Ethical issues in reporting and referring in research with low-income minority children

Recruiting African American parents of school-aged children in a physical activity study: Lessons learned

OBJECTIVES

To describe the recruitment strategies and lessons learned when enrolling African American parents/caregivers of school-aged children (ages 6-12 years) in an online survey of physical activity. With physical activity serving as a modifiable behavioral risk factor for several chronic diseases (obesity and cardiovascular diseases), little is understood regarding the influences on African Americans' physical activity participation to develop culturally appropriate physical activity interventions. Gaining a better understanding of physical activity influences is possible through research, yet recruiting and enrolling African Americans in health research is a challenge.

METHODS

Over a three-month period, a multidimensional approach (distribution of flyers, community partnerships, network sampling, African American researcher, effective communication, and data collection procedures) was used for study recruitment.

RESULTS

We exceeded our recruitment goal of 105 participants. A total of 127 African American parent/caregivers of school-aged children enrolled, which included both females/mothers (n = 87, 69%) and males/fathers (n = 40, 31%). Network sampling was the single most effective recruitment strategy for reaching this population. Lessons learned in this study includes considering participant burden and their comfort with technology, as well as gaining community trust.

DISCUSSION

Lessons learned in recruiting African American parents provides a guide for future research. Efforts are needed to further increase the representation of African American males in health research.

Using the case-study methodology to teach ethics to public health students

This article uses the case-study methodology as a strategy to facilitate examination of ethical principles that underlie developmental risk research carried out among adolescents. Description of the ethical dilemmas that arose during the implementation of a longitudinal randomized controlled trial is presented along with discussion guidelines. As youth were being enrolled and the trial was being conducted, it was noted that a small but significant number had responded "yes" to a question on suicidal ideation. After review by the Institutional Review Boards overseeing the trial, it was decided that confidentiality had to be breached. A revised protocol was implemented explicitly stating that confidentiality would be broken if a youth reported suicidal ideation. The number of youth reporting suicidal ideation after the consent form was amended decreased significantly. Presentation of this research by use of the case study method sensitizes students to issues that arise at the intersection of disease prevention and health promotion intervention research.

Adolescent and parent perspectives on ethical issues in youth drug use and suicide survey research

The contribution of adolescent and parent perspectives to ethical planning of survey research on youth drug use and suicide behaviors are highlighted through an empirical examination of 322 7th-12th graders' and 160 parents' opinions on questions related to 4 ethical dimensions of survey research practice: (a) evaluating research risks and benefits, (b) establishing guardian permission requirements, (c) developing confidentiality and disclosure policies, and (d) using cash incentives for recruitment. Generational and ethnic variation in response to questionnaire items developed from discussions within adolescent and parent focus groups are described. The article concludes with a discussion of the potential contributions and challenges of adolescent and parent perspectives for planning scientifically valid and ethically responsible youth risk survey research.

Ethical issues in qualitative health research with homeless youths

BACKGROUND

There is a need for increased guidance for the ethical conduct of qualitative research with vulnerable populations such as homeless youths.

AIM

The purpose of this paper is to provide an overview of the main ethical challenges of conducting qualitative research with homeless youths and to propose possible solutions to these challenges.

METHODS

This paper was informed by a review of professional guidelines for the ethical conduct of adolescent health research, national (US) and international bioethics bibliographical searches, and personal experience with qualitative research with homeless youths.

FINDINGS

The main ethical challenges of conducting qualitative research with homeless youths include establishing and maintaining healthy researcher roles and boundaries, addressing the risks of researcher burn-out and safety issues, assuring optimal confidentiality, and avoiding sensationalism and voyeurism.

CONCLUSION

It is important for qualitative researchers who work with vulnerable populations to ensure that research is conducted in the most ethical way possible.

Research ethics for mental health science involving ethnic minority children and youths

In response to U.S. Public Health Service projects promoting attention to disparities in the outcomes of mental health treatments, in July 2001, the American Psychological Association, the National Institute of Mental Health, and the Fordham University Center for Ethics Education convened a group of national leaders in bioethics, multicultural research, and ethnic minority mental health to produce a living document to guide ethical decision making for mental health research involving ethnic minority children and youths. This report summarizes the key recommendations distilled from these discussions.

Are researchers bound by child abuse reporting laws?

OBJECTIVE

To discuss issues concerning mandatory reporting of child abuse in research settings.

METHOD

An overview of existing Federal and State statutes regarding mandatory reporting of child abuse is presented. A critical review of the literature addresses the following issues: (1) whether researchers have a moral duty to place the health and safety of children above concerns about confidentiality and the benefits of obtaining new knowledge; (2) whether the Certificate of Confidentiality preempts reporting requirements; (3) whether researchers who are not health professionals (such as child developmentalists, psychobiologists, neuroscientists) should be required to report; and (4) whether researchers should be required to expand their protocols to include more in-depth investigation of potential abuse.

RESULTS

Existing child abuse reporting laws do not specifically designate researchers as among the category of individuals mandated to report suspected child abuse. Currently, Human Subject Protection Committees and Federal funding agencies are tending to interpret reporting laws as applying to researchers, including requiring that research subjects are informed of this responsibility in consenting procedures. It is unclear whether the Certificate of Confidentiality preempts child abuse reporting laws.

CONCLUSION

The authors recommend that legislatures specifically designate researchers as mandated reporters to ensure more uniform reporting practices in research settings. For both investigators and Human Subject Protection Committees, inclusion of researchers among the categories of those mandated to report would also help address issues of immunity from civil and criminal liability for "good faith" reports that turn out to be false and injurious.

Culturally competent research: an ethical perspective

This article addresses the perspective of the Ethical Principles and Guidelines for Providers regarding issues affecting research with ethnic minority populations. Issues such as failure to report or give informed consent to research participants, lack of diversity among researchers, inappropriate study of ethnic minority populations, and culturally insensitive assessment instruments are discussed. Examples of recommended responsibilities and criteria for culturally competent research are provided, including increased involvement of minorities in research, both as investigators and concerned citizens. In sum, the recommendations address the larger problem of failure to acknowledge people in their cultural context. Finally, implications for the Ethical Principles and Guidelines for Providers are considered.