title: Development and evaluation of a web-based assent for adolescents considering an HIV vaccine trial.
abstract: HIV vaccine trials with minors will likely require parental permission and informed assent from adolescents. For this to be a valid process, the information needs to be presented in a manner that promotes adolescent comprehension. Previous studies suggest that adolescent comprehension of assent is often insufficient. We developed an interactive web-based assent that included interspersed quiz questions for a hypothetical HIV vaccine trial. Efficacy of the web-based assent was compared to a standard paper assent with and without interspersed questions. One hundred twenty teen participants, ages 15-17 years, from five community organizations were randomized to self-administered web-based assent (n=60) or investigator-administered paper assent with (n=29) or without (n=31) interspersed quiz questions. After reviewing the assent, participants completed a 27-item comprehension test. Comprehension scores were compared between groups. The mean number of correctly answered questions were 21.2 for the full paper group and 21.1 for the web-based group (t118=-0.08, p=0.94). Scores were 20.2 for the paper without interspersed questions sub-group and 22.1 for the paper with interspersed questions sub-group (t58=1.96, p=0.055). Participants in the web-based group performed as well on the comprehension test as those in the paper group, and those in the paper with questions sub-group performed better than those in the paper without questions sub-group, suggesting that interspersed quiz questions may improve understanding of a traditional paper assent. The minimal investigator time and standardized administration of the web-based assent as well as ability to tailor the assent discussion to topics identified by incorrect comprehension test responses are advantages worthy of further investigation.
authors: a Department of Pediatrics , University of Massachusetts Medical School , Worcester , MA , USA.
authors: Diane R
authors: DR
authors: Blake
authors: Celeste A
authors: CA
authors: Lemay
authors: Louise S
authors: LS
authors: Maranda
authors: J Dennis
authors: JD
authors: Fortenberry
authors: Margaret H
authors: MH
authors: Kearney
authors: Kathleen M
authors: KM
authors: Mazor
mesh_terms: D016915:AIDS Vaccines; D000293:Adolescent; D032882:Comprehension; D005260:Female; D015658:HIV Infections / Q000517:prevention & control*; D006801:Humans; D007258:Informed Consent; D057828:Informed Consent By Minors; D020407:Internet; D008297:Male; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D014611:Vaccination
chemical_list: D016915:AIDS Vaccines
keywords: HIV infection and AIDS; adolescence; clinical trials; computer-assisted instruction; informed consent; research ethics