Koren Gideon, Beller Daniella, Laifenfeld Daphna, Grossman Iris, Shalev Varda
Research Institute, Maccabi Health Services, Tel Aviv, Israel.
Tel Aviv University, Tel Aviv, Israel.
BMC Med Ethics. 2017 Nov 17;18(1):63. doi: 10.1186/s12910-017-0223-8.
As part of the preparations to establish a population-based biobank in a large Israeli health organization, we aimed to investigate through focus groups the knowledge, perceptions and attitudes of insured Israelis, toward biobanking, and then, after input from focus groups' participants, to empirically assess the impact of a revised recruitment process on recruitment rates.
At the outset of the focus groups there was an overall positive response to the prospect of a population-based biobank. Concerns revolved around infringement on privacy, fears of the "big brother"(e.g. insurance companies), and anxiety about inequality. Reaction to the language of the informed consent document revolved around concerns over ability to maintain anonymity, to withdraw consent, involvement of commercial entities, and the general tenor of the informed consent, which was perceived as legalistic and unilateral. In general, the longer participants were exposed to discussion about the biobank, the less likely they were to consent to sign in. Overall, only 20% (12) of the 60 participants stated they would agree to sign in by the end of the 2 hour group session. The feedback obtained from the focus groups was used in the second stage ("real life") of the study. A team of recruiters received extensive training to enable fruitful discussion and a detailed explanation to questions and concerns raised during the recruitment process. During the second stage of the study, after revising the consent form and training recruiters, a 53% consent rate was observed among 10,262 participants, more than 4 fold higher than estimated at the focus group stage.
The qualitative focus group research helped identify important perceptions and concerns, which were subsequently addressed in the revised consent form and in the discussion the recruiters had with potential biobank donors.
作为在以色列一家大型健康组织中建立基于人群的生物样本库筹备工作的一部分,我们旨在通过焦点小组调查参保以色列人对生物样本库的知识、认知和态度,然后,在焦点小组参与者提供意见后,实证评估修订后的招募流程对招募率的影响。
1)对过去两年内进行过常规血液实验室检测的个人进行了6次焦点小组讨论(每组n = 10)。2)在解决了焦点小组中提出的问题并修订招募流程后,邀请在采血诊所进行常规血液检测的个人(N = 10262)参与未来的生物样本库。
在焦点小组开始时,对基于人群的生物样本库的前景总体反应积极。担忧主要围绕隐私侵犯、对“老大哥”(如保险公司)的恐惧以及对不平等的焦虑。对知情同意文件措辞的反应主要围绕对保持匿名的能力、撤回同意、商业实体的参与以及知情同意的总体基调的担忧,知情同意书被认为是法律主义的和单方面的。总体而言,参与者接触生物样本库讨论的时间越长,他们同意签署的可能性就越小。在2小时的小组会议结束时,60名参与者中只有20%(12人)表示他们会同意签署。从焦点小组获得的反馈被用于研究的第二阶段(“现实生活”)。一组招募人员接受了广泛培训,以便能够进行富有成效的讨论,并对招募过程中提出的问题和担忧进行详细解释。在研究的第二阶段,在修订同意书并培训招募人员后,在10262名参与者中观察到同意率为53%,比焦点小组阶段估计的高出4倍多。
定性的焦点小组研究有助于识别重要的认知和担忧,随后在修订后的同意书以及招募人员与潜在生物样本库捐赠者的讨论中得到了解决。