Neonatal Screening Clinical Trial
Official title:
The Effect of Electronic Informed Consent Information (EICI) on Residual Newborn Specimen Research
Obtaining adequate informed consent from potential research participants is a significant
challenge for biobank-dependent research. To maintain public trust and support, it is
important to establish an informed decision-making process for the collection and use of
biospecimens collected within clinical settings. For the majority of all infants born in the
US, residual dried blood biospecimens are generated after newborn screening is completed.
Some programs choose to store these specimens for several uses including biomedical research.
Identifying ways to improve comprehension about broad consent for future biobank-dependent
research is a national priority. Specific Aim 1: Identify the key information items necessary
to make an informed decision about broad consent for the retention and future research use of
residual biospecimens. Methods include focus groups with new parents to determine key
information elements relevant to consent for use of residual biospecimens within the Michigan
BioTrust. Additional meetings with IRB personnel within the participating hospitals, health
departments and universities will also be conducted to ascertain their expectations and
requirements for the consent process. Specific Aim 2: Based on the data collected in Aim 1,
create a state-of-the-art electronic informed consent information (EICI) tool for use in the
clinical setting about the retention and use of residual biospecimens. The award-winning
Genetic Science Learning Center will develop the professional EICI in Spanish and English.
Validation of the EICI will be completed using feedback from both community and scientific
advisory boards for the Michigan BioTrust. Specific Aim 3: Evaluate the EICI consent approach
by comparing it to: a) traditional consent delivered on an electronic tablet; and b) the
current paper-based consent approach. Both Spanish and English speaking parents (n = 630) in
the state of Michigan, where informed consent is required for biobank research during
postpartum clinical care, will be recruited and randomized to one of three groups. Specific
Aim 4: Assess feasibility of the EICI through focus groups and interviews with birthing
hospitals and Department of Community Health staff before and after the intervention.
- Hypothesis 1) Women in the Interactive technology group (Group A) and the video group
(Group B) will demonstrate higher knowledge at Time 1 and Time 2 about the consent
elements and the BioTrust than those who do not receive either EICI tool (Group C).
- Hypothesis 2) Women in the EICI groups (Groups A and B) will demonstrate lower
decisional conflict at Time 1 and Time 2 toward biobanking than those who do not receive
the EICI (Group C).
- Hypothesis 3) Women in the EICI groups (Groups A and B) will not differ significantly in
their choices about biobanking and attitudes toward NBS and biobank research compared to
participants who do not receive EICI tool (Group C).
For the intervention, a research assistant (RA) at each hospital, with permission of the
healthcare professional, will ask potential participants if they are interested in
participating in this study. If they are interested, the RAs will seek verbal consent for
this study at this time. The RA will inform patients that when a healthcare provider comes
into their room about the BioTrust, they will have the study information for them.
Then the RAs at the labor and deliver units of the hospitals will give an iPad to the
healthcare providers seeking consent for the BioTrust. The healthcare providers will be blind
to the study group assignment until they enter the patient's room. When a healthcare
professional enters a patients' room, she will touch the iPad to see the study group
assignment. Participants will be randomized to one of three study groups and this will be
programmed automatically on the iPad. If they are in Group A or B, the healthcare providers
will give the iPad to the patients to watch or read the consent information. If they are in
Group C (control group) the standard brochure will be given about the BioTrust. Immediately
following their decision, all participants will complete a brief knowledge survey on the
iPad.
This recruitment approach mirrors the current clinical encounter for the BioTrust. This
current approach is as follows. After newborn screening is completed, a healthcare
professional approaches the mother in the hospital and provides them with the Michigan
BioTrust brochure (see appendix) and then asks for the mother to consent to allow or not
allow their infants' residual DBS to be stored in the Michigan BioTrust. This consent form is
a simply check for yes and no with their signature and is attached to the back of the newborn
screening card. For this study, after they receive the information in any of the study
groups, all participants will still be required to sign this same consent form because it is
attached to the physical sample of the newborn screening blood specimens.
All participating women will complete a survey 1) immediately following the
intervention/control on the electronic table (Time 1) and 2) also will be surveyed by
telephone 2-4 weeks follow up (Time 2).
Drs. Rothwell, Johnson and Tarini will provide guidance for the coordination of the clinical
sites, due to their extensive experience. To ensure success there will be at least weekly
communication between the sites and the Project Director, Dr. Johnson and monthly among the
site personnel. Drs. Botkin, Rothwell and Johnson will visit each site prior to
implementation of data collection to introduce the project and discuss issues sites may have.
Once the RAs have been hired at each site they will provide weekly reports of activities and
recruitment to the Research team in Utah. Monthly a teleconference will be held and the Site
PI's will report on activities and recruitment to the Utah research team and the other site
PI. Consistency among the sites will be monitored with these reports and communication
strategies. Research team coordination with communication and meetings is based on the
successful accomplishment of previous research project (R01 HD058854).
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