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Who should decide about children's and adolescents' participation in health research? The views of children and adults in rural Kenya.
Marsh, Vicki; Mwangome, Nancy; Jao, Irene; Wright, Katharine; Molyneux, Sassy; Davies, Alun.
Afiliación
  • Marsh V; Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Institute, PO Box 230, Kilifi, 80108, Kenya. vmarsh@kemri-wellcome.org.
  • Mwangome N; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, Oxford University, Peter Medawar Building, South Parks Road, Oxford, OX13SY, UK. vmarsh@kemri-wellcome.org.
  • Jao I; Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Institute, PO Box 230, Kilifi, 80108, Kenya.
  • Wright K; Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Institute, PO Box 230, Kilifi, 80108, Kenya.
  • Molyneux S; UK Nuffield Council on Bioethics, 28 Bedford Square, London, WC1B 3JS, UK.
  • Davies A; Kenya Medical Research Institute (KEMRI) Wellcome Trust Research Institute, PO Box 230, Kilifi, 80108, Kenya.
BMC Med Ethics ; 20(1): 41, 2019 06 14.
Article en En | MEDLINE | ID: mdl-31200697
BACKGROUND: International research guidance has shifted towards an increasingly proactive inclusion of children and adolescents in health research in recognition of the need for more evidence-based treatment. Strong calls have been made for the active involvement of children and adolescents in developing research proposals and policies, including in decision-making about research participation. Much evidence and debate on this topic has focused on high-income settings, while the greatest health burdens and research gaps occur in low-middle income countries, highlighting the need to take account of voices from more diverse contexts. METHODS: Between January and March 2014, 56 community representatives and secondary school students were involved in eight group discussions to explore views on the acceptability of involving children and adolescents in research, and how these groups should be involved in decision-making about their own participation. Discussions were voice-recorded and transcriptions analyzed using Framework Analysis, combining deductive and inductive approaches. RESULTS: Across these discussions, the idea of involving children and adolescents in decision-making about research participation was strongly supported given similar levels of responsibility carried in everyday life; existing capacity that should be recognized; the opportunity for learning involved; varying levels of parental control; and generational shifts towards greater understanding of science for adolescents than their parents. Joint decision-making processes were supported for older children and adolescents, with parental control influenced by perceptions of the risks involved in participation. CONCLUSIONS: Moves towards more active involvement of children and adolescents in planning studies and in making decisions about their participation are supported by these findings from Kenya. Important emerging considerations include the need to take account of the nature of proposed studies and prevailing attitudes and understanding of research in identifying children's and adolescents' roles. More research is needed to expand diversity and develop approaches to joint assent and consent processes that would fairly represent children's and adolescents' wishes and interests, towards their long term benefit.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Actitud Frente a la Salud / Selección de Paciente / Toma de Decisiones Tipo de estudio: Guideline / Prognostic_studies Aspecto: Determinantes_sociais_saude Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged País/Región como asunto: Africa Idioma: En Revista: BMC Med Ethics Asunto de la revista: ETICA Año: 2019 Tipo del documento: Article País de afiliación: Kenia Pais de publicación: Reino Unido

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Actitud Frente a la Salud / Selección de Paciente / Toma de Decisiones Tipo de estudio: Guideline / Prognostic_studies Aspecto: Determinantes_sociais_saude Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged País/Región como asunto: Africa Idioma: En Revista: BMC Med Ethics Asunto de la revista: ETICA Año: 2019 Tipo del documento: Article País de afiliación: Kenia Pais de publicación: Reino Unido