Treuman Katz Center for Pediatric Bioethics and Palliative Care, Seattle Children's Research Institute, Seattle, WA; Department of Pediatrics, University of Washington School of Medicine, Seattle, WA.
Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD; Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
J Pediatr. 2024 Dec;275:113923. doi: 10.1016/j.jpeds.2024.113923. Epub 2024 Mar 15.
To describe parents' motivations for and against participation in neonatal research, including the views of those who declined participation.
We performed 44 semi-structured, qualitative interviews of parents approached for neonatal research. Here we describe their motivations for and against participation.
Altruism was an important reason parents chose to participate. Some hoped participation in research would benefit their infant. Burdens of participation to the family, such as transportation to follow up (distinct from risks/burdens to the infant), were often deciding factors among those who declined participation. Perceived risks to the infant were reasons against participation, but parents often did not differentiate between baseline risks and incremental risk of study participation. Concerns regarding their infant being treated like a "guinea pig" were common among those who declined. Finally, historical abuses and institutional racism were reported as important concerns by some research decliners from minoritized populations.
Within a diverse sample of parents approached to enroll their infant in neonatal research, motivations for and against participation emerged, which may be targets of future interventions. These motivations included reasons for participation which we may hope to encourage, such as altruism. They also included reasons against participation, which we may hope to, as feasible, eliminate, mitigate, or at least acknowledge. These findings can help clinical trialists, regulators, and funders attempting to improve neonatal research recruitment processes.
描述父母参与新生儿研究的动机和反对意见,包括那些拒绝参与的人的观点。
我们对参与新生儿研究的父母进行了 44 次半结构化、定性访谈。在这里,我们描述了他们参与和反对的动机。
利他主义是父母选择参与的一个重要原因。一些人希望参与研究能使他们的婴儿受益。参与研究给家庭带来的负担,如随访的交通(与婴儿的风险/负担不同),是那些拒绝参与的人决定参与的重要因素。对婴儿的潜在风险是反对参与的原因,但父母往往无法区分基线风险和研究参与的增量风险。一些拒绝参与的父母普遍担心他们的婴儿会被当作“豚鼠”对待。最后,一些来自少数族裔的研究拒绝者报告说,历史上的虐待和制度性种族主义是他们关注的重要问题。
在对接受新生儿研究的父母进行的多样化样本中,出现了参与和反对的动机,这可能是未来干预的目标。这些动机包括我们可能希望鼓励的参与理由,如利他主义。它们还包括反对参与的理由,我们可能希望尽可能消除、减轻或至少承认这些理由。这些发现可以帮助临床试验人员、监管机构和资助者改进新生儿研究的招募流程。