1
|
Orievulu K, Hinga A, Nkosi B, Ngwenya N, Seeley J, Akanlu A, Tindana P, Molyneux S, Kinyanjui S, Kamuya D. A scoping review of ethics review processes during public health emergencies in Africa. BMC Med Ethics 2024; 25:63. [PMID: 38778293 PMCID: PMC11110293 DOI: 10.1186/s12910-024-01054-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic forced governments, multilateral public health organisations and research institutions to undertake research quickly to inform their responses to the pandemic. Most COVID-19-related studies required swift approval, creating ethical and practical challenges for regulatory authorities and researchers. In this paper, we examine the landscape of ethics review processes in Africa during public health emergencies (PHEs). METHODS We searched four electronic databases (Web of Science, PUBMED, MEDLINE Complete, and CINAHL) to identify articles describing ethics review processes during public health emergencies and/or pandemics. We selected and reviewed those articles that were focused on Africa. We charted the data from the retrieved articles including the authors and year of publication, title, country and disease(s) reference, broad areas of (ethical) consideration, paper type, and approach. RESULTS Of an initial 4536 records retrieved, we screened the titles and abstracts of 1491 articles, and identified 72 articles for full review. Nine articles were selected for inclusion. Of these nine articles, five referenced West African countries including Liberia, Guinea and Sierra Leone, and experiences linked to the Ebola virus disease. Two articles focused on South Africa and Kenya, while the other two articles discussed more general experiences and pitfalls of ethics review during PHEs in Africa more broadly. We found no articles published on ethics review processes in Africa before the 2014 Ebola outbreak, and only a few before the COVID-19 outbreak. Although guidelines on protocol review and approval processes for PHEs were more frequently discussed after the 2014 Ebola outbreak, these did not focus on Africa specifically. CONCLUSIONS There is a gap in the literature about ethics review processes and preparedness within Africa during PHEs. This paper underscores the importance of these processes to inform practices that facilitate timely, context-relevant research that adequately recognises and reinforces human dignity within the quest to advance scientific knowledge about diseases. This is important to improve fast responses to PHEs, reduce mortality and morbidity, and enhance the quality of care before, during, and after pandemics.
Collapse
Affiliation(s)
- Kingsley Orievulu
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa.
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa.
- Centre for Africa China Studies, University of Johannesburg, Johannesburg, South Africa.
| | - Alex Hinga
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
| | - Busisiwe Nkosi
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
- University of Toledo, Ohio, Toledo, USA
| | - Nothando Ngwenya
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
| | - Janet Seeley
- Africa Health Research Institute, KwaZulu-Natal, Durban, South Africa
- School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
- Global Health and Development Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Anthony Akanlu
- West Africa Centre for Cell Biology and Infectious Pathogens, University of Ghana, Accra, Ghana
| | - Paulina Tindana
- Department of Health Policy, Planning and Management, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Sassy Molyneux
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Samson Kinyanjui
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Dorcas Kamuya
- KEMRI Wellcome Trust Research Programme, Kilifi, Kenya
- Centre for Tropical Medicine and Pandemic Sciences Institute, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| |
Collapse
|
2
|
Gordon BG, Lowe AE, Kratochvil CJ. Rapid Review of Therapy Protocols for Public Health Emergencies. Ethics Hum Res 2024; 46:16-21. [PMID: 38446100 DOI: 10.1002/eahr.500203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
How research during a public health emergency is conducted is recognized as essential to the public health response to that emergency. Such research needs to undergo substantive and meaningful ethical review in a timely manner. Rapid ethical review may be accomplished through a number of mechanisms, including use of local rapid-response institutional review boards (IRBs). We describe use of such a model in the setting of the 2014 Ebola virus disease epidemic and the Rapid-Response IRB's subsequent transition to a multisite single IRB model during the current Covid-19 pandemic. The rapid-response review model is characterized by a small IRB with extensive use of alternate members with specific expertise and by close collaboration with the investigator in an iterative process.
Collapse
Affiliation(s)
- Bruce G Gordon
- Assistant vice-chancellor for regulatory affairs, and executive chairman of the IRBs at the University of Nebraska Medical Center
| | - Abigail E Lowe
- Assistant professor at the College of Allied Health Professions and a scholar at the Global Center for Health Security at the University of Nebraska Medical Center
| | - Christopher J Kratochvil
- Senior advisor and Distinguished Chair at the Global Center for Health Security, and vice chancellor of external relations at the University of Nebraska Medical Center
| |
Collapse
|
3
|
Adams RM, Evans CM, Peek L. Defining, collecting, and sharing perishable disaster data. DISASTERS 2024; 48:e12592. [PMID: 37212533 DOI: 10.1111/disa.12592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Researchers across disciplines have long sought to collect 'perishable data' in the context of disasters. Yet, this data type is neither consistently defined nor discussed in specific detail in the literature. To address this gap, this paper defines perishable data and provides guidance on ways to improve both how it is collected and shared. Here, perishable data is conceptualised as highly transient data that may degrade in quality, be irrevocably altered, or be permanently lost if not gathered soon after it is generated. Perishable data may include ephemeral information that must be collected to characterise pre-existing hazardous conditions, near-miss events, actual disasters, and longer-term recovery processes. This data may need to be gathered at multiple points in time across varying geographic scales to accurately characterise exposure, susceptibility to harm, or coping capacity. The paper considers ethical and logistical challenges and discusses opportunities to advance equitable perishable data collection and dissemination.
Collapse
Affiliation(s)
- Rachel M Adams
- Research Associate, Natural Hazards Center, University of Colorado Boulder, United States
| | - Candace M Evans
- Doctoral Candidate, Department of Sociology, and Graduate Research Assistant, Natural Hazards Center, University of Colorado Boulder, United States
| | - Lori Peek
- Professor, Department of Sociology, and Director, Natural Hazards Center, University of Colorado Boulder, United States
| |
Collapse
|
4
|
Wang Y, Berger KI, Zhang Y, Shao Y, Goldring RM, Reibman J, Liu M. Novel approach to studying effects of inhalational exposure on lung function in civilians exposed to the World Trade Center disaster. Sci Rep 2023; 13:3218. [PMID: 36828851 PMCID: PMC9958097 DOI: 10.1038/s41598-023-30030-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/14/2023] [Indexed: 02/26/2023] Open
Abstract
It is increasingly important to study the impact of environmental inhalation exposures on human health in natural or man-made disasters in civilian populations. The members of the World Trade Center Environmental Health Center (WTC EHC; WTC Survivors) had complex exposures to environmental disaster from the destruction of WTC towers and can serve to reveal the effects of WTC exposure on the entire spectrum of lung functions. We aimed to investigate the associations between complex WTC exposures and measures of spirometry and oscillometry in WTC Survivors and included 3605 patients enrolled between Oct 1, 2009 and Mar 31, 2018. We performed latent class analysis and identified five latent exposure groups. We applied linear and quantile regressions to estimate the exposure effects on the means and various quantiles of pre-bronchodilator (BD) % predicted forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC ratio, as well as the resistance at an oscillating frequency of 5 Hz (R5), frequency dependence of resistance R5-20, and reactance area (AX). Compared with Group 5, which had low or unknown exposure and was treated as the reference group, Group 1, the local workers with both acute and chronic exposures, had a lower median of % predicted FVC (-3.6; 95% CI: -5.4, -1.7) and higher (more abnormal) measures of AX at 10th quantile (0.77 cmH2O L-1 s; 95% CI: 0.41, 1.13) and 25th quantile (0.80 cmH2O L-1 s; 95% CI: 0.41, 1.20). Results suggested heterogeneous exposures to the WTC disaster had differential effects on the distributions of lung functions in the WTC Survivors. These findings could provide insights for future investigation of environmental disaster exposures.
Collapse
Affiliation(s)
- Yuyan Wang
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
| | - Kenneth I Berger
- Department of Medicine, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, 10016, USA
| | - Yian Zhang
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
| | - Yongzhao Shao
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA
- Department of Environmental Medicine, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, 10016, USA
| | - Roberta M Goldring
- Department of Medicine, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, 10016, USA
| | - Joan Reibman
- Department of Medicine, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, 10016, USA.
- Department of Environmental Medicine, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, 10016, USA.
| | - Mengling Liu
- Department of Population Health, New York University Grossman School of Medicine, 180 Madison Avenue, New York, NY, 10016, USA.
- Department of Environmental Medicine, New York University Grossman School of Medicine, 550 1st Avenue, New York, NY, 10016, USA.
| |
Collapse
|
5
|
Lowe AE, Kraft C, Kortepeter MG, Hansen KF, Sanger K, Johnson A, Grein JD, Martin J, Rousselle R, Garland JA, Spotts J, Lowe JJ, Sauer LM, Kratochvil CJ, Gordon BG. Developing a Rapid Response Single IRB Model for Conducting Research During a Public Health Emergency. Health Secur 2022; 20:S60-S70. [PMID: 35544310 DOI: 10.1089/hs.2021.0181] [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: 11/12/2022] Open
Abstract
Research is foundational for evidence-based management of patients. Clinical research, however, takes time to plan, conduct, and disseminate-a luxury that is rarely available during a public health emergency. The University of Nebraska Medical Center (UNMC) developed a single institutional review board (IRB), with a vision to establish a rapid review resource for a network focused on clinical research of emerging pathogens in the United States. A core aspect of successful initiation of research during a pandemic or epidemic is the ability to operationalize an approach for rapid ethical review of human subject research and conduct those reviews at multiple sites-without losing any of the substantive aspects of ethics review. This process must be cultivated in anticipation of a public health emergency. US guidance for operationalizing IRB review for multisite research in a public health emergency is not well studied and processes are not well established. UNMC sought to address operational gaps and identify the unique procedural needs of rapid response single IRB (RR-sIRB) review of multisite research by conducting a series of preparedness exercises to develop and test the RR-sIRB model. For decades, emergency responder, healthcare, and public health organizations have conducted emergency preparedness exercises to test requirements for emergency response. In this article, we describe 2 types of simulation exercises conducted by UNMC: workshops and tabletops. This effort represents a unique use of emergency preparedness exercises to develop, refine, and test rapid review functions for an sIRB and to validate readiness of regulatory research processes. Such processes are crucial for conducting rapid, ethical, and sound clinical research in public health emergencies.
Collapse
Affiliation(s)
- Abigail E Lowe
- Abigail E. Lowe, MA, is an Assistant Professor, Global Center for Health Security, College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE
| | - Colleen Kraft
- Colleen Kraft, MD, MS, is a Professor, Department of Pathology and Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, and Associate Chief Medical Officer, Emory Hospital, Emory University, Atlanta, GA
| | - Mark G Kortepeter
- Mark G. Kortepeter, MD, is Vice President for Research, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Keith F Hansen
- Keith F. Hansen, MBA, is Co-Director, Center for Preparedness Education, College of Public Health; Co-Executive Director, Association of Healthcare Emergency Preparedness Professionals; and an Instructor, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Kristine Sanger
- Kristine Sanger is Director of Training and Exercise Programs, Center for Preparedness Education, College of Public Health, and Co-Executive Director, Association of Healthcare Emergency Preparedness Professionals, University of Nebraska Medical Center, Omaha, NE
| | - Ann Johnson
- Ann Johnson, PhD, MPH, CIP, is Director, Institutional Review Board and Human Research Program, University of Utah, Salt Lake City, UT
| | - Jonathan D Grein
- Jonathan D. Grein, MD, is Director, Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Julie Martin
- Julie Martin, RN, MEd, CIP, is Assistant Director, Institutional Review Board, Emory University, Atlanta, GA
| | - Rebecca Rousselle
- Rebecca Rousselle, BA, CIP, is Assistant Vice President, Human Research Protection Program, Emory University, Atlanta, GA
| | - Jennifer A Garland
- Jennifer A. Garland, RN-BC, PhD, CIC, is an Epidemiologist and Special Pathogens Clinical Program Manager, Hospital Epidemiology, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jessica Spotts
- Jessica Spotts, CIP, is a Senior IRB Education and Quality Improvement Analyst, Cedars-Sinai Medical Center, Los Angeles, CA
| | - John J Lowe
- John J. Lowe, PhD, is Co-Principal Investigator, National Emerging Special Pathogens Training and Education Center (NETEC), a Professor, Department of Environmental, Agricultural, and Occupational Health, College of Public Health, and Assistant Vice Chancellor for Health Security Training and Education, University of Nebraska Medical Center, Omaha, NE
| | - Lauren M Sauer
- Lauren M. Sauer, MSc, is Director, Special Pathogens Research Network, Global Center for Health Security, and an Associate Professor, Department of Environmental, Agricultural, and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Christopher J Kratochvil
- Christopher J. Kratochvil, MD, Associate Vice Chancellor for Clinical Research, University of Nebraska Medical Center, Omaha, NE
| | - Bruce G Gordon
- Bruce G. Gordon, MD, is Assistant Vice Chancellor for Regulatory Affairs, Executive Chairman of Institutional Review Boards, and Professor in the Department of Pediatrics, University of Nebraska Medical Center, Omaha, NE
| |
Collapse
|
6
|
Rohlman D, Samon S, Allan S, Barton M, Dixon H, Ghetu C, Tidwell L, Hoffman P, Oluyomi A, Symanski E, Bondy M, Anderson K. Designing Equitable, Transparent Community-Engaged Disaster Research. CITIZEN SCIENCE : THEORY AND PRACTICE 2022; 7:22. [PMID: 36909292 PMCID: PMC9997484 DOI: 10.5334/cstp.443] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Disaster research faces significant infrastructure challenges: regional and federal coordination, access to resources, and community collaboration. Disasters can lead to chemical exposures that potentially impact human health and cause concern in affected communities. Community-engaged research, which incorporates local knowledge and voices, is well-suited for work with communities that experience impacts of environmental exposures following disasters. We present three examples of community-engaged disaster research (CEnDR) following oil spills, hurricanes, and wildfires, and their impact on long-term social, physical, and technical community infrastructure. We highlight the following CEnDR structures: researcher/community networks; convenient research tools; adaptable data collection modalities for equitable access; and return of data.
Collapse
|
7
|
Khan AS, Wittenauer R, Patel R, Baseman J, Miller A, Errett NA. Developing a Concept of Operations Template to Guide Collaborative Disaster Research Response Between Academic Public Health and Public Health Agencies. Disaster Med Public Health Prep 2021; 17:e39. [PMID: 34612184 PMCID: PMC10497370 DOI: 10.1017/dmp.2021.280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Research conducted in the context of a disaster or public health emergency is essential to improve knowledge about its short- and long-term health consequences, as well as the implementation and effectiveness of response and recovery strategies. Integrated approaches to conducting Disaster Research Response (DR2) can answer scientific questions, while also providing attendant value for operational response and recovery. Here, we propose a Concept of Operations (CONOPS) template to guide the collaborative development and implementation of DR2 among academic public health and public health agencies, informed by previous literature, semi-structured interviews with disaster researchers from academic public health across the United States, and discussion groups with public health practitioners. The proposed CONOPS outlines actionable strategies to address DR2 issues before, during, and after disasters for public health scholars and practitioners who seek to operationalize or enhance their DR2 programs. Additional financial and human resources will be necessary to promote widespread implementation of collaborative DR2 programs.
Collapse
Affiliation(s)
- Amber S Khan
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington
| | - Rachel Wittenauer
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington
- Department of Global Health, School of Public Health, University of Washington
| | - Resham Patel
- Public Health - Seattle and King County
- Department of Health Services, School of Public Health, University of Washington
| | - Janet Baseman
- Department of Health Services, School of Public Health, University of Washington
- Department of Epidemiology, School of Public Health, University of Washington
- Office of the Dean, School of Public Health, University of Washington
| | - Aubrey Miller
- Office of the Director, National Institute of Environmental Health Sciences, National Institutes of Health
| | - Nicole A Errett
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington
- Department of Health Services, School of Public Health, University of Washington
| |
Collapse
|
8
|
Peek L, Tobin J, van de Lindt JW, Andrews A. Getting Interdisciplinary Teams into the Field: Institutional Review Board Preapproval and Multi-Institution Authorization Agreements for Rapid Response Disaster Research. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2021; 41:1204-1212. [PMID: 33960513 PMCID: PMC8360063 DOI: 10.1111/risa.13740] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 03/16/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
This article describes an interdisciplinary community resilience research project and presents a case study that supports bringing researchers together before a disaster to develop plans, procedures, and preapproved Institutional Review Board (IRB) protocols. In addition, this article explains how researchers from various academic institutions and their federal agency partners can effectively collaborate by creating an IRB Authorization Agreement (IAA). Such preparations can support interdisciplinary rapid response disaster fieldwork that is timely, ethically informed, and scientifically rigorous. This fieldwork preplanning process can also advance interdisciplinary team formation and data collection efforts over the long term.
Collapse
Affiliation(s)
- Lori Peek
- Department of Sociology and Natural Hazards CenterUniversity of Colorado BoulderBoulderCOUSA
| | - Jennifer Tobin
- Natural Hazards CenterUniversity of Colorado BoulderBoulderCOUSA
| | - John W. van de Lindt
- Department of Civil and Environmental EngineeringColorado State UniversityFort CollinsCOUSA
| | - Anne Andrews
- Research Protections OfficeNational Institute of Standards and TechnologyGaithersburgMDUSA
| |
Collapse
|
9
|
Institutional Review Board Preparedness for Disaster Research: a Practical Approach. Curr Environ Health Rep 2021; 8:127-137. [PMID: 33974244 PMCID: PMC8111380 DOI: 10.1007/s40572-021-00311-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/05/2021] [Indexed: 11/05/2022]
Abstract
Purpose of Review Disasters are becoming more common and challenge national and global resiliency and response efforts. As a result, government agencies have increased interest in disaster research to understand their environmental impact and health-related consequences. With the research field greatly expanding, Institutional Review Boards (IRBs) are being asked to review research protocols aimed at assessing health risks, exposures, and outcomes from disaster survivors. Few IRBs have experience reviewing disaster research protocols. This article describes approaches for IRB preparedness in reviewing disaster research. Recent Findings From a human research protections perspective, primary attention has focused on vulnerability of individuals and/or populations affected by a disaster who may serve as research participants [3, 4]. From our review of the current literature, there is a lack of best practices and/or guidance for IRBs in the review of disaster research protocols. Summary The growth of the disaster research field has brought more attention to potential ethical concerns of disaster research studies. Disaster survivors, responders, and those that assist in cleanup and remedial efforts may be left with significant unmet needs and long-term physical and emotional challenges as a result of their experiences. It is important for IRBs and investigators to collaboratively address how best to protect the welfare of individuals and communities affected by a disaster. A new approach is needed to systematically consider the various factors relevant to an assessment of human research protection issues following disasters.
Collapse
|
10
|
Edwards CJ, Miller A, Cobb JP, Erstad BL. The pharmacist's role in disaster research response. Am J Health Syst Pharm 2021; 77:1054-1059. [PMID: 32350533 DOI: 10.1093/ajhp/zxaa093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
PURPOSE The need for high-quality research during disaster responses has been well described in the literature, and such research is supported by efforts at the federal level through the National Institutes of Health Disaster Research Response (DR2) Program. This article describes the fourth DR2 workshop with a specific focus on opportunities for pharmacists to get involved with disaster research efforts. SUMMARY Pharmacists have historically played a significant role in disaster planning and response, and there are a number of opportunities for pharmacists to bring their unique perspective, positioning, and skills to disaster research response (ie, onsite and other research on the medical and public health aspects of disasters and public health emergencies). In February 2019, the fourth DR2 workshop was held in Tucson, AZ, in conjunction with the University of Arizona College of Medicine-Tucson, the university's Mel and Enid Zuckerman College of Public Health, University of Arizona College of Pharmacy, and the university's Bio5 Institute to explore clinical and population-based research in a simulated disaster setting. This article describes the workshop and discusses several opportunities for pharmacists to design, lead, and support research efforts during disaster scenarios through involvement in research areas including clinical, operational, educational, and logistic aspects of pharmacy practice. CONCLUSION Due to their positioning throughout health systems, unique perspective, training, and skills, pharmacists are uniquely situated to play an important role in disaster research response.
Collapse
Affiliation(s)
- Christopher J Edwards
- Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ
| | | | - J Perren Cobb
- Keck Medicine of USC, University of Southern California, Los Angeles, CA
| | - Brian L Erstad
- Department of Pharmacy Practice & Science, University of Arizona College of Pharmacy, Tucson, AZ
| |
Collapse
|
11
|
Goldstein BD. Broadening the Mandate of the Incident Command System to Address Community Mental and Behavioral Health Effects as Part of the Federal Response to Disasters. Curr Environ Health Rep 2020; 7:282-291. [PMID: 32594324 DOI: 10.1007/s40572-020-00283-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW In the United States, the Federal Incident Command System (ICS) directs response to major oil spills. Its initial imperative is to prevent immediate impacts on human health and safety. Subsequently, the ICS primarily turns its attention to environmental concerns, including considering vulnerable ecosystems. There is a growing body of evidence that disasters such as major oil spills lead to adverse psychosocial effects; yet, preventing such effects has not been formally incorporated into ICS disaster mitigation considerations. RECENT FINDINGS Community mental and behavioral effects are increasingly recognized as a significant impact of disasters. Standardized ecosystem analytical frameworks are key to ICS responses to its mandate for environmental protection. Similar frameworks have only begun to be developed for mental and behavioral effects. Providing the ICS with a formal mandate would likely lead to the prevention of community mental and behavioral effects being more systematically incorporated into ICS disaster responses.
Collapse
Affiliation(s)
- Bernard D Goldstein
- Graduate School of Public Health, University of Pittsburgh, 166 N. Dithridge St Apt A5, Pittsburgh, PA, 15213, USA.
| |
Collapse
|
12
|
Bruno W, Haar RJ. A systematic literature review of the ethics of conducting research in the humanitarian setting. Confl Health 2020; 14:27. [PMID: 32489418 PMCID: PMC7245798 DOI: 10.1186/s13031-020-00282-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 05/13/2020] [Indexed: 11/17/2022] Open
Abstract
Background Research around humanitarian crises, aid delivery, and the impact of these crises on health and well-being has expanded dramatically. Ethical issues around these topics have recently received more attention. We conducted a systematic literature review to synthesize the lessons learned regarding the ethics of research in humanitarian crises. Methods We conducted a systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines to identify articles regarding the ethics of research in humanitarian contexts between January 1, 1997 and September 1, 2019. We analyzed the articles to extract key themes and develop an agenda for future research. Results We identified 52 articles that matched our inclusion criteria. We categorized the article data into five categories of analysis: 32 were expert statements, 18 were case studies, 11 contained original research, eight were literature reviews and three were book chapters. All included articles were published in English. Using a step-wise qualitative analysis, we identified 10 major themes that encompassed these concepts and points. These major themes were: ethics review process (21 articles, [40.38%]); community engagement (15 articles [28.85%]); the dual imperative, or necessity that research be both academically sound and policy driven, clinical trials in the humanitarian setting (13 articles for each, [25.0%)]; informed consent (10 articles [19.23%]); cultural considerations (6 articles, [11.54%]); risks to researchers (5 articles, [9.62%]); child participation (4 articles [7.69%]); and finally mental health, and data ownership (2 articles for each [3.85%]). Conclusions Interest in the ethics of studying humanitarian crises has been dramatically increasing in recent years. While key concepts within all research settings such as beneficence, justice and respect for persons are crucially relevant, there are considerations unique to the humanitarian context. The particular vulnerabilities of conflict-affected populations, the contextual challenges of working in humanitarian settings, and the need for ensuring strong community engagement at all levels make this area of research particularly challenging. Humanitarian crises are prevalent throughout the globe, and studying them with the utmost ethical forethought is critical to maintaining sound research principles and ethical standards.
Collapse
Affiliation(s)
- William Bruno
- Department of Emergency Medicine, University of Southern California, Keck School of Medicine, Los Angeles, USA
| | - Rohini J Haar
- Division of Epidemiology and Biostatistics, School of Public Health, Research Fellow, Human Rights Center, School of Law, University of California at Berkeley, Berkeley, USA
| |
Collapse
|
13
|
Text Messaging and Disaster Preparedness Aids Engagement, Re-Engagement, Retention, and Communication Among Puerto Rican Participants in a Human Immunodeficiency Virus (HIV) Self-Testing Study After Hurricanes Irma and Maria. Disaster Med Public Health Prep 2020; 17:e2. [PMID: 32264992 PMCID: PMC8544602 DOI: 10.1017/dmp.2020.25] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Hurricanes can interrupt communication, exacerbate attrition, and disrupt participant engagement in research. We used text messaging and disaster preparedness protocols to re-establish communication, re-engage participants, and ensure retention in a human immunodeficiency virus (HIV) self-test study. METHODS Participants were given HIV home test kits to test themselves and/or their non-monogamous sexual partners before intercourse. A daily text message-based short message service computer-assisted self-interview (SMS-CASI) tool reminded them to report 3 variables: (1) anal sex without a condom, (2) knowledge of partners' testing history, and (3) proof of partners' testing history. A disaster preparedness protocol was put in place for hurricanes in Puerto Rico. We analyzed 6315 messages from participants (N = 12) active at the time of Hurricanes Irma and Maria. Disaster preparedness narratives were assessed. RESULTS All participants were able to communicate sexual behavior and HIV testing via SMS-CASI within 30 days following María. Some participants (n = 5, 42%) also communicated questions. Re-engagement within 30 days after the hurricane was 100% (second week/89%, third week/100%). Participant re-engagement ranged from 0-16 days (average = 6.4 days). Retention was 100%. CONCLUSIONS Daily SMS-CASI and disaster preparedness protocols helped participant engagement and communication after 2 hurricanes. SMS-CASI responses indicated high participant re-engagement, retention, and well-being.
Collapse
|
14
|
Ferreira RJ, Buttell F, Cannon C. Ethical Issues in Conducting Research With Children and Families Affected by Disasters. Curr Psychiatry Rep 2018; 20:42. [PMID: 29777320 DOI: 10.1007/s11920-018-0902-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW We review topical evidence on ethical issues in conducting disaster research with children and families affected by natural disasters, with an emphasis on analyzing specific vulnerabilities associated with children and families affected by disasters, identifying significant findings and trends of ethical guidelines and approaches, and discussing key observations into ethical research in a disaster setting. RECENT FINDINGS Current evidence indicates that there is a wide range of research methods for child disaster studies. Vulnerability as a concept in child disaster studies is more prevalent with several scholars underscoring the need for an ethical approach to disaster research. Current disaster research evidence suggests that there is specifically an interest in conducting disaster research with children and families. With the increase in investigations, it is strongly recommended that investigators adhere to ethical standards in research practice when conducting research with vulnerable populations (e.g., children) within a postdisaster context.
Collapse
Affiliation(s)
- Regardt J Ferreira
- Tulane School of Social Work, 127 Elk Place, New Orleans, LA, 70118, USA. .,Department of Social Work, University of the Free State, Bloemfontein, South Africa.
| | - Fred Buttell
- Tulane School of Social Work, 127 Elk Place, New Orleans, LA, 70118, USA.,Department of Social Work, University of the Free State, Bloemfontein, South Africa
| | - Clare Cannon
- Department of Social Work, University of the Free State, Bloemfontein, South Africa.,Department of Human Ecology, UC Davis, Davis, USA
| |
Collapse
|
15
|
Maxwell K. A coupled human-natural systems framework of community resilience. JOURNAL OF NATURAL RESOURCES POLICY RESEARCH 2018; 8:110-130. [PMID: 31534603 PMCID: PMC6750716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
This article compares and contrasts resilience frameworks to identify commonalities and gaps. It proposes use of a coupled human-natural systems framework (CHNS) to analyze community resilience to disasters. CHNS builds on the human ecosystem model that analyzes how institutions and social order shape fluxes and flows of resources between and within social and environmental systems. It expands on the model by including anthropological concepts of culture, agency, power, and discourse. The framework covers environmental and social legacies, pre-disaster trends and conditions, resilience measures, and system changes provoked by a disaster. The article proposes eleven categories of variables that affect resilience and discusses research steps for putting the framework into action. The CHNS framework can be used to predict system changes and identify resilience measures that allow communities to articulate and achieve their resilience goals.
Collapse
Affiliation(s)
- Keely Maxwell
- US Environmental Protection Agency, Washington, United States
| |
Collapse
|