Flicker Sarah, Travers Robb, Guta Adrian, McDonald Sean, Meagher Aileen
Faculty of Environmental Studies, York University, Toronto, Canada.
J Urban Health. 2007 Jul;84(4):478-93. doi: 10.1007/s11524-007-9165-7.
National and international codes of research conduct have been established in most industrialized nations to ensure greater adherence to ethical research practices. Despite these safeguards, however, traditional research approaches often continue to stigmatize marginalized and vulnerable communities. Community-based participatory research (CBPR) has evolved as an effective new research paradigm that attempts to make research a more inclusive and democratic process by fostering the development of partnerships between communities and academics to address community-relevant research priorities. As such, it attempts to redress ethical concerns that have emerged out of more traditional paradigms. Nevertheless, new and emerging ethical dilemmas are commonly associated with CBPR and are rarely addressed in traditional ethical reviews. We conducted a content analysis of forms and guidelines commonly used by institutional review boards (IRBs) in the USA and research ethics boards (REBs) in Canada. Our intent was to see if the forms used by boards reflected common CBPR experience. We drew our sample from affiliated members of the US-based Association of Schools of Public Health and from Canadian universities that offered graduate public health training. This convenience sample (n = 30) was garnered from programs where application forms were available online for download between July and August, 2004. Results show that ethical review forms and guidelines overwhelmingly operate within a biomedical framework that rarely takes into account common CBPR experience. They are primarily focused on the principle of assessing risk to individuals and not to communities and continue to perpetuate the notion that the domain of "knowledge production" is the sole right of academic researchers. Consequently, IRBs and REBs may be unintentionally placing communities at risk by continuing to use procedures inappropriate or unsuitable for CBPR. IRB/REB procedures require a new framework more suitable for CBPR, and we propose alternative questions and procedures that may be utilized when assessing the ethical appropriateness of CBPR.
大多数工业化国家已制定国家和国际研究行为准则,以确保更严格地遵守道德研究规范。然而,尽管有这些保障措施,传统研究方法往往继续给边缘化和弱势群体带来污名。基于社区的参与性研究(CBPR)已发展成为一种有效的新研究范式,它试图通过促进社区与学者之间的伙伴关系发展,以解决与社区相关的研究重点,从而使研究成为一个更具包容性和民主性的过程。因此,它试图纠正源于更传统范式的伦理问题。尽管如此,新出现的伦理困境通常与CBPR相关,而在传统伦理审查中很少得到解决。我们对美国机构审查委员会(IRB)和加拿大研究伦理委员会(REB)常用的表格和指南进行了内容分析。我们的目的是查看委员会使用的表格是否反映了常见的CBPR经验。我们从美国公共卫生学院协会的附属成员以及提供公共卫生研究生培训的加拿大大学中抽取样本。这个便利样本(n = 30)来自2004年7月至8月期间可在线下载申请表的项目。结果表明,伦理审查表格和指南绝大多数在生物医学框架内运作,很少考虑到常见的CBPR经验。它们主要关注评估对个人而非社区的风险原则,并继续延续“知识生产”领域是学术研究人员专有权利的观念。因此,IRB和REB可能会因继续使用不适合或不适用于CBPR的程序而无意中使社区面临风险。IRB/REB程序需要一个更适合CBPR的新框架,我们提出了在评估CBPR的伦理适宜性时可采用的替代问题和程序。
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