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Radu S, Zarinafsar S, Ryan GW, Chainani S, Becker S, Arenas J, Spano MA, Shillan HN, Hoque S, Sadasivam R, Pbert L, Luther J, Trivedi MK. Participant Perspectives on the Implementation of a School-Linked Text-Message Intervention to Improve Pediatric Asthma Medication Adherence. Pediatr Allergy Immunol Pulmonol 2024; 37:13-21. [PMID: 38324020 PMCID: PMC10951618 DOI: 10.1089/ped.2023.0093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 12/14/2023] [Indexed: 02/08/2024]
Abstract
Background: Poor adherence to inhaled corticosteroids (ICS) is a significant challenge in pediatric asthma, contributing to health inequities. Text-message reminders for ICS therapy are an evidence-based approach that improves pediatric asthma medication adherence, yet has not been widely adopted into practice, partly due to lack of (1) participant input on design and implementation and (2) use of sustainable community linkages. Remote Asthma Link™ (RAL) seeks to fill this gap as a school-linked text-message intervention wherein parents of children with poorly controlled asthma received daily, 2-way text-message reminders for preventive inhaler use. Responses were shared with school nurses who conducted remote check-ins with families. Enrolled children, largely from underserved backgrounds, experienced improvements in medication adherence and asthma health outcomes. While initial results were promising, we have yet to elicit participant input to refine the protocol for more widespread implementation. Objective: Examine participant perspectives on barriers and facilitators of RAL implementation. Methods: Semistructured interviews were conducted May-June 2022 with intervention participants: 10 parents, 7 school nurses, and 4 pediatric providers (n = 21) until thematic saturation was reached. Interview transcripts were coded using thematic analysis. Results: Several facilitators for RAL implementation were identified, including ease of use and accessibility, personal connection to the school nurse, and receipt of a visual notification for habit formation. Barriers included challenges with school nurses reaching parents, poor understanding of program expectations, and lack of reimbursement structure. Participant-proposed solutions to barriers included utilizing alternate communication methods (eg, social media), educational sessions, and meeting with payors to consider reimbursement models. Conclusion: RAL is a school-linked text-message intervention demonstrating promise in improving outcomes and equity in asthma care. Key implementation facilitators, barriers, and proposed solutions will inform protocol adaptations to promote successful implementation of this and other text-message interventions into clinical practice.
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Affiliation(s)
- Sonia Radu
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sheerin Zarinafsar
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Grace W. Ryan
- Department of Population and Quantitative Health Sciences; Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sanjay Chainani
- Department of Internal Medicine; Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Sarah Becker
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Juliana Arenas
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Michelle A. Spano
- Division of Pulmonary Medicine, Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Holly N. Shillan
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Shushmita Hoque
- Department of Internal Medicine; Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Rajani Sadasivam
- Department of Population and Quantitative Health Sciences; Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Lori Pbert
- Department of Population and Quantitative Health Sciences; Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Janki Luther
- Department of Medicine, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Michelle K. Trivedi
- Department of Population and Quantitative Health Sciences; Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Division of Pulmonary Medicine, Department of Pediatrics; University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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Bevan JHJ, Theodosiou AA, Corner J, Dorey RB, Read RC, Jones CE. A Questionnaire-based Study Exploring Participant Perspectives in a Perinatal Human Challenge Trial. Pediatr Infect Dis J 2023; 42:935-941. [PMID: 37463362 PMCID: PMC10569679 DOI: 10.1097/inf.0000000000004036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/18/2023] [Indexed: 07/20/2023]
Abstract
BACKGROUND Pregnant women have historically been excluded from most medical research, including human challenge studies. The proof-of-concept Lactamica 9 human challenge study investigated whether nasal inoculation of pregnant women with commensal bacteria leads to horizontal transmission to the neonate. Given the unique practical and ethical considerations of both human challenge studies and interventional research involving pregnant women and their newborns, we sought to investigate the motivations, concerns and experiences of these volunteers. METHODS Pre- and post-participation questionnaires were given to all participants in the Lactamica 9 study. These fully anonymized qualitative and Semi-quantitative questionnaires used forced Likert scales, word association and free-text questions. RESULTS Pre- and post-participation questionnaires were completed by 87.1% (27/31) and 62.5% (15/24) of eligible participants, respectively. Almost all pre-participation respondents agreed with altruistic motivations for participation, and most concerns were related to discomfort from study procedures, with few concerned about the theoretical risks of inoculation to themselves (5/27; 18.5%) or their baby (6/27; 22.2%). Participants most frequently associated the study intervention with the terms "bacteria," "natural," "protective" and "safe." For the post-participation questionnaire, 93.3% (14/15) found all study procedures acceptable, and qualitative feedback was almost entirely positive, with particular emphasis on the research team's flexibility, approachability and friendliness. CONCLUSIONS The successful completion of the Lactamica 9 study demonstrates that human challenge research in healthy pregnant women can be acceptable and feasible. Participants' initial concerns of potential discomfort were outweighed by predominantly altruistic motivations and perception of the intervention as "natural."
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Affiliation(s)
- James H. J. Bevan
- From the Faculty of Medicine, University of Southampton, School of Primary Care, Population Science and Medical Education, Southampton, United Kingdom
| | - Anastasia A. Theodosiou
- Clinical and Experimental Sciences, University Hospital Southampton, Southampton, United Kingdom
| | - James Corner
- University of Southampton Medical School, Southampton, United Kingdom
| | - Robert B. Dorey
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
| | - Robert C. Read
- Clinical and Experimental Sciences, University Hospital Southampton, Southampton, United Kingdom
- NIHR Southampton Clinical Research Facility and Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
| | - Christine E. Jones
- Faculty of Medicine and Institute for Life Sciences, University of Southampton, Southampton, United Kingdom
- NIHR Southampton Clinical Research Facility and Southampton Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom
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Levy L, Ebadi H, Smith AP, Taiclet L, Pouratian N, Feinsinger A. Disentangling Function from Benefit: Participant Perspectives from an Early Feasibility Trial for a Novel Visual Cortical Prosthesis. AJOB Neurosci 2023:1-19. [PMID: 37812142 PMCID: PMC11001790 DOI: 10.1080/21507740.2023.2257152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
Visual cortical prostheses (VCPs) have the potential to provide artificial vision for visually impaired persons. However, the nature and utility of this form of vision is not yet fully understood. Participants in the early feasibility trial for the Orion VCP were interviewed to gain insight into their experiences using artificial vision, their motivations for participation, as well as their expectations and assessments of risks and benefits. Analyzed using principles of grounded theory and an interpretive description approach, these interviews yielded six themes, including: the irreducibility of benefit to device functionality, mixed expectations for short-term device functionality and long-term technological advancement of visual prostheses, and a broad range of risks, concerns, and fears related to trial participation. We argue that these narratives motivate a nuanced set of ethical considerations related to the complex relationship between functionality and benefit, the intersection of user experience with disability justice, and the import of expectations and indirect risks on consent.
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Affiliation(s)
- Lilyana Levy
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Hamasa Ebadi
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ally Peabody Smith
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Lauren Taiclet
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - Nader Pouratian
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ashley Feinsinger
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
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Oyeleye T, Walker R, Cunningham SJ. A qualitative exploration of the experiences of young people and their parents regarding the impact of missing school to attend hospital-based orthodontic appointments. J Orthod 2023; 50:229-236. [PMID: 37026577 DOI: 10.1177/14653125231159141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
OBJECTIVE To explore the experiences of young people and their parents regarding the impact on school performance due to time away from school for orthodontic appointments and to explore their views about a possible extension to the current service. DESIGN A qualitative study using semi-structured interviews. SETTING UK district hospitals. PARTICIPANTS A total of 11 pairs of interviewees: young people undergoing fixed appliances and their parents. METHODS Semi-structured interviews were conducted with young people and their parents. The interviews were audio recorded and transcribed verbatim. A framework approach was used to analyse the data. RESULTS A thematic analysis of the data identified five main themes which were as follows: (1) expectations of the treatment process and appointments; (2) impact of school absences and treatment; (3) appointments; (4) implications for young people, parents and others; and (5) satisfaction with treatment. These themes were then further subdivided and analysed. CONCLUSION Young people and their parents felt that attending appointments for orthodontic treatment had minimal impact on a young person's school performance. However, some young people did engage in coping mechanisms in order to ensure this was the case. Young people and their parents advised they were satisfied with the process of the treatment despite the time missed at school/work. Some young people and their parents saw a real benefit to appointments that could be fitted into a 'NHS seven-day' service model, but this did not apply to all interviewees.
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Affiliation(s)
- Teniola Oyeleye
- Orthodontic Department, Dorset County Hospital, Dorchester, UK
| | - Roz Walker
- Orthodontic Department, St Richard's Hospital, Chichester, UK
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Smith AP, Taiclet L, Ebadi H, Levy L, Weber M, Caruso EM, Pouratian N, Feinsinger A. "They were already inside my head to begin with": Trust, Translational Misconception, and Intraoperative Brain Research. AJOB Empir Bioeth 2023; 14:111-124. [PMID: 36137012 PMCID: PMC10030379 DOI: 10.1080/23294515.2022.2123869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Background: Patients undergoing invasive neurosurgical procedures offer researchers unique opportunities to study the brain. Deep brain stimulation patients, for example, may participate in research during the surgical implantation of the stimulator device. Although this research raises many ethical concerns, little attention has been paid to basic studies, which offer no therapeutic benefits, and the value of patient-participant perspectives.Methods: Semi-structured interviews were conducted with fourteen individuals across two studies who participated in basic intraoperative research during their deep brain stimulator surgery. Interviews explored interpretations of risks and benefits, enrollment motivations, and experiences of participating in awake brain research. Reflexive thematic analysis was conducted.Results: Seven themes were identified from participant narratives, including robust attitudes of trust, high valuations of basic science research, impacts of the surgical context, and mixed experiences of participation.Conclusion: We argue that these narratives raise the potential for a translational misconception and motivate intraoperative re-consent procedures.
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Affiliation(s)
- Ally Peabody Smith
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Lauren Taiclet
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Hamasa Ebadi
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, United States
| | - Liliana Levy
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
| | - Megan Weber
- Anderson School of Management, University of California, Los Angeles, United States
| | - Eugene M. Caruso
- Anderson School of Management, University of California, Los Angeles, United States
| | - Nader Pouratian
- Department of Neurological Surgery, University of Texas Southwestern Medical Center, Dallas, United States
| | - Ashley Feinsinger
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, United States
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Holth K, Gould KR, Hicks AJ, Analytis P, Feeney TJ, Ponsford JL. "I've never been positive … I am now": Participant perspectives of a Positive Behaviour Support intervention (PBS + PLUS) for community-living individuals with ABI and their close others. Neuropsychol Rehabil 2022; 32:2411-2428. [PMID: 34233578 DOI: 10.1080/09602011.2021.1947326] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Challenging behaviours are common following moderate to severe acquired brain injury (ABI). These behaviours cause relationship and community participation difficulties and are a significant source of stress for many individuals with ABI and their close others (COs). A Positive Behaviour Support intervention, PBS + PLUS, was implemented to assist individuals with ABI to collaboratively build meaningful lives and self-regulate their behaviour. This study explored the perspectives of individuals with ABI and COs (family members, friends, and carers) who had completed an individualized 12-month PBS + PLUS intervention. Fifty-two individuals participated in semi-structured interviews, and a thematic analysis of interview transcripts identified the interrelated themes of Openness to Change, Embeddedness, Clinician Connection, and Preparedness for the Future. Participant perceptions of, and engagement with, PBS + PLUS were influenced by an attitude of openness to new ideas and by the intervention itself. Achieving contextual relevance allowed the intervention to become embedded in participants' lives, and the client-clinician relationship was central to participants' positive experiences. While most participants felt better equipped to cope with the future, some experienced difficulties transitioning to post-intervention life. These results suggest PBS + PLUS may assist individuals with ABI to lead meaningful lives and more confidently overcome behavioural challenges, while encouraging supportive and empowered COs.
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Affiliation(s)
- Kristian Holth
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - Kate Rachel Gould
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - Amelia J Hicks
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - Penelope Analytis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
| | - Timothy J Feeney
- Belvedere Health Services and the Mill School, Winooski, Vermont, USA
| | - Jennie Louise Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash Epworth Rehabilitation Research Centre, Epworth Healthcare, Richmond, Australia
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Benson McKendall S, McKendall A, Kuhn S, Morton C, McMillion M, Freeland S. The Health Sciences and Technology Academy: Re-Imagining Programmatic Delivery During the COVID-19 Pandemic. J STEM Outreach 2021; 4. [PMID: 34988385 DOI: 10.15695/jstem/v4i4.06] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Out-of-school time academic/STEM programs provide educational enrichment to a myriad of student populations with some designed to assist those underrepresented and at-risk who desire to purse post-secondary studies. One such program in West Virginia (WV) is the Health Sciences and Technology Academy (HSTA), which provides hands-on, in person and engaging educational enrichment with the intent to increase the college going rates of Appalachia's most vulnerable youth. In March 2020, HSTA key personnel encountered the task of redesigning program delivery due to the immediate shutdown of all in person operations resulting from the novel coronavirus, SARS-CoV-19 (COVID-19) pandemic. This paper discusses the programmatic changes of program delivery during HSTA's key program components-the Summer Institute and the Community Based Programming. This paper also utilizes repeated measures one-way multivariate analysis (MANOVA) and paired t-test analysis to examine participants' perspectives on learning, enjoyment and satisfaction of the aforementioned components prior to and during the COVID-19 pandemic.
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Affiliation(s)
| | - Alan McKendall
- Department of Industrial and Management Systems Engineering, West Virginia University, Morgantown, WV
| | - Summer Kuhn
- Health Sciences and Technology Academy, West Virginia University, Morgantown, WV
| | - Catherine Morton
- Health Sciences and Technology Academy, West Virginia University, Morgantown, WV
| | - Mary McMillion
- Health Sciences and Technology Academy, West Virginia University, Morgantown, WV
| | - Sean Freeland
- Health Sciences and Technology Academy, West Virginia University, Morgantown, WV
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Nebeker C, Zlatar ZZ. Learning From Older Adults to Promote Independent Physical Activity Using Mobile Health (mHealth). Front Public Health 2021; 9:703910. [PMID: 34476229 PMCID: PMC8406525 DOI: 10.3389/fpubh.2021.703910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 07/16/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Healthy aging is critically important for several reasons, including economic impact and quality of life. As the population of older adults rapidly increases, identifying acceptable ways to promote healthy aging is a priority. Technologies that can facilitate health promotion and risk reduction behaviors may be a solution, but only if these mobile health (mHealth) tools can be used by the older adult population. Within the context of a physical activity intervention, this study gathered participant's opinions about the use of an mHealth device to learn about acceptance and to identify areas for improvement. Methods: The Independent Walking for Brain Health study (NCT03058146) was designed to evaluate the effectiveness of a wearable mHealth technology in facilitating adherence to a physical activity prescription among participants in free-living environments. An Exit Survey was conducted following intervention completion to gauge participant's perceptions and solicit feedback regarding the overall study design, including exercise promotion strategies and concerns specific to the technology (e.g., privacy), that could inform more acceptable mHealth interventions in the future. The Digital Health Checklist and Framework was used to guide the analysis focusing on the domains of Privacy, Access and Usability, and Data Management. Results: Participants (n = 41) were in their early 70's (mean = 71.6) and were predominantly female (75.6%) and White (92.7%). Most were college educated (16.9 years) and enjoyed using technology in their everyday life (85.4%). Key challenges included privacy concerns, device accuracy, usability, and data access. Specifically, participants want to know what is being learned about them and want control over how their identifiable data may be used. Overall, participants were able to use the device despite the design challenges. Conclusions: Understanding participant's perceptions of the challenges and concerns introduced by mHealth is important, as acceptance will influence adoption and adherence to the study protocol. While this study learned from participants at studycompletion, we recommend that researchers consider what might influence participant acceptance of the technology (access, data management, privacy, risks) and build these into the mHealth study design process. We provide recommendations for future mHealth studies with older adults.
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Affiliation(s)
- Camille Nebeker
- Design Lab and Research Center for Optimal Digital Ethics in Health (ReCODE Health), Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, United States
| | - Zvinka Z Zlatar
- Wellness Initiative for Senior Enrichment (WISE) Lab, Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
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Matson M, Macapagal K, Kraus A, Coventry R, Bettin E, Fisher CB, Mustanski B. Sexual and gender minority youth's perspectives on sharing de-identified data in sexual health and HIV prevention research. Sex Res Social Policy 2019; 16:1-11. [PMID: 31890053 PMCID: PMC6936765 DOI: 10.1007/s13178-018-0372-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Funding agencies encourage and sometimes require data sharing. However, there is limited empirical research on participant perspectives on sharing de-identified data from research on sensitive topics (e.g., HIV, sexual health) with other researchers, and virtually none from adolescents or sexual and gender minority (SGM) participants. SGM teens (N = 197) ages 14-17 completed an online survey with multiple choice and open-ended items assessing perspectives toward sharing survey responses and blood samples from sexual health and HIV testing studies with other researchers. SGM youth were willing to share data but frequently cited confidentiality and privacy concerns, including fears about parents finding out about their identities even after de-identification was explained. Researchers need to ensure youth understand explanations of data security protections in order to make well-informed decisions about participating in research.
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Affiliation(s)
- Margaret Matson
- Department of Medical Social Sciences & Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine (Chicago, IL)
| | - Kathryn Macapagal
- Department of Medical Social Sciences & Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine (Chicago, IL)
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine (Chicago, IL)
| | - Ashley Kraus
- Department of Medical Social Sciences & Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine (Chicago, IL)
| | - Ryan Coventry
- Department of Medical Social Sciences & Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine (Chicago, IL)
| | - Emily Bettin
- Department of Medical Social Sciences & Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine (Chicago, IL)
| | - Celia B. Fisher
- Center for Ethics Education & Department of Psychology, Fordham University (Bronx, NY)
| | - Brian Mustanski
- Department of Medical Social Sciences & Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University Feinberg School of Medicine (Chicago, IL)
- Department of Psychiatry & Behavioral Sciences, Northwestern University Feinberg School of Medicine (Chicago, IL)
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Portz JD, Waddington E, Atler KE, Van Puymbroeck M, Schmid AA. Self-Management and Yoga for Older Adults with Chronic Stroke: A Mixed-Methods Study of Physical Fitness and Physical Activity. Clin Gerontol 2018; 41:374-381. [PMID: 28452644 DOI: 10.1080/07317115.2016.1252453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study investigated changes in physical fitness and physical activity among older patients with chronic stroke (stroke ≥ 6 months previous) after participation in a yoga infused self-management intervention. METHODS A mixed-methods secondary data analysis examined quantitative measures of endurance, strength, and gait speed and qualitative perspectives of intervention participants. RESULTS Based on Wilcoxon analysis, physical fitness outcome measures including endurance and lower and upper body strength significantly (p < .02) improved. Based on qualitative results of 2 focus groups and 14 individual interviews, participants expressed positive changes in endurance, strength, gait speed, flexibility, and balance. They also reported improvements in walking ability and duration, and expressed a desire to continue yoga and increase levels of exercise. CONCLUSIONS With the objective of improving physical fitness and exercise for older adults with chronic stroke, it is important for self-management interventions to provide specific safe and feasible physical activity components, such as yoga. CLINICAL IMPLICATIONS Health professionals may improve offered chronic stroke self-management interventions by incorporating yoga.
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Affiliation(s)
| | | | - Karen E Atler
- a Colorado State University , Fort Collins , Colorado , USA
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Abstract
OBJECTIVE In the United States, data from federally funded genomics studies are stored in national databases, which may be accessible to anyone online (public release) or only to qualified researchers (restricted release). The availability of such data exposes participants to privacy risk and limits the ability to withdraw from research. This exposure is especially challenging for pediatric participants, who are enrolled in studies with parental permission. The current study examines genomic research participants' attitudes to explore differences in data sharing (DS) preferences between parents of pediatric patients and adult patients. METHODS A total of 113 parents of pediatric patients and 196 adult participants from 6 genomics studies were randomly assigned to 3 experimental consent forms. Participants were invited to a follow-up structured interview exploring DS preferences, study understanding, and attitudes. Descriptive analyses and regression models were built on responses. RESULTS Most parents (73.5%) and adult participants (90.3%) ultimately consented to broad public release. However, parents were significantly more restrictive in their data release decisions, not because of understanding or perceived benefits of participation but rather autonomy and control. Parents want to be more involved in the decision about DS and are significantly more concerned than adult participants about unknown future risks. CONCLUSIONS Parents have the same altruistic motivations and grasp of genomics studies as adult participants. However, they are more concerned about future risks to their child, which probably motivates them to choose more restrictive DS options, but only when such options are made available.
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Affiliation(s)
- Matthew D. Burstein
- Structural and Computation Biology & Molecular Biophysics Graduate Program,,Medical Scientist Training Program
| | | | | | | | - Ching C. Lau
- Structural and Computation Biology & Molecular Biophysics Graduate Program,,Dan L. Duncan Cancer Center, and,Department of Pediatrics, Hematology–Oncology Section, Baylor College of Medicine, Houston, Texas
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Robinson JO, Slashinski MJ, Wang T, Hilsenbeck SG, McGuire AL. Participants' recall and understanding of genomic research and large-scale data sharing. J Empir Res Hum Res Ethics 2013; 8:42-52. [PMID: 24169421 PMCID: PMC3995160 DOI: 10.1525/jer.2013.8.4.42] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
As genomic researchers are urged to openly share generated sequence data with other researchers, it is important to examine the utility of informed consent documents and processes, particularly as these relate to participants' engagement with and recall of the information presented to them, their objective or subjective understanding of the key elements of genomic research (e.g., data sharing), as well as how these factors influence or mediate the decisions they make. We conducted a randomized trial of three experimental informed consent documents (ICDs) with participants (n = 229) being recruited to genomic research studies; each document afforded varying control over breadth of release of genetic information. Recall and understanding, their impact on data sharing decisions, and comfort in decision making were assessed in a follow-up structured interview. Over 25% did not remember signing an ICD to participate in a genomic study, and the majority (54%) could not correctly identify with whom they had agreed to share their genomic data. However, participants felt that they understood enough to make an informed decision, and lack of recall did not impact final data sharing decisions or satisfaction with participation. These findings raise questions about the types of information participants need in order to provide valid informed consent, and whether subjective understanding and comfort with decision making are sufficient to satisfy the ethical principle of respect for persons.
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Abstract
This study used semi-structured interviews and content analysis to examine moral principles that street drug users apply to three hypothetical addiction research ethical dilemmas. Participants (n = 90) were ethnically diverse, economically disadvantaged drug users recruited in New York City in 2009 . Participants applied a wide range of contextually sensitive moral precepts, including respect, beneficence, justice, relationality, professional obligations, rules, and pragmatic self-interest. Limitations and implications for future research and the responsible conduct of addiction research are discussed.
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Affiliation(s)
- Celia B Fisher
- Department of Psychology, Fordham University, Bronx, New York 10458, USA.
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Oransky M, Fisher CB, Mahadevan M, Singer M. Barriers and opportunities for recruitment for nonintervention studies on HIV risk: perspectives of street drug users. Subst Use Misuse 2009; 44:1642-59. [PMID: 19938935 PMCID: PMC3638737 DOI: 10.1080/10826080802543671] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study used focus-group discussions in response to a video vignette to examine attitudes toward recruitment for nonintervention research involving HIV testing. Participants were 100 ethnically diverse, economically disadvantaged urban drug users, who were recruited from New York City and Hartford, Connecticut in the spring and summer of 2006. Content analyses revealed themes including (1) fears of stigma and legal trouble balanced by trustworthiness of the recruiter; (2) fears of learning one's HIV status balanced by prospects for health benefits, and (3) the right to receive fair monetary compensation balanced by risks of coercion during periods of cravings. Limitations and implications for recruitment practices have been discussed here.
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Affiliation(s)
- Matthew Oransky
- Center for Ethics Education, Fordham University, Bronx, New York 10458, USA
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