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Luseno WK, Iritani BJ, Hartman S, Odongo FS, Otieno FA, Ongili BO, Rennie S. Assessment of Consent Comprehension Among Kenyan Adolescents, Young Adults, and Parents: Comparison of Enhanced and Standard Consenting Procedures. J Adolesc Health 2024; 74:605-612. [PMID: 38069940 PMCID: PMC10873115 DOI: 10.1016/j.jadohealth.2023.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/22/2023] [Accepted: 10/05/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE Youth aged 15-19 years and parents of minors aged 15-17 years in sub-Saharan Africa are under-represented in empirical consent research. Thus, knowledge is limited concerning the adequacy of consent procedures and need for strategies to improve consent comprehension among these groups. We assessed comprehension following standard consent procedures and evaluated an enhanced procedure among Kenyan youth and parents. METHODS Participants were adolescents aged 15-17 years (n = 273), their parents (n = 196), and young adults aged 18-19 years (n = 196). We used a quasi-experimental cohort design to implement standard and enhanced (single condition: extended discussion, test/feedback) consent procedures. Participants completed a 21-item informed consent comprehension assessment instrument. RESULTS After standard consent procedures, mean comprehension scores were 11.36, 13.64, and 13.43 (score range: 0-21) among adolescents, young adults, and parents, respectively. About 6.2% of adolescents, 19.6% of young adults, and 21.4% of parents answered ≥ 80% of the questions correctly. After the enhanced procedures, comprehension scores (15.87 adolescents, 17.81 young adults, and 16.77 parents) and proportions answering ≥ 80% of the questions correctly (44.9% adolescents, 76.8% young adults, and 64.3% parents) increased significantly. Regression analysis indicated statistically significant differences (p < .001) in comprehension scores between the enhanced and standard groups (β = 3.87 adolescents, β = 4.03 young adults, and β = 3.60 parents) after controlling for sociodemographic factors. DISCUSSION Enhancing consent procedures with extended discussions, quizzes, and additional explanation where understanding is inadequate is a promising approach for improving comprehension. However, poorer comprehension among adolescents compared to young adults and parents underscores the need for research to identify additional approaches to improve understanding.
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Affiliation(s)
| | - Bonita J Iritani
- Pacific Institute for Research and Evaluation (PIRE), Chapel Hill, North Carolina
| | - Shane Hartman
- Pacific Institute for Research and Evaluation (PIRE), Chapel Hill, North Carolina
| | - Fredrick S Odongo
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | | | - Barrack Otieno Ongili
- Centre for Global Health Research, Kenya Medical Research Institute (KEMRI), Kisumu, Kenya
| | - Stuart Rennie
- Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Craig SG, Robillard CL, Ames ME, Feldman S, Pepler DJ. Adherence to and Motivations for Complying With Public Health Measures Among Adolescents During the Coronavirus Disease (COVID-19) Pandemic in Canada. Psychol Rep 2023:332941231201355. [PMID: 37732514 DOI: 10.1177/00332941231201355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Background: Public health measures (e.g., minimizing social interactions, social distancing, and mask wearing) have been implemented in Canada to reduce the transmission of COVID-19. Given that adolescents may be a high-risk demographic for spreading COVID-19, this study investigated adherence to and motivations for complying with public health measures among Canadian youth at two points of the COVID-19 pandemic. Methods: Adolescents (N = 1,484, 53% girls, Mage = 15.73 [SD = 1.41]) completed an online survey in either Summer 2020 (Cohort 1 [C1]; n = 809, 56% girls) or Winter 2020/2021 (Cohort 2 [C2]; n = 675, 50% girls). We investigated differences in adherence across cohorts using independent sample t-tests and predictors of adherence using a path analysis. Results: Youth engaged in similar levels of social interaction in C1 and C2. Relative to adolescents in C1, adolescents in C2 reported more mask wearing, but less social distancing. Social responsibility was associated with adherence to almost all public health measures across both cohorts, with one exception: it did not predict minimizing social interactions in C2. Not wanting to get sick predicted minimizing social interactions and mask wearing. Concern with population health predicted adherence to all public health measures in C1 and all but mask wearing in C2. Maintaining social ties was negatively associated with minimizing social interactions in both cohorts, and with social distancing in C1. Conclusions: Youth engaged in more mask wearing but less social distancing as the pandemic progressed. Social responsibility and not wanting to get sick were consistent predictors of adherence to most public health measures throughout the pandemic. Youth shifted away from adhering to mask wearing measures due to concern with population health over the course of the pandemic. These results can inform targeted campaigns to bolster compliance with public health measures among adolescents.
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Affiliation(s)
| | | | - Megan E Ames
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | | | - Debra J Pepler
- Department of Psychology, York University, Toronto, ON, Canada
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Goulter N, Balanji S, Davis BA, James T, McIntyre CL, Smith E, Thornton EM, Craig SG, Moretti MM. Psychometric Evaluation of the Affect Regulation Checklist: Clinical and Community Samples, Parent-Reports and Youth Self-Reports. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:344-360. [PMID: 35699159 DOI: 10.1111/jora.12779] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The Affect Regulation Checklist (ARC) was designed to capture affect dysregulation, suppression, and reflection. Importantly, affect dysregulation has been established as a transdiagnostic mechanism underpinning many forms of psychopathology. We tested the ARC psychometric properties across clinical and community samples and through both parent-report and youth self-report information. Clinical sample: Participants included parents (n = 814; Mage = 43.86) and their child (n = 608; Mage = 13.98). Community sample: Participants included independent samples of parents (n = 578; Mage = 45.12) and youth (n = 809; Mage = 15.67). Exploratory structural equation modeling supported a three-factor structure across samples and informants. Dysregulation was positively associated with all forms of psychopathology. In general, suppression was positively associated with many forms of psychopathology, and reflection was negatively associated with externalizing problems and positively associated with internalizing problems.
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Groff E, Orzechowski M, Schuetz C, Steger F. Ethical Aspects of Personalized Research and Management of Systemic Inflammatory Response Syndrome (SIRS) in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:470. [PMID: 36612792 PMCID: PMC9819223 DOI: 10.3390/ijerph20010470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 12/21/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
Systemic inflammatory response syndrome (SIRS) is a life-threatening condition with nonspecific symptoms. Because of that, defining a targeted therapy against SIRS in children and adults remains a challenge. The identification of diagnostic patterns from individualized immuneprofiling can lead to development of a personalized therapy. The aim of this study was to identify and analyze ethical issues associated with personalized research and therapy for SIRS in pediatric populations. We conducted an ethical analysis based on a principled approach according to Beauchamp and Childress' four bioethical principles. Relevant information for the research objectives was extracted from a systematic literature review conducted in the scientific databases PubMed, Embase and Web of Science. We searched for pertinent themes dealing with at least one of the four bioethical principles: "autonomy", "non-maleficence", "beneficence" and "justice". 48 publications that met the research objectives were included in the thorough analysis, structured and discussed in a narrative synthesis. From the analysis of the results, it has emerged that traditional paradigms of patient's autonomy and physician paternalism need to be reexamined in pediatric research. Standard information procedures and models of informed consent should be reconsidered as they do not accommodate the complexities of pediatric omics research.
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Affiliation(s)
- Elisa Groff
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, 89073 Ulm, Germany
| | - Marcin Orzechowski
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, 89073 Ulm, Germany
| | - Catharina Schuetz
- Paediatric Immunology, Medical Faculty “Carl Gustav Carus”, Technic University Dresden, 01307 Dresden, Germany
| | - Florian Steger
- Institute of the History, Philosophy and Ethics of Medicine, Ulm University, 89073 Ulm, Germany
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Caruso Brown AE. Constrained Adolescent Autonomy for Healthcare Should Include Participation in Survey Research. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2020; 20:85-87. [PMID: 32945753 DOI: 10.1080/15265161.2020.1806377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
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Soll D, Guraiib MM, Rollins NC, Reis AA. Improving assent in health research: a rapid systematic review. BMC Med Res Methodol 2020; 20:114. [PMID: 32404063 PMCID: PMC7222594 DOI: 10.1186/s12874-020-01000-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 04/30/2020] [Indexed: 11/21/2022] Open
Abstract
Background Enrolment in a research study requires the participant’s informed consent. In the case of minors, informed consent of the respective legal guardian is obtained in conjunction with informed assent of the underage p articipant. Since comprehension of the information provided may be limited, effective interventions to improve understanding should be identified. Thus, it is the objective of this study to review quantitative studies that tested interventions to improve the understanding of information provided during assent processes in health research. The studied population consisted of minors that participated or were willing to participate in research. The primary outcome was the level of comprehension after intervention. Methods A systematic search was conducted in eleven databases including regional databases: PubMed, Web of Science, ERIC, PsycINFO, CINAHL, POPLINE, AIM, LILACS, WPRIM, IMSEAR, and IMEMR and included references from inception of the database until July 2018 except PubMed which spanned the period from May 2013 to July 2018. Search terms focused on Informed Consent/Assent, Minors, and Comprehension. To complement the search, reference lists of retrieved publications were additionally searched. We included all quantitative studies that were conducted in minors, tested an intervention, covered assent processes in health research, and assessed comprehension. One reviewer screened titles, abstracts, and full-texts to determine eligibility and collected data on study design, population, intervention, methods, outcome, and for critical appraisal. Interventions comprised enhanced paper forms, interspersed questions, multimedia format, and others. Results Out of 7089 studies initially identified, 19 studies comprising 2805 participants and conducted in seven countries were included in the review. Fourteen studies (74 %) tested an intervention against control and ten (53 %) were randomized controlled trials. Heterogeneous methodology as well as incomplete outcome and statistical reporting impaired the reliability of the collected data. Positive effects were suggested for use of enhanced paper forms, interspersed questions, use of pie charts, and organizational factors. Conclusions Improving assent in health research is an under-researched area with little reliable evidence. While some interventions are proposed to improve understanding in assent processes, further investigation is necessary to be able to give evidence-based recommendations. Trial registration PROSPERO ID: 106808.
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Affiliation(s)
- Dominik Soll
- Department of Endocrinology and Metabolism, Charité Universitätsmedizin Berlin, Berlin, Germany.
| | | | - Nigel Campbell Rollins
- Maternal, Newborn, Child and Adolescent Health, World Health Organization, Geneva, Switzerland
| | - Andreas Alois Reis
- Global Health Ethics Team, World Health Organization, Geneva, Switzerland
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Hokke S, Hackworth NJ, Quin N, Bennetts SK, Win HY, Nicholson JM, Zion L, Lucke J, Keyzer P, Crawford SB. Ethical issues in using the internet to engage participants in family and child research: A scoping review. PLoS One 2018; 13:e0204572. [PMID: 30261041 PMCID: PMC6160098 DOI: 10.1371/journal.pone.0204572] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 09/11/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND The internet is an increasingly popular tool in family and child research that is argued to pose new ethical challenges, yet few studies have systematically assessed the ethical issues of engaging parents and children in research online. This scoping review aims to identify and integrate evidence on the ethical issues reported when recruiting, retaining and tracing families and children in research online, and to identify ethical guidelines for internet research. METHODS Academic literature was searched using electronic academic databases (Scopus, PsycINFO, Embase, ERIC, CINAHL and Informit) and handsearching reference lists for articles published in English between January 2006 and February 2016. Grey literature was searched using Google to identify relevant ethical guidelines. RESULTS Sixty-five academic articles were included after screening 3,537 titles and abstracts and 205 full-text articles. Most articles reported using the internet to recruit participants (88%) with few reporting online retention (12%) or tracing (10%). Forty percent commented on ethical issues; the majority did not discuss ethics beyond general consent or approval procedures. Some ethical concerns were specific to engaging minors online, including parental consent, age verification and children's vulnerability. Other concerns applied when engaging any research participant online, including privacy and confidentiality, informed consent and disparities in internet access. Five professional guidelines and 10 university guidelines on internet research ethics were identified. Few academic articles (5%) reported using these guidelines. CONCLUSIONS Engaging families and children in research online introduces unique challenges requiring careful consideration. While researchers regarded themselves as responsible for ensuring research is conducted ethically, lack of use of available guidelines and limited academic literature suggests internet research is occurring without suitable guidance. We recommend broad dissemination of ethical guidelines and encourage researchers to report the methodological and ethical issues of using the internet to engage families and children in research.
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Affiliation(s)
- Stacey Hokke
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Naomi J. Hackworth
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Parenting Research Centre, Melbourne, Victoria, Australia
| | - Nina Quin
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Shannon K. Bennetts
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
| | - Hnin Yee Win
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Jan M. Nicholson
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
- Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lawrie Zion
- Department of Communications and Media, La Trobe University, Melbourne, Victoria, Australia
| | - Jayne Lucke
- Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Victoria, Australia
- School of Public Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Patrick Keyzer
- La Trobe Law School, La Trobe University, Melbourne, Victoria, Australia
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