Consent for genetics studies among clinical trial participants: findings from Action for Health in Diabetes (Look AHEAD)

Background Increasingly, genetic specimens are collected to expand the value of clinical trials through study of genetic effects on disease incidence, progression or response to interventions. Purpose and methods We describe the experience obtaining IRB-approved DNA consent forms across the 19 institutions in the Action for Health in Diabetes (Look AHEAD), a clinical trial examining the effect of a lifestyle intervention for weight loss on the risk of serious cardiovascular events among individuals with type 2 diabetes. We document the rates participants provided consent for DNA research, identify participant characteristics associated with consent, and discuss implications for genetics research. Results IRB approval to participate was obtained from 17 of 19 institutions. The overall rate of consent was 89.6% among the 15 institutions that had completed consenting at the time of our analysis, which was higher than reported for other types of cohort studies. Consent rates were associated with factors expected to be associated with weight loss and cardiovascular disease and to affect the distribution of candidate genes. Non-consent occurred more frequently among participants grouped as African-American, Hispanic, female, more highly educated or not dyslipidemic. Limitations The generalizabilty of results is limited by the inclusion/exclusion criteria of the trial. Conclusions Barriers to obtaining consent to participate in genetic studies may differ from other recruitment settings. Because of the potentially complex associations between personal characteristics related to adherence, outcomes and gene distributions, differential rates of consent may introduce biases in estimates of genetic relationships.

T. Wadden | A. Kriska | M. Nevitt | D. Simons-Morton | S. Heshka | M. Montez | P. Bolin | W. Knowler | L. Palermo | M. Espeland | E. Obarzanek | A. Bertoni | J. Regensteiner | F. Brancati | J. Foreyt | J. Charleston | S. Kahn | M. Safford | S. Yanovski | L. Delahanty | S. Kumanyika | W. Rejeski | W. Lang | J. Jakicic | Jennifer Patricio | K. Brelje | J. Bahnson | H. Raynor | Emily A. Finch | V. DiLillo | M. Klem | C. Thorson | M. Mullen | Kara I. Gallagher | P. Ribisl | H. Lambeth | C. Lorenzo | B. Harrison | J. Mancino | L. Cheskin | B. J. Maschak-Carey | H. Turgeon | J. Bantle | S. Marcovina | Kathy Lane | A. Balasubramanyam | B. Montgomery | J. Redmon | Jacqueline Wesche-Thobaben | Caitlin M. Egan | Siran Ghazarian | T. Killean | C. Crerand | Erica Ferguson | D. Trence | D. Edmundowicz | Kim Chula-Maguire | A. Fabricatore | Louise A. Hesson | D. A. Raynor | D. Ryan | Sandra Sangster | A. Goebel-Fabbri | K. Vujevich | Brandi Armand | V. Goldman | K. Dotson | Nita Webb | L. Bissett | S. D. Jackson | Shandiin Begay | E. Mayer‐Davis | Jeanne M. Clark | M. Gee | J. Bonk | Tricia Skarphol | S. A. Jaramillo | Marsha Miller | Sarah Ledbury | Lynne C. Lichtermann | M.G.Z. Botrous | Justin Glass | Tina Morgan | Ann V. Schwartz | Michaela Rahorst | Cynthia Hayashi | Zhu-Ming Zhang | Barbara Bancroft | Karen C. Johnson | Barbara Elnyczky | V. Hubbard | A. Schwartz | J. M. Curtis | X. Pi-Sunyer | Raymond Carvajal | David M. Nathan | Robert I. Berkowitz | Pamela Coward | Lawton S. Cooper | George A. Bray | Gary D. Miller | Robert H. Knopp | David E. Kelley | Robert S. Schwartz | Matthew L. Maciejewski | Lynne E. Wagenknecht | Mara Z. Vitolins | Karen C. Johnson | L. H. Kuller | Peter Jones | Richard F. Hamman | A. S. Jaramillo | E. S. Kahn | B. Harrison | P. J. Foreyt | C. W. Knowler | Debi Celnik | Kerry J. Stewart | Richard R. Rubin | Kathy Horak | Kristina K. Rau | Allison Strate | F. Greenway | Donald A. Williamson | Elizabeth Tucker | Mandy Shipp | Kim Landry | Jennifer Perault | Cora E. Lewis | Sheikilya Thomas | Stephen P. Glasser | Clara Smith | Cathy Roche | Charlotte Bragg | Staci Gilbert | Amy Dobelstein | L. C. Oden | Trena Johnsey | Kristina P. Schumann | Enrico Cagliero | Kathryn Hayward | Barbara Steiner | Ellen J. Anderson | Alan McNamara | Richard Ginsburg | Virginia Harlan | Theresa Michel | Edward S. Horton | Osama Hamdy | A. E. Caballero | Maureen Malloy | Kerry Ovalle | Sarah Bain | Elizabeth Bovaird | Lori Lambert | George L. Blackburn | Christos S. Mantzoros | Ann McNamara | Heather McCormick | James O. Hill | Brent VanDorsten | Michael T. McDermott | JoAnn A. Phillipp | Patrick Reddin | Kristin Wallace | Paulette Cohrs | April Hamilton | Salma Benchekroun | Susan Green | Loretta Rome | Lindsey Munkwitz | Rebecca S. Reeves | Henry J. Pownall | Mohammed F. Saad | Ken C. Chiu | Kati Szamos | Magpuri Perpetua | Michelle Chan | Abbas E. Kitabchi | Leeann Carmichael | Robert W. Jeffery | Richard S. Crow | Jeanne Carls | Carolyne Campbell | La Donna James | Therese Ockenden | M. Snyder | Amy Keranen | Cara Walcheck | Birgitta I. Rice | Vicki A. Maddy | Jennifer Mayer | Carmen Pal | Mary Anne Holowaty | Diane Hirsch | G. D. Foster | Stanley Schwartz | Patricia Lipschutz | Robert H. Kuehnel | Renee Davenport | Helen Chomentowski | Jennifer Rush | Rebecca Danchenko | Janet Krulia | Donna Wolf | Patricia H. Harper | Anne E. Mathews | R. Wing | Vincent Pera | Deborah F. Tate | A. A. Gorin | Renee Bright | Natalie Robinson | Tammy Monk | Anna Bertorelli | Maureen Daly | Tatum Charron | Rob Nicholson | Erin Patterson | Julie Currin | Linda Foss | Deborah Robles | Jennifer Gauvin | Deborah Maier | Suzanne Phelan | Don Kieffer | Lauren Lessard | Richard Carey | Jane Tavares | Heather Chenot | J. P. Massaro | S. M. Haffner | Connie Mobley | Steven E. Kahn | Edward W. Lipkin | Roque M. Murillo | S. T. Barrett | Carol Percy | Rita Donaldson | Bernadette Todacheenie | Sarah Michaels | Jonathan Krakoff | P. H. Bennett | Ruby Johnson | Cathy Manus | Janelia Smiley | Minnie Roanhorse | Didas Fallis | Nancy Scurlock | Leigh A. Shovestull | D. Reboussin | Amelia Hodges | Patricia E. Hogan | Carrie Combs | Christian Speas | D. S. West | WH Herman | John A. Shepherd | Jason Maeda | Greg Strylewicz | R. Prineas | Charles Campbell | Sharon Hall | C. Farach | David F. Williamson | Edward W. Gregg | Peter H. Jones | Sheikilya Thomas | Jeanne M. Clark | G. A. Bray | J. Perault | Robert S. Schwartz

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