title: Testing an alternate informed consent process.
abstract: BACKGROUND
  One of the main problems in conducting clinical trials is low participation rate due to potential participants' misunderstanding of the rationale for the clinical trial or perceptions of loss of control over treatment decisions.
  
  
  OBJECTIVE
  The objective of this study was to test an alternate informed consent process in cardiac rehabilitation participants that involved the use of a multimedia flip chart to describe a future randomized clinical trial and then asked, hypothetically, if they would participate in the future trial.
  
  
  METHODS
  An attractive and inviting visual presentation of the study was created in the form of a 23-page flip chart that included 24 color photographs displaying information about the purpose of the study, similarities and differences between the two treatment groups, and the data collection process. We tested the flip chart in 35 cardiac rehabilitation participants. Participants were asked if they would participate in this future study on two occasions: immediately after the description of the flip chart and 24 hours later, after reading through the informed consent document. Participants were also asked their perceptions of the flip chart and consent process.
  
  
  RESULTS
  Of the 35 participants surveyed, 19 (54%) indicated that they would participate in the future study. No participant changed his or her decision 24 hours later after reading the full consent form. The participation rate improved 145% over that of an earlier feasibility study where the recruitment rate was 22%. Most participants stated that the flip chart was helpful and informative and that the photographs were effective in communicating the purpose of the study.
  
  
  CONCLUSIONS
  Participation rates could be enhanced in future clinical trials by using a visual presentation to explain and describe the study as part of the informed consent process. More research is needed to test alternate methods of obtaining informed consent.
authors.affiliation: College of Nursing, University of Nebraska Medical Center, 985330 Nebraska Medical Center, Omaha, NE 68198-5330, USA. bcyates@unmc.edu
authors.forename: Bernice C
authors.initials: BC
authors.lastname: Yates
authors.forename: Diane
authors.initials: D
authors.lastname: Dodendorf
authors.forename: Judy
authors.initials: J
authors.lastname: Lane
authors.forename: Louise
authors.initials: L
authors.lastname: LaFramboise
authors.forename: Bunny
authors.initials: B
authors.lastname: Pozehl
authors.forename: Kathleen
authors.initials: K
authors.lastname: Duncan
authors.forename: Kendra
authors.initials: K
authors.lastname: Knodel
mesh_terms: D001296:Audiovisual Aids / Q000592:standards; D003194:Computer-Assisted Instruction / Q000379:methods*; D032962:Consent Forms; D005240:Feasibility Studies; D005260:Female; D006331:Heart Diseases / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D019212:Multimedia / Q000592:standards*; D015402:Nursing Education Research; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010353:Patient Education as Topic / Q000379:methods*; D018579:Patient Selection; D010865:Pilot Projects; D016032:Randomized Controlled Trials as Topic / Q000523:psychology*; D013997:Time Factors