a best practice, the barriers to doing so are considerable and there is a need for guidance and examples. To that end, the authors of this article reviewed the articles in this special issue to identify challenges common to the five countries and to offer some practical advice to assist researchers in navigating this "uncharted territory," as some termed it. Concerns around informed consent, data management, data dissemination, and validation of research contributions were cited frequently as particularly challenging areas, so the authors focused on these four topics with the goal of providing specific resources to consult as well as examples of successful projects attempting to solve many of the problems raised.
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Affiliation(s)
- George C Alter
- Institute for Social Research, Inter-university Consortium for Political and Social Research (ICPSR), University of Michigan, Ann Arbor, USA
| | - Mary Vardigan
- Institute for Social Research, Inter-university Consortium for Political and Social Research (ICPSR), University of Michigan, Ann Arbor, USA
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Tindana P, de Vries J. Broad Consent for Genomic Research and Biobanking: Perspectives from Low- and Middle-Income Countries. Annu Rev Genomics Hum Genet 2016; 17:375-93. [PMID: 26905784 DOI: 10.1146/annurev-genom-083115-022456] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Genomic research and biobanking are increasingly being conducted in the context of collaborations between researchers in high-income countries and those in low- and middle-income countries. Although these scientific advancements have presented unique opportunities for researchers to contribute to cutting-edge scientific projects and address important health problems, they have also challenged existing ethical and regulatory frameworks, particularly in sub-Saharan Africa. Broad consent is a model that allows the use of human biological samples and associated data in future research that may be unrelated to the original study. Drawing on emerging perspectives in low- and middle-income countries, we argue that broad consent is equivalent to consent to governance and that a robust governance framework for genomics and biobanking should seek to promote global health and research equity and take into account five key elements: respect, authentic community engagement and trust building, the preservation of privacy and confidentiality, feedback of results, and capacity strengthening.
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Affiliation(s)
- Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana;
| | - Jantina de Vries
- Department of Medicine, Faculty of Health Sciences, University of Cape Town, 7925 Cape Town, South Africa;
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Munung NS, Marshall P, Campbell M, Littler K, Masiye F, Ouwe-Missi-Oukem-Boyer O, Seeley J, Stein DJ, Tindana P, de Vries J. Obtaining informed consent for genomics research in Africa: analysis of H3Africa consent documents. JOURNAL OF MEDICAL ETHICS 2016; 42:132-137. [PMID: 26644426 PMCID: PMC4752624 DOI: 10.1136/medethics-2015-102796] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2015] [Revised: 09/07/2015] [Accepted: 09/15/2015] [Indexed: 05/29/2023]
Abstract
BACKGROUND The rise in genomic and biobanking research worldwide has led to the development of different informed consent models for use in such research. This study analyses consent documents used by investigators in the H3Africa (Human Heredity and Health in Africa) Consortium. METHODS A qualitative method for text analysis was used to analyse consent documents used in the collection of samples and data in H3Africa projects. Thematic domains included type of consent model, explanations of genetics/genomics, data sharing and feedback of test results. RESULTS Informed consent documents for 13 of the 19 H3Africa projects were analysed. Seven projects used broad consent, five projects used tiered consent and one used specific consent. Genetics was mostly explained in terms of inherited characteristics, heredity and health, genes and disease causation, or disease susceptibility. Only one project made provisions for the feedback of individual genetic results. CONCLUSION H3Africa research makes use of three consent models-specific, tiered and broad consent. We outlined different strategies used by H3Africa investigators to explain concepts in genomics to potential research participants. To further ensure that the decision to participate in genomic research is informed and meaningful, we recommend that innovative approaches to the informed consent process be developed, preferably in consultation with research participants, research ethics committees and researchers in Africa.
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Affiliation(s)
| | - Patricia Marshall
- Center for Genetic Research Ethics and Law Department of Bioethics, School of Medicine, Case Western Reserve University, Cleaveland, Ohio, USA
| | - Megan Campbell
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | | | - Francis Masiye
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Odile Ouwe-Missi-Oukem-Boyer
- Centre de Recherche Médicale et Sanitaire (CERMES), Niamey, Niger
- Cameroon Bioethics Initiative (CAMBIN), Yaounde, Cameroon
| | - Janet Seeley
- MRC/UVRI Uganda Research Unit on AIDS, Entebbe, Uganda
| | - D J Stein
- MRC Unit on Anxiety & Stress Disorders Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Paulina Tindana
- Navrongo Health Research Centre, Ghana Health Service, Navrongo, Ghana
| | - Jantina de Vries
- Department of Medicine, University of Cape Town, Cape Town, South Africa
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Jao I, Kombe F, Mwalukore S, Bull S, Parker M, Kamuya D, Molyneux S, Marsh V. Research Stakeholders' Views on Benefits and Challenges for Public Health Research Data Sharing in Kenya: The Importance of Trust and Social Relations. PLoS One 2015; 10:e0135545. [PMID: 26331716 PMCID: PMC4557837 DOI: 10.1371/journal.pone.0135545] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 07/22/2015] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is increasing recognition of the importance of sharing research data within the international scientific community, but also of the ethical and social challenges this presents, particularly in the context of structural inequities and varied capacity in international research. Public involvement is essential to building locally responsive research policies, including on data sharing, but little research has involved stakeholders from low-to-middle income countries. METHODS Between January and June 2014, a qualitative study was conducted in Kenya involving sixty stakeholders with varying experiences of research in a deliberative process to explore views on benefits and challenges in research data sharing. In-depth interviews and extended small group discussions based on information sharing and facilitated debate were used to collect data. Data were analysed using Framework Analysis, and charting flow and dynamics in debates. FINDINGS The findings highlight both the opportunities and challenges of communicating about this complex and relatively novel topic for many stakeholders. For more and less research-experienced stakeholders, ethical research data sharing is likely to rest on the development and implementation of appropriate trust-building processes, linked to local perceptions of benefits and challenges. The central nature of trust is underpinned by uncertainties around who might request what data, for what purpose and when. Key benefits perceived in this consultation were concerned with the promotion of public health through science, with legitimate beneficiaries defined differently by different groups. Important challenges were risks to the interests of study participants, communities and originating researchers through stigmatisation, loss of privacy, impacting autonomy and unfair competition, including through forms of intentional and unintentional 'misuse' of data. Risks were also seen for science. DISCUSSION Given background structural inequities in much international research, building trust in this low-to-middle income setting includes ensuring that the interests of study participants, primary communities and originating researchers will be promoted as far as possible, as well as protected. Important ways of building trust in data sharing include involving the public in policy development and implementation, promoting scientific collaborations around data sharing and building close partnerships between researchers and government health authorities to provide checks and balances on data sharing, and promote near and long-term translational benefits.
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Affiliation(s)
- Irene Jao
- Health Systems and Research Ethics Department, Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
| | - Francis Kombe
- Health Systems and Research Ethics Department, Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
| | - Salim Mwalukore
- Health Systems and Research Ethics Department, Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
| | - Susan Bull
- Ethox Centre, Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom
| | - Michael Parker
- Ethox Centre, Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom
| | - Dorcas Kamuya
- Health Systems and Research Ethics Department, Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
- Ethox Centre, Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom
| | - Sassy Molyneux
- Health Systems and Research Ethics Department, Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
| | - Vicki Marsh
- Health Systems and Research Ethics Department, Kenya Medical Research Institute Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Oxford, United Kingdom
- * E-mail:
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Parker M, Bull S. Sharing Public Health Research Data: Toward the Development of Ethical Data-Sharing Practice in Low- and Middle-Income Settings. J Empir Res Hum Res Ethics 2015; 10:217-24. [PMID: 26297744 PMCID: PMC4547199 DOI: 10.1177/1556264615593494] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
It is increasingly recognized that effective and appropriate data sharing requires the development of models of good data-sharing practice capable of taking seriously both the potential benefits to be gained and the importance of ensuring that the rights and interests of participants are respected and that risk of harms is minimized. Calls for the greater sharing of individual-level data from biomedical and public health research are receiving support among researchers and research funders. Despite its potential importance, data sharing presents important ethical, social, and institutional challenges in low-income settings. In this article, we report on qualitative research conducted in five low- and middle-income countries exploring the experiences of key research stakeholders and their views about what constitutes good data-sharing practice.
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34
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Bull S, Roberts N, Parker M. Views of Ethical Best Practices in Sharing Individual-Level Data From Medical and Public Health Research: A Systematic Scoping Review. J Empir Res Hum Res Ethics 2015; 10:225-38. [PMID: 26297745 PMCID: PMC4548478 DOI: 10.1177/1556264615594767] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is increasing support for sharing individual-level data generated by medical and public health research. This scoping review of empirical research and conceptual literature examined stakeholders' perspectives of ethical best practices in data sharing, particularly in low- and middle-income settings. Sixty-nine empirical and conceptual articles were reviewed, of which, only five were empirical studies and eight were conceptual articles focusing on low- and middle-income settings. We conclude that support for sharing individual-level data is contingent on the development and implementation of international and local policies and processes to support ethical best practices. Further conceptual and empirical research is needed to ensure data sharing policies and processes in low- and middle-income settings are appropriately informed by stakeholders' perspectives.
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Merson L, Phong TV, Nhan LNT, Dung NT, Ngan TTD, Kinh NV, Parker M, Bull S. Trust, Respect, and Reciprocity: Informing Culturally Appropriate Data-Sharing Practice in Vietnam. J Empir Res Hum Res Ethics 2015; 10:251-63. [PMID: 26297747 PMCID: PMC4692260 DOI: 10.1177/1556264615592387] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
International science funders and publishers are driving a growing trend in data sharing. There is mounting pressure on researchers in low- and middle-income settings to conform to new sharing policies, despite minimal empirically grounded accounts of the ethical challenges of implementing the policies in these settings. This study used in-depth interviews and focus group discussions with 48 stakeholders in Vietnam to explore the experiences, attitudes, and expectations that inform ethical and effective approaches to sharing clinical research data. Distinct views on the role of trust, respect, and reciprocity were among those that emerged to inform culturally appropriate best practices. We conclude by discussing the challenges that authors of data-sharing policies should consider in this unique context.
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Affiliation(s)
- Laura Merson
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Tran Viet Phong
- Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
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36
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Bull S, Cheah PY, Denny S, Jao I, Marsh V, Merson L, Shah More N, Nhan LNT, Osrin D, Tangseefa D, Wassenaar D, Parker M. Best Practices for Ethical Sharing of Individual-Level Health Research Data From Low- and Middle-Income Settings. J Empir Res Hum Res Ethics 2015; 10:302-13. [PMID: 26297751 PMCID: PMC4547207 DOI: 10.1177/1556264615594606] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sharing individual-level data from clinical and public health research is increasingly being seen as a core requirement for effective and efficient biomedical research. This article discusses the results of a systematic review and multisite qualitative study of key stakeholders' perspectives on best practices in ethical data sharing in low- and middle-income settings. Our research suggests that for data sharing to be effective and sustainable, multiple social and ethical requirements need to be met. An effective model of data sharing will be one in which considered judgments will need to be made about how best to achieve scientific progress, minimize risks of harm, promote fairness and reciprocity, and build and sustain trust.
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Affiliation(s)
| | | | - Spencer Denny
- University of KwaZulu-Natal, Pietermaritzburg, South Africa
| | - Irene Jao
- KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Vicki Marsh
- University of Oxford, UK KEMRI Wellcome Trust Research Programme, Nairobi, Kenya
| | - Laura Merson
- Oxford University Clinical Research Unit, Ho Chi Minh City, Viet Nam
| | - Neena Shah More
- Society for Nutrition, Education and Health Action, Mumbai, India
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