Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA.
School of Social Work, San Diego State University, San Diego, CA, USA.
Schizophr Bull. 2024 Apr 30;50(3):673-683. doi: 10.1093/schbul/sbad159.
Latinxs are vastly underrepresented in mental health research; one of many contributing factors may be complexities in the research consent process, including language preferences. We examined determinants of comprehension of research consent procedures and tested the effects of a preconsent research schema condition among 180 adults with schizophrenia (60 Latinx-English and 60 Latinx-Spanish preference, and 60 non-Latinx White).
Participants were randomly assigned (equal allocation) to an educational session regarding clinical research concepts and processes (schema condition) or to an attention control. Following a subsequent simulated consent procedure for a hypothetical drug trail, comprehension of consent disclosures was measured with 2 standard measures.
One-way ANOVAs showed significant medium effect size differences between ethnicity/language groups on both measures of comprehension (η2s = 0.066-0.070). The Latinx-Spanish group showed lower comprehension than non-Latinx White participants; differences between the 2 Latinx groups did not reach statistical significance. Group differences were not statistically significant after adjusting for differences in education, or on scores from structured measures of acculturation, health literacy, or research literacy. Two-way ANOVAs showed no significant main effects for consent procedure on either comprehension measure (Ps > .369; partial η2s < 0.006) and no significant group-by-consent interactions (Ps > .554; partial η2s < 0.008).
Although the preconsent procedure was not effective, the results suggest health and research literacy may be targets for reducing disparities in consent comprehension. The onus is on researchers to improve communication of consent information as an important step to addressing health care disparities.
拉丁裔在心理健康研究中严重代表性不足;造成这种情况的原因之一可能是研究同意过程中的各种复杂性,包括语言偏好。我们研究了理解研究同意程序的决定因素,并在 180 名精神分裂症患者中检验了预同意研究方案条件的效果(60 名拉丁裔-英语和 60 名拉丁裔-西班牙语偏好,以及 60 名非拉丁裔白人)。
参与者被随机分配(均等分配)到关于临床研究概念和过程的教育课程(方案条件)或注意力控制组。在随后对假设的药物试验进行模拟同意程序后,使用 2 项标准措施来衡量同意披露的理解程度。
单向方差分析显示,在理解程度的 2 项测量指标上,种族/语言群体之间存在显著的中等效应大小差异(η2s = 0.066-0.070)。拉丁裔西班牙语组的理解程度低于非拉丁裔白人参与者;两组拉丁裔之间的差异没有达到统计学意义。在调整教育差异、文化适应、健康素养或研究素养的结构化测量评分后,组间差异没有统计学意义。双向方差分析显示,同意程序对理解程度的 2 项测量指标均没有显著的主要影响(P >.369;部分 η2s < 0.006),也没有显著的组间交互作用(P >.554;部分 η2s < 0.008)。
尽管预同意程序无效,但结果表明健康素养和研究素养可能是减少同意理解差异的目标。研究人员有责任改善同意信息的沟通,作为解决医疗保健差异的重要步骤。