A REDCap-based model for electronic consent (eConsent): Moving toward a more personalized consent

Abstract Introduction: The updated common rule, for human subjects research, requires that consents “begin with a ‘concise and focused’ presentation of the key information that will most likely help someone make a decision about whether to participate in a study” (Menikoff, Kaneshiro, Pritchard. The New England Journal of Medicine. 2017; 376(7): 613–615.). We utilized a community-engaged technology development approach to inform feature options within the REDCap software platform centered around collection and storage of electronic consent (eConsent) to address issues of transparency, clinical trial efficiency, and regulatory compliance for informed consent (Harris, et al. Journal of Biomedical Informatics 2009; 42(2): 377–381.). eConsent may also improve recruitment and retention in clinical research studies by addressing: (1) barriers for accessing rural populations by facilitating remote consent and (2) cultural and literacy barriers by including optional explanatory material (e.g., defining terms by hovering over them with the cursor) or the choice of displaying different videos/images based on participant’s race, ethnicity, or educational level (Phillippi, et al. Journal of Obstetric, Gynecologic, & Neonatal Nursing. 2018; 47(4): 529–534.). Methods: We developed and pilot tested our eConsent framework to provide a personalized consent experience whereby users are guided through a consent document that utilizes avatars, contextual glossary information supplements, and videos, to facilitate communication of information. Results: The eConsent framework includes a portfolio of eight features, reviewed by community stakeholders, and tested at two academic medical centers. Conclusions: Early adoption and utilization of this eConsent framework have demonstrated acceptability. Next steps will emphasize testing efficacy of features to improve participant engagement with the consent process.

[1]  S. Koyfman,et al.  Informed consent conversations and documents: A quantitative comparison , 2016, Cancer.

[2]  Zachary P. Hallinan,et al.  Barriers to Change in the Informed Consent Process: A Systematic Literature Review. , 2016, IRB.

[3]  Paul A. Harris,et al.  The REDCap consortium: Building an international community of software platform partners , 2019, J. Biomed. Informatics.

[4]  J. Botkin,et al.  A Randomized Controlled Trial of an Electronic Informed Consent Process , 2014, Journal of empirical research on human research ethics : JERHRE.

[5]  E. Zerhouni Translational and clinical science--time for a new vision. , 2005, The New England journal of medicine.

[6]  A. Pacey,et al.  Lack of compliance by UK andrology laboratories with World Health Organization recommendations for sperm morphology assessment. , 2005, Human reproduction.

[7]  Mph David W. Baker MD The meaning and the measure of health literacy , 2007, Journal of General Internal Medicine.

[8]  K. McConnochie Webside Manner: A Key to High-Quality Primary Care Telemedicine for All. , 2019, Telemedicine journal and e-health : the official journal of the American Telemedicine Association.

[9]  S. Gehlert,et al.  Seeing Beyond the Margins: Challenges to Informed Inclusion of Vulnerable Populations in Research , 2018, Journal of Law, Medicine & Ethics.

[10]  G. Bernard,et al.  A collaborative, academic approach to optimizing the national clinical research infrastructure: The first year of the Trial Innovation Network , 2018, Journal of Clinical and Translational Science.

[11]  A HarrisPaul,et al.  Research electronic data capture (REDCap)-A metadata-driven methodology and workflow process for providing translational research informatics support , 2009 .

[12]  K. Norris,et al.  A systematic review of barriers and facilitators to minority research participation among African Americans, Latinos, Asian Americans, and Pacific Islanders. , 2014, American journal of public health.

[13]  J. Schallhorn,et al.  Informed consent in refractive surgery: in-person vs telemedicine approach , 2018, Clinical ophthalmology.

[14]  James Flory,et al.  Interventions to improve research participants' understanding in informed consent for research: a systematic review. , 2004, JAMA.

[15]  Julia C Phillippi,et al.  Electronic Informed Consent to Facilitate Recruitment of Pregnant Women Into Research , 2018, Journal of obstetric, gynecologic, and neonatal nursing : JOGNN.

[16]  Jon C. Gould,et al.  Research Electronic Data Capture (REDCap) electronic Informed Consent Form (eICF) is compliant and feasible in a clinical research setting , 2015 .

[17]  S. Person,et al.  An Innovative Simulation-based Community-engaged Intervention for Training Research Assistants in Culturally Appropriate Informed Consent , 2018, Progress in community health partnerships : research, education, and action.

[18]  Shari Bolen,et al.  Barriers to recruiting underrepresented populations to cancer clinical trials: A systematic review , 2008, Cancer.

[19]  Zachary P. Hallinan,et al.  Informed consent in clinical research: Consensus recommendations for reform identified by an expert interview panel , 2015, Clinical trials.

[20]  Michael Frankel,et al.  Utilization of a Smartphone Platform for Electronic Informed Consent in Acute Stroke Trials , 2017, Stroke.

[21]  Thomas K Houston,et al.  Culturally Appropriate Storytelling to Improve Blood Pressure , 2011, Annals of Internal Medicine.

[22]  S. Lemon,et al.  Psychometric Development of the Research and Knowledge Scale , 2016, Medical care.

[23]  D. Baker The meaning and the measure of health literacy , 2006, Journal of general internal medicine.

[24]  G. Bernard,et al.  Community Engagement Studios: A Structured Approach to Obtaining Meaningful Input From Stakeholders to Inform Research , 2015, Academic medicine : journal of the Association of American Medical Colleges.

[25]  Robert Levine,et al.  Patient comprehension of an interactive, computer-based information program for cardiac catheterization: a comparison with standard information. , 2009, Archives of internal medicine.

[26]  P. Shenoy Electronic informed consenting: A boon to modernize consenting process , 2015, Perspectives in clinical research.

[27]  Cindy Brach,et al.  Integrating literacy, culture, and language to improve health care quality for diverse populations. , 2007, American journal of health behavior.

[28]  Hsin-Chieh Yeh,et al.  Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial. , 2013, JAMA internal medicine.

[29]  K. Saag,et al.  A pragmatic randomized trial comparing tablet computer informed consent to traditional paper-based methods for an osteoporosis study , 2016, Contemporary clinical trials communications.