Guidance for Obtaining Informed Consent in School-Based Research Introduction One common challenge in conducting research in schools is obtaining consent from parents. Because students in K-12 are almost always under 18 years of age, parental consent is usually required. A few high schools require the researchers obtain parental consent for all students, even those 18 years or older. In most cases, parental consent means that the parents read and sign a consent document before the child can participate in the study. Additionally, appropriate assent from the minor is also required, with the particular form of that assent depending on the development of the participants (e.g., younger children may not be required to sign for assent but older children might be). Obtaining Parental Consent Researchers have developed a number of different techniques for obtaining informed consent from parents. There is no set list of ways to do this because each research design is different, but in many cases it is possible to contact parents directly to obtain consent. There are often activities such as school registration or sporting events when parents can be contacted directly to obtain consent. Also, some researchers have had success getting consent from parents by giving the class an incentive if a certain percentage of parent consent documents are returned. There are many other possibilities. School districts vary in the policies related to conducting research projects and the written, informed consent of participants. Some school districts always require signed documentation of parental consent for all research involving students. The IRB expects that researchers following the rules of the districts in which they conduct research. The Office of School University Research Relations (OSURR) can help researchers identify differing policies and practices at various school districts but the researchers are responsible for finding out about district specific requirements. “Passive Consent” Usually is Not a Sufficient Form of Consent Under the Regulations Researchers sometimes ask for approval of what is commonly called “passive consent.” Because the federal regulations do not include a provision for passive consent, it is more formally considered a type of a waiver of informed consent. This procedure involves informing parents of the study through some combination of mail, newsletters, or other channels and then allowing parents to opt out of the study if they do not want their child to participate. Because there is no way to know that parents actually receive or read these materials, there is always some uncertainty about whether the absence of a response from a parent indicates consent or indicates that they have not learned about the study. Thus, it is unclear in these situations whether consent has actually been given. This means that the notion of “passive consent” is usually not sufficient. The only way that a purely passive consent process could be considered actual consent would be if the researchers had some Guidance for Obtaining Informed Consent in School-Based Research UIUC IRB 072011 way to be sure that a parent for each child actually saw a consent form (e.g., if the researcher was able to hand a consent document to a parent for each child). Even in that case, if the researchers did not collect signed consent forms, the researcher would need a waiver of documentation of consent. Typically, because it is not possible to know for sure that parents have seen the consent form when “passive consent” procedures are used, such procedures are not usually considered a viable form of confirmed consent. Under certain conditions, however, a ‘waiver of consent’ procedure can be used as part of a consent process. Still, because passive consent is almost never a viable form of consent itself, the use of passive consent nearly always requires a waiver of consent. Waivers of Informed Consent The federal regulations recognize conditions when consent can be waived, and these conditions for granting a waiver also apply to parental consent. Most of the time when researchers request “passive consent” what they really need to apply for is a waiver of consent (because in most cases it cannot be known for sure that the parents have seen the consent document). The conditions necessary to grant a waiver of informed consent are: 1. The research involves no more than minimal risk to the subjects. 2. The waiver or alteration will not adversely affect the rights or welfare of the subjects. In the case of school based research, this would also include the rights of the parents. 3. The research could not be practicably carried out without the waiver. 4. Whenever appropriate, the subjects (and parents) will be provided with additional pertinent information after participation. Factors to Consider about Waivers of Informed Consent Deciding on whether the four conditions for granting a waiver have been met is not always a straightforward decision. One reason for this complexity is the various criteria interact. For example, even within the category of research that can be called “no more than minimal risk,” there are variations in the extent to which the research has some risk involved. For instance, even though (depending on the specifics of the design) both might eventually be labeled no more than minimal risk, there is a difference between a study that involves simply observing students without recording identifying information and a study that asks students some potentially sensitive questions. Although risk level is more pertinent to the first criterion, it is also related to the second one because parents are more likely to believe their rights have been violated if the research involves some sensitive questions rather than simple observations. Thus, deciding on whether a waiver can be granted is not as simple as assessing each criterion independently; instead, researchers and the board have to think about various factors that may be pertinent to multiple criteria. Some of factors include the following. Nature of the Activity Guidance for Obtaining Informed Consent in School-Based Research UIUC IRB 072011 Researchers need to consider what the research entails. Parents have greater and lesser expectations that they be directly consulted depending on the nature of the activity. For example, if the researchers are examining their child’s records that are not normally available to the public, there is a greater expectation that parents must provide documented informed consent than if the researchers are simply observing classes without recording identities. Research involving direct interaction with students (interviews, questionnaires, and so forth) is more likely to require that parents formally consent than is research not involving interaction with students. Sensitivity of Topics Interview and questionnaire research that asks about sensitive topics tends to involve more risks than research on less sensitive topics. There are different types of sensitivity. Some research involves asking subjects questions that (if answered in certain ways) could put them at risk of legal consequences; for example, asking about illegal drug use or underage drinking could put the participants at risk of legal consequences if the answers were to become known. Another important type of legal risk is asking students about events that could lead to a mandated report of child abuse or neglect (e.g., if the questions are likely to elicit specific information about ongoing abuse of a minor). The sensitivity of a particular set of questions has to be evaluated on a case by case basis rather than by general topics. Many general topics can be more or less sensitive depending on what is specifically asked. For example, if students are asked to confidentially report on their general perception of whether there is a lot of bullying at their school, it is much less sensitive than if students are asked to report on their own specific bullying behaviors or are asked to specifically name bullies and their actions. Because the sensitivity of questions must be evaluated on an ad hoc basis, it is impossible to list all the topics that are considered sensitive, but there are certain topics that often are associated with more sensitive questions. These include questions about abuse of children or the elderly, sexual assaults, bullying, illegal behaviors, risky behaviors, sexual activities, and thoughts about suicide. Research on any of these topics is often (but not necessarily) considered fairly sensitive. In such cases, the bar for granting a waiver of consent is higher than it would be with less sensitive questions. It is also important to recognize that even if a study asks about sensitive topics, there are steps that can be taken to mitigate the sensitivity of the study. For example, if there are some particularly sensitive questions, the right to refuse to answer them can be highlighted by including a response option such as “I do not want to answer.” Alternatively, having multiple reminders that questions can be skipped is preferable to having that information stated only one time in the assent document. In cases when the sensitivity of a research topic is mitigated by the specific design features of the study, this increases the chances that a waiver of parental consent may be appropriate. Guidance for Obtaining Informed Consent in School-Based Research UIUC IRB 072011 Developmental Stage of the Children The level of development of potential participants is relevant in various ways. First, as children get closer to the age of legal consent, they typically become more capable of understanding what they are assenting to than are younger children. This is important because such children are more likely to be granted some autonomy in their decision-making and therefore if they assent to a study that their parents have not actively consented to, this is less likely to be considered a violation of the parent’s rights than with a younger child. To be clear, this in no way implies that minors under 18 can give consent in some cases; instead, it simply means that norms about what parents have a right to know about is somewhat influenced by the age of the child. All other things being equal, the younger the child, the less likely it will be that a waiver of parent consent can be granted. It is also important to note that the importance of developmental stages is not necessarily linear. For example, there may be periods during preadolescence when children are particularly susceptible to pressure from their peers or from authority figures. This would impede on their ability to freely refuse to participate or to withdraw from the study. If there is reason to believe that a particular group or cohort is particularly susceptible to such pressures, it is less likely that a waiver of parental consent will be appropriate. Because the waiver requires making a case that all the conditions for the waiver have been met, researchers desiring a waiver of the parents’ consent should provide evidence that the participants in the study are at a developmental stage where they can reasonably be expected to be able to refuse or withdraw assent. Protections for Privacy and Confidentiality The measures taken to protect privacy and confidentiality influence the risk level, even within the category of research that is considered no more than minimal risk. If a study gathers no identifying information, it generally reduces the risk of the study and therefore increases the changes that a waiver of parental consent may be appropriate. If the research collects identifiable information, the appropriateness of a waiver depends on other factors such as the sensitivity of the questions and how secure the measure taking to ensure confidentiality are. Privacy and confidentiality are, of course, particularly crucial considerations if the data gathered are somewhat sensitive (see above). Sufficiency of Efforts at Contacting Parents Short of watching a potential participant (or parent) read a consent form and then quizzing him or her over its contents, it usually is not possible in most research to know if a participant has truly given informed consent. This problem in all research is compounded by circumstances when parents are sent information about the study and then asked to opt out. In an opt in procedure, one can at least be certain that the parent has seen the document (even if one cannot be certain that the parent has read it). Because of the uncertainty inherent in an opt out procedure, the key question becomes whether the researchers have made sufficient efforts to provide the parents a chance to see the information about the study so that it is clear that their rights have not been violated. Guidance for Obtaining Informed Consent in School-Based Research UIUC IRB 072011 There is a wide range of ways that information about a study can be made available to parents, and some are more likely to be considered a violation of rights than others. For instance, if researchers choose to make the information about the study available only on the school webpage, it is very likely that many parents would not see this, even though it was technically available for any parent to see. In such a case, going forward with a study using an opt out procedure would generally be considered a violation of the parents’ right to know that the research is going on. The general principle is that researchers should use a method that is reasonably likely to contact the parents of all the children. This can be accomplished in different ways, but one method that is often appropriate is a mailing to the parent or parents’ home address. Although one cannot be sure that the parent will open and read the mailing, the researcher can be reasonably sure that the parent at least had the opportunity to see it (i.e., the parent’s rights to have access to the information were not violated). If researchers do not use the mail, the IRB typically expects that researchers use multiple methods for trying to inform parents such as going to registration or open houses, having survey questions available for parents to review at the school, including information about the student in newsletters, and so forth. Because documents given to students to take home often do not make it to the parent or parents, “backpack mail” is not sufficient by itself. If backpack mail is used as a way to contact parents, there must be other additional means used to contact the parents about the study. There is no firm list of approved and disapproved methods for contacting parents, but the key question is always whether there is a reasonable likelihood that the means of providing information will successfully make it available to a parent or parents of all potential student participants. Ease of Opting Out For a waiver of consent to be granted, it must be easy for parents to opt out if they wish for their child not to participate. The ideal is for parents to have multiple options for opting out (such as both by email or by phone). Providing an opt out procedure that is onerous to parents violates their rights by implicitly pressuring them to allow participation. Also, it is unreasonable to expect that parents would review materials about the research and reply immediately. Therefore, the researchers should give ample time for parents to opt out. In most cases, the IRB has expected that parents be given at least two weeks to opt out from the time they are likely to have received the information about the study. Guidance for Obtaining Informed Consent in School-Based Research UIUC IRB 072011
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