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Nordfalk F, Jensen AMB. Mothering a population: How Danish mothers experience newborn dried blood spot samples and their
considerations about re-use of samples for research purposes. Eur J Midwifery 2022; 6:58. [PMID: 36119406 PMCID: PMC9442974 DOI: 10.18332/ejm/152322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 06/08/2022] [Accepted: 07/22/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Newborn dried blood spot (NDBS) samples have a primary clinical purpose of screening, but often also a secondary purpose of re-use for research purposes. This study investigates how Danish mothers experience the sample being taken, their considerations about potential re-use for research, and their reflections on the level of information they receive about NDBS samples and their re-use for research purposes. METHODS This study is based on semi-structured interviews with 19 mothers of newborn babies, conducted within the first year after the birth. Mothers were recruited through online media and interviewed in their own homes or at the university. All interviews were coded thematically with an abductive approach. RESULTS Generally, mothers have difficulties in recollecting the NDBS sample. Overall, they are pleased with the re-use of samples for research purposes. However, some mothers are concerned about the consent procedure. The mothers did not have one specific attitude towards more information about the research done using newborn samples. Based on our findings, we recommend a higher level of transparency regarding national genetic research in general; and, for the NDBS samples specifically, a more complete information and consent procedure. Further, we encourage more studies into what kinds of information parents might find useful about research based on NDBS samples. CONCLUSIONS Mothers do not always remember experiencing the NDBS sample, are generally positive towards re-use for research purposes, but unsure about best information level.
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Affiliation(s)
- Francisca Nordfalk
- Center for Medical Science and Technology Studies, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Anja M. B. Jensen
- Center for Medical Science and Technology Studies, Section for Health Services Research, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Jansen ME, van den Bosch LJM, Hendriks MJ, Scheffer MMJ, Heijnen ML, Douglas CMW, van El CG. Parental perspectives on retention and secondary use of neonatal dried bloodspots: a Dutch mixed methods study. BMC Pediatr 2019; 19:230. [PMID: 31288776 PMCID: PMC6615086 DOI: 10.1186/s12887-019-1590-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/19/2019] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Neonatal bloodspot screening (NBS) identifies conditions to offer early intervention and minimize irreversible damage. NBS policies guide a comprehensive system including processes for storage of neonatal dried blood spots (NDBS). NDBS retention and secondary use policies have been subject of public debates internationally, suggesting that the public's perceptions of NDBS policy are not always on par with existing policies. The current study aims to provide insight in relevant factors for new parents in the Netherlands regarding retention and secondary use of NDBS. These factors can be taken into account when developing or updating NDBS policies. METHODS A mixed methods design was used combining an online survey (n = 753), focus groups (6 groups, 37 participants), and individual in-depth interviews (n = 7). The discussed topics included: parental information, obtaining informed consent, support for retention, and support for secondary use. The study population consisted of Dutch-speaking new parents: pregnant women (≥20 weeks) and/or their partner, and parents of at least one child (≤5 years). RESULTS New parents expressed needs for easily accessible information, adequate communication on the retention and (potential) use of NDBS, clearly described safeguards for privacy, a more active consent process, regulation for the actors conducting NDBS research, and parental involvement in decisions on secondary use. Overall, participants were positive about prolonged retention and different types of secondary use if those needs were met. CONCLUSIONS While parental involvement is a challenge, our study is an example of gauging parent's perspectives on NDBS policy and contributes to including these perspectives in the current policy discussion on longer retention. Prolonged retention could be a feasible option in the Netherlands if several prerequisites are met. Therefore, implementation studies involving parents are needed.
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Affiliation(s)
- Marleen E. Jansen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Genetics and Amsterdam Public Health research institute, Section Community Genetics, de Boelelaan 1117, Amsterdam, the Netherlands
- National Institute for Public Health and the Environment (RIVM), Centre for Health Protection, Postbus 1, Bilthoven, 3720 BA the Netherlands
| | - Lion J. M. van den Bosch
- National Institute for Public Health and the Environment (RIVM), Centre for Population Screening, Postbus 1, Bilthoven, 3720 BA the Netherlands
| | - Marjolein J. Hendriks
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Genetics and Amsterdam Public Health research institute, Section Community Genetics, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Mariska M. J. Scheffer
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Genetics and Amsterdam Public Health research institute, Section Community Genetics, de Boelelaan 1117, Amsterdam, the Netherlands
| | - Marie-Louise Heijnen
- National Institute for Public Health and the Environment (RIVM), Centre for Population Screening, Postbus 1, Bilthoven, 3720 BA the Netherlands
| | - Conor M. W. Douglas
- Department of Science and Technology Studies, Faculty of Sciences, York University, 307 Bethune College, 4700 Keele St, Toronto, ON M3J 1P3 Canada
| | - Carla G. van El
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Clinical Genetics and Amsterdam Public Health research institute, Section Community Genetics, de Boelelaan 1117, Amsterdam, the Netherlands
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Cunningham S, O’Doherty KC, Sénécal K, Secko D, Avard D. Public concerns regarding the storage and secondary uses of residual newborn bloodspots: an analysis of print media, legal cases, and public engagement activities. J Community Genet 2015; 6:117-28. [PMID: 25533753 PMCID: PMC4356669 DOI: 10.1007/s12687-014-0206-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 12/03/2014] [Indexed: 11/29/2022] Open
Abstract
Recently, public concerns have been expressed regarding the non-consented storage and secondary research uses of residual newborn bloodspot (RBS) samples. The purpose of this paper is to examine public responses to the storage and secondary uses of RBS that can be identified through analysis of media, legal cases, and documented public engagement activities. Coverage in the examined print media confirmed the importance of RBS to journalists and those people who expressed their concerns to these journalists. Several lawsuits, brought by parents concerned about the storage of newborn bloodspots, placed the practice of storing NBS into the spotlight. This resulted in controversial debates and the mandatory destruction of millions of samples. Analysis of public engagement activities across several jurisdictions indicated that across (inter)national boundaries there are common elements to what is perceived as inappropriate governance of RBS. Public concerns were grouped into five main themes: trust, transparency, confidentiality, ownership, and stigmatization/discrimination. The results of our analysis help to make a compelling case for placing citizens at the center of the debate and developing policy about the storage and secondary uses of newborn bloodspots.
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Affiliation(s)
| | - Kieran C. O’Doherty
- />Department of Psychology, University of Guelph, Guelph, ON Canada NIG 2 W1
| | | | - David Secko
- />McGill University, Montréal, Quebec Canada
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Hart A, Petros M, Charrow J, Nash C, Wicklund C. Storage and use of Newborn Screening Blood Specimens for Research: Assessing Public Opinion in Illinois. J Genet Couns 2014; 24:482-90. [PMID: 25410141 DOI: 10.1007/s10897-014-9788-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2014] [Accepted: 10/24/2014] [Indexed: 11/25/2022]
Abstract
Storage and use of residual dried blood spots (DBS) from newborn screening (NBS) for research purposes has been a topic of elevated interest following high profile disputes between genetic privacy advocacy groups and state NBS programs. Our objective was to assess public opinion in Illinois regarding storage and use of residual DBS for research. Five hundred twenty-six Illinois residents completed a survey assessing attitudes about research uses for DBS, storage length, and consent issues. Over 80 % of respondents expressed agreement with questions regarding research uses of DBS. Eighty-three percent of respondents were in favor of storage for at least one year with 44 % favoring indefinite storage. Respondents with higher educational attainment were more likely to support research use of DBS and less likely to desire contact for each future study (P < 0.05). Black respondents were less likely than white respondents to express agreement for the use of DBS for research or to favor long-term storage (P < 0.05). Support was high for storage and use of DBS in our sample. Consent was important and respondents wanted choices about participation. Forty-two percent of respondents were not aware of NBS prior to this survey, highlighting a need for greater education about this public health program. Trust in the public health service of NBS must be protected through transparency in the policy process.
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Affiliation(s)
- Alexa Hart
- Fetal and Neonatal Medicine Center, Rush University Medical Center, 1725 W. Harrison St., Suite 308, Chicago, IL, 60612, USA,
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Thiel DB, Platt J, Platt T, King SB, Fisher N, Shelton R, Kardia SLR. Testing an online, dynamic consent portal for large population biobank research. Public Health Genomics 2014; 18:26-39. [PMID: 25359560 DOI: 10.1159/000366128] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 07/25/2014] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Michigan's BioTrust for Health, a public health research biobank comprised of residual dried bloodspot (DBS) cards from newborn screening contains over 4 million samples collected without written consent. Participant-centric initiatives are IT tools that hold great promise to address the consent challenges in biobank research. METHODS Working with Private Access Inc., a pioneer in patient-centric web solutions, we created and pilot tested a dynamic informed consent simulation, paired with an educational website, focusing on consent for research utilizing DBSs in Michigan's BioTrust for Health. RESULTS Out of 187 pilot testers recruited in 2 groups, 137 completed the consent simulation and exit survey. Over 50% indicated their willingness to set up an account if the simulation went live and to recommend it to others. Participants raised concerns about the process of identity verification and appeared to have little experience with sharing health information online. CONCLUSIONS Applying online, dynamic approaches to address the consent challenges raised by biobanks with legacy sample collections should be explored, given the positive reaction to our pilot test and the strong preference for active consent. Balancing security and privacy with accessibility and ease of use will continue to be a challenge.
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Affiliation(s)
- Daniel B Thiel
- Life Sciences and Society Program, University of Michigan School of Public Health, Ann Arbor, Mich., USA
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Arnold CG. Two faces of patient advocacy: the current controversy in newborn screening. JOURNAL OF MEDICAL ETHICS 2014; 40:558-562. [PMID: 23592379 DOI: 10.1136/medethics-2012-101019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Newborn screening programmes began in the 1960s, have traditionally been conducted without parental permission and have grown dramatically in the last decade. Whether these programmes serve patients' best interests has recently become a point of controversy. Privacy advocates, concerned that newborn screening infringes upon individual liberties, are demanding fundamental changes to these programmes. These include parental permission and limiting the research on the blood samples obtained, an agenda at odds with the viewpoints of newborn screening advocates. This essay presents the history of newborn screening in the USA, with attention to factors that have contributed to concerns about these programmes. The essay suggests that the rapid increase in the number of disorders screened for and the addition of research without either public knowledge or informed consent were critical to the development of resistance to mandatory newborn screening and research. Future newborn screening initiatives should include public education and comment to ensure continued support.
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Charles T, Pitt J, Halliday J, Amor DJ. Implementation of written consent for newborn screening in Victoria, Australia. J Paediatr Child Health 2014; 50:399-404. [PMID: 24373027 DOI: 10.1111/jpc.12484] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/20/2013] [Indexed: 11/28/2022]
Abstract
AIMS There has been increasing evidence of a lack of public awareness of newborn screening and concern about inadequate consent being obtained from parents. Apprehension also exists in relation to storage and secondary use of screening samples. Our objective was to introduce a written consent process across Victoria as a means of strengthening programme transparency, quality and supporting parental choice. In addition, more comprehensive information covering all aspects of the programme was developed. METHODS A 'two-stage' written consent protocol allowed parents to give separate consent for (i) their baby to be screened and (ii) secondary use of the sample in de-identified health research. At the time of sample collection, parents were asked to complete the consent form, included as part of the screening card. The protocol was piloted in four public hospitals and subsequently implemented statewide. RESULTS Twelve months of laboratory data showed that although refusals for screening increased, overall participation remained above 99%. The percentage of parents opting out of research use was 6.5%. Provider compliance with the new protocol was high, with only 1.4% of cards received without a completed consent form. CONCLUSION This quality improvement project has demonstrated that parents can participate more fully in newborn screening without jeopardising high uptake. As a secondary benefit, the public health resource of stored cards can be maintained with parental support. Future work needs to examine the quality of consent being given by parents and investigation of the reasons why some choose to decline.
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Affiliation(s)
- Taryn Charles
- Murdoch Children's Research Institute, Royal Children's Hospital, Melbourne, Victoria, Australia
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Langbo C, Bach J, Kleyn M, Downes FP. From newborn screening to population health research: implementation of the Michigan BioTrust for health. Public Health Rep 2013; 128:377-84. [PMID: 23997284 DOI: 10.1177/003335491312800508] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In June 2009, the Michigan Department of Community Health launched the Michigan BioTrust for Health to improve preservation and utility of residual dried blood spots from newborn screening (NBS) for biomedical research while maintaining public support and integrity of NBS. In this article, we chronicle implementation of the BioTrust and document its impact on NBS. Overall, the percentage of new parents who consent to possible future research use of their children's dried blood spots through the BioTrust has remained consistent with previous public opinion surveys. No significant increase in refusal of NBS has been observed despite increased publicity. There was, however, a slight increase in requests to destroy samples following completion of NBS, indicating readily accessible opt-out information. Given adequate training and cooperation of birthing hospital staff, as well as outreach education for parents and health-care providers, we conclude it is possible to implement a biobanking initiative without adversely impacting NBS.
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Affiliation(s)
- Carrie Langbo
- Michigan Department of Community Health, Bureau of Disease Control, Prevention and Epidemiology, Lansing, MI
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Platt JE, Platt T, Thiel D, Kardia SLR. 'Born in Michigan? You're in the biobank': engaging population biobank participants through Facebook advertisements. Public Health Genomics 2013; 16:145-58. [PMID: 23796763 DOI: 10.1159/000351451] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 04/17/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Despite a broad call for biobanks to use social media, data is lacking regarding the capacity of social media tools, especially advertising, to engage large populations on this topic. METHODS We used Facebook advertising to engage Michigan residents about the BioTrust for Health. We conducted a low-budget (<USD 5,000), 26-day social media campaign targeting Michigan residents aged 18-28. We placed 25 Facebook advertisements and analyzed their performance in terms of reach and cost across 3 engagement types: passive, active and interactive. We compared engagement before, during and after the campaign. RESULTS The Facebook page was viewed 1,249 times during the month of the advertising campaign, versus once in the month prior. 779,004 Michigan residents saw ads an average of 25.8 times; 4,275 clicked ads; the average click-through-ratio was 0.021%. Interactions included 516 'likes' and 30 photo contest entries. Cost per outcome ranged from <USD 0.005 per exposure to USD 182 per photo entry. The average cost per click was USD 1.04. CONCLUSION A social media strategy to build public awareness about biobanking is not likely to be effective without a promotional 'push' to distribute content. Social media advertisements have the capacity to scale-up engagement on biobanking while keeping costs manageable. Facebook advertisements provide necessary access points for unaware participants, with implications for public trust.
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Affiliation(s)
- J E Platt
- Life Sciences and Society Program, Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Mich 48109-2029, USA.
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Gong LM, Tu WJ, He J, Shi XD, Wang XY, Li Y. The use of newborn screening dried blood spots for research: the parental perspective. JOURNAL OF BIOETHICAL INQUIRY 2012; 9:189-193. [PMID: 23180262 DOI: 10.1007/s11673-012-9368-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2011] [Accepted: 01/24/2012] [Indexed: 09/11/2023]
Abstract
OBJECTIVE To investigate the attitudes of Chinese parents regarding the storage of dried blood spots collected for newborn screening (NBS) and their use in research. METHODS We conducted a hospital-based survey of parents and examined parental attitudes regarding (a) allowing NBS sample storage, (b) permitting use of children's NBS samples for research with parental permission, and (c) permitting use of children's NBS samples for research without parental permission. RESULTS The response rate was 52 percent. Of parents surveyed, 68 percent would permit their infant's NBS sample to be stored for at least some length of time. If permission is obtained, 69 percent of parents "strongly agreed" or "agreed" to permit use of the NBS sample for research. If permission is not obtained, only 14 percent of parents "strongly agreed" or "agreed." There was no significant association between permitting use of NBS samples for research and parental gender, education, household income, number of children, or site of residence. CONCLUSIONS This is the first survey of Chinese parents regarding the use of NBS samples for different types of research, with results indicating that most parents would permit their infant's sample to be stored and would support the use of NBS dried blood spots for research purposes.
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Affiliation(s)
- Li-Ming Gong
- Key Laboratory of Cell Engineering, Hospital of Zunyi Medical College, Zunyi, 563003, China
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Storage and use of residual newborn screening blood spots: a public policy emergency. Genet Med 2011; 13:619-20. [PMID: 21673578 DOI: 10.1097/gim.0b013e31822176df] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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