From the Faculty of Medicine, University of Southampton, School of Primary Care, Population Science and Medical Education, Southampton, United Kingdom.
Clinical and Experimental Sciences, University Hospital Southampton, Southampton, United Kingdom.
Pediatr Infect Dis J. 2023 Nov 1;42(11):935-941. doi: 10.1097/INF.0000000000004036. Epub 2023 Jul 18.
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."
背景:在大多数医学研究中,包括人体挑战研究,孕妇都被排除在外。Lactamica 9 人体挑战研究旨在证明,向孕妇鼻腔接种共生细菌是否会导致水平传播给新生儿。鉴于人体挑战研究以及涉及孕妇及其新生儿的干预性研究在实践和伦理方面的独特考虑,我们试图调查这些志愿者的动机、关注点和体验。
方法:对 Lactamica 9 研究的所有参与者进行了参与前和参与后问卷调查。这些完全匿名的定性和半定量问卷使用强制李克特量表、词联想和自由文本问题。
结果:分别有 87.1%(27/31)和 62.5%(15/24)的合格参与者完成了参与前和参与后问卷。几乎所有参与前的受访者都同意参与的利他动机,大多数关注点与研究程序的不适有关,很少有人担心接种对自己(5/27;18.5%)或婴儿(6/27;22.2%)的理论风险。参与者最常将研究干预与“细菌”、“自然”、“保护”和“安全”等术语联系起来。对于参与后问卷,93.3%(14/15)的人认为所有研究程序都可以接受,定性反馈几乎完全是积极的,特别强调研究团队的灵活性、可接近性和友好性。
结论:Lactamica 9 研究的成功完成表明,健康孕妇的人体挑战研究是可以接受和可行的。参与者最初对潜在不适的担忧被主要的利他动机和对干预措施的“自然”感知所抵消。
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