Department of Family and Community Medicine, University of New Mexico, Albuquerque, New Mexico 87131, USA.
Ann Fam Med. 2010 Sep-Oct;8(5):433-9. doi: 10.1370/afm.1138.
The increasing attention paid to community-based research highlights the question of whether human research protections focused on the individual are adequate to safeguard communities. We conducted a study to explore how community members perceive low-risk health research, the adequacy of human research protection processes, and the ethical conduct of community-based research.
Eighteen focus groups were conducted among rural and urban Hispanic and Native American communities in New Mexico using a semistructured guide. Group transcriptions were analyzed using iterative readings and coding, with review of the analytic summary by group members.
Although participants recognized the value of health research, many also identified several adverse effects of research in their communities, including social (community and individual labeling, stigmatization, and discrimination) and economic (community job losses, increased insurance rates, and loss of community income). A lack of community beneficence was emphasized by participants who spoke of researchers who fail to communicate results adequately or assist with follow-through. Many group members did not believe current human research and data privacy processes were adequate to protect or assist communities.
Ethical review of community-based health research should apply the Belmont principles to communities. Researchers should adopt additional approaches to community-based research by engaging communities as active partners throughout the research process, focusing on community priorities, and taking extra precautions to assure individual and community privacy. Plans for meaningful dissemination of results to communities should be part of the research design.
越来越多的人关注基于社区的研究,这突出了一个问题,即针对个人的人类研究保护措施是否足以保护社区。我们进行了一项研究,以探讨社区成员如何看待低风险健康研究、人类研究保护过程的充分性以及基于社区的研究的伦理行为。
在新墨西哥州的农村和城市西班牙裔和美国原住民社区中进行了 18 次焦点小组讨论,使用半结构化指南。通过迭代阅读和编码对小组记录进行分析,并由小组成员对分析摘要进行审查。
尽管参与者认识到健康研究的价值,但许多人也指出了研究在其社区中带来的一些负面影响,包括社会方面(社区和个人的标签、污名化和歧视)和经济方面(社区工作机会流失、保险费率上升和社区收入损失)。一些参与者强调了缺乏社区慈善,他们提到研究人员未能充分沟通研究结果或协助后续工作。许多小组成员认为,目前的人类研究和数据隐私流程不足以保护或协助社区。
基于社区的健康研究的伦理审查应将贝尔蒙原则应用于社区。研究人员应通过在整个研究过程中让社区作为积极的合作伙伴、关注社区的优先事项并采取额外的预防措施来确保个人和社区的隐私,采用额外的方法来进行基于社区的研究。将有意义的研究结果传播给社区的计划应成为研究设计的一部分。