title: Factors that influence parental decisions to participate in clinical research: consenters vs nonconsenters.
abstract: OBJECTIVE
  A child's health, positive perceptions of the research team and consent process, and altruistic motives play significant roles in the decision-making process for parents who consent for their child to enroll in clinical research. This study identified that nonconsenting parents were better educated, had private insurance, showed lower levels of altruism, and less understanding of study design.
  
  
  OBJECTIVE
  To determine the factors associated with parental consent for their child's participation in a randomized, placebo-controlled trial.
  
  
  METHODS
  Cross-sectional survey conducted from July 2008 to May 2011. The survey was an ancillary study to the Randomized Intervention for Children with VesicoUreteral Reflux Study.
  
  
  METHODS
  Seven children's hospitals participating in a randomized trial evaluating management of children with vesicoureteral reflux.
  
  
  METHODS
  Parents asked to provide consent for their child's participation in the randomized trial were invited to complete an anonymous online survey about factors influencing their decision. A total of 120 of the 271 (44%) invited completed the survey; 58 of 125 (46%) who had provided consent and 62 of 144 (43%) who had declined consent completed the survey.
  
  
  METHODS
  A 60-question survey examining child, parent, and study characteristics; parental perception of the study; understanding of the design; external influences; and decision-making process. RESULTS Having graduated from college and private health insurance were associated with a lower likelihood of providing consent. Parents who perceived the trial as having a low degree of risk, resulting in greater benefit to their child and other children, causing little interference with standard care, or exhibiting potential for enhanced care, or who perceived the researcher as professional were significantly more likely to consent to participate. Higher levels of understanding of the randomization process, blinding, and right to withdraw were significantly positively associated with consent to participate. CONCLUSIONS AND RELEVANCE Parents who declined consent had a relatively higher socioeconomic status, had more anxiety about their decision, and found it harder to make their decision compared with consenting parents, who had higher levels of trust and altruism, perceived the potential for enhanced care, reflected better understanding of randomization, and exhibited low decisional uncertainty. Consideration of the factors included in the conceptual model should enhance the quality of the informed consent process and improve participation in pediatric clinical trials.
authors.affiliation: University of Pittsburgh, Pittsburgh, PA, USA. hoberman@chp.edu
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Nader
authors.initials: N
authors.lastname: Shaikh
authors.forename: Sonika
authors.initials: S
authors.lastname: Bhatnagar
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Haralam
authors.forename: Diana H
authors.initials: DH
authors.lastname: Kearney
authors.forename: D Kathleen
authors.initials: DK
authors.lastname: Colborn
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Kienholz
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Clareann H
authors.initials: CH
authors.lastname: Bunker
authors.forename: Ron
authors.initials: R
authors.lastname: Keren
authors.forename: Myra A
authors.initials: MA
authors.lastname: Carpenter
authors.forename: Saul P
authors.initials: SP
authors.lastname: Greenfield
authors.forename: Hans G
authors.initials: HG
authors.lastname: Pohl
authors.forename: Ranjiv
authors.initials: R
authors.lastname: Mathews
authors.forename: Marva
authors.initials: M
authors.lastname: Moxey-Mims
authors.forename: Russell W
authors.initials: RW
authors.lastname: Chesney
mesh_terms: D000328:Adult; D000533:Altruism; D000890:Anti-Infective Agents / Q000627:therapeutic use; D001007:Anxiety; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D007348:Insurance, Health; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D033282:Parental Consent / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D016032:Randomized Controlled Trials as Topic / Q000379:methods / Q000523:psychology*; D045808:Refusal to Participate / Q000523:psychology*; D055502:Secondary Prevention; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D035502:Trust; D014552:Urinary Tract Infections / Q000517:prevention & control
chemical_list: D000890:Anti-Infective Agents
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