The Belmont Report's concept of """"""""justice"""""""" means adolescents should participate in studies regarding sexually transmitted infections, given their high rates of infection. Yet they are also a """"""""vulnerable"""""""" population, which means they should benefit from parental guidance without being inappropriately influenced in their decision-making. Understanding parent-adolescent discordance about willingness to participate (WTP) helps develop strategies to insure that both are comfortable with the final decision. Decision-making is influenced by developmental characteristics, thus, given the rapid changes during adolescence there will be changes over time. A safety trial of topical microbicides will be the context in which to examine WTP, allowing for applicability to other trial types.
Specific Aims : 1) Describe the relationship between developmental characteristics (cognition and relevant experience, parenting and family variables) and WTP, attitudes towards privacy and parental influence, and discordance in the context of a study of STI prevention;2) Describe the relationship between changes in developmental characteristics (cognition and relevant experience, parenting and family relationships) over time and WTP and attitudes towards privacy and parental influence, and discordance in WTP in the context of a study of STI prevention;3) Describe adolescent-parent management of discordance as it relates to perceptions of the salient aspects of the trial and adolescent-parent interactional style as it relates to discordance and satisfaction with the final decision regarding participation. Methods: A multi-level strategy will be used to recruit 14-17 year old male and female adolescents and parents from primary care clinics. Data about non-participation will be obtained at all stages of decision-making in order to collect information about parents and adolescents who would normally not participate in research. The use of a hypothetical clinical trial allows for assessment of families who would not participate in trials. Parents and adolescents will be interviewed simultaneously by two different interviewers, and then complete a joint interview, which will be videotaped for coding of the interaction. To evaluate the impact of developmental change, participants will be re-interviewed one year later. Outcomes: This information will be used to develop and evaluate interventions designed to provide adolescents the opportunity to participate in studies with as much guidance as needed from parents and the autonomy to make their own decision.

Public Health Relevance

The results of this study will foster the inclusion of a broad representation of adolescents in studies of sexual health and other sensitive topics, while insuring that adolescents receive adequate and appropriate guidance from their parents.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD067287-02
Application #
8324875
Study Section
Social Sciences and Population Studies Study Section (SSPS)
Program Officer
Newcomer, Susan
Project Start
2011-09-01
Project End
2016-08-31
Budget Start
2012-09-01
Budget End
2013-08-31
Support Year
2
Fiscal Year
2012
Total Cost
$551,291
Indirect Cost
$184,400
Name
Columbia University (N.Y.)
Department
Pediatrics
Type
Schools of Medicine
DUNS #
621889815
City
New York
State
NY
Country
United States
Zip Code
10032
Francis, Jenny K R; Dapena Fraiz, Lauren; de Roche, Ariel M et al. (2018) Management of Adolescent-Parent Dyads' Discordance for Willingness to Participate in a Reproductive Health Clinical Trial. J Empir Res Hum Res Ethics 13:42-49
Rosenthal, Susan L; Morris, Marilyn C; Hoffman, Lily F et al. (2018) Inclusion of Adolescents in STI/HIV Biomedical Prevention Trials: Autonomy, Decision Making, and Parental Involvement. Clin Pract Pediatr Psychol 6:299-307
Francis, Jenny K R; de Roche, Ariel M; Mauro, Christine et al. (2018) Adolescent-Parent Dyadic Retention in an Interview Study and Changes in Willingness to Participate in a Hypothetical Microbicide Safety Study. J Pediatr Adolesc Gynecol 31:592-596
Tsevat, Rebecca K; Radecki Breitkopf, Carmen; Landers, Sara E et al. (2018) Adolescents' and Parents' Attitudes Toward Adolescent Clinical Trial Participation: Changes Over One Year. J Empir Res Hum Res Ethics 13:383-390
Chang, Jane; Ipp, Lisa S; de Roche, Ariel M et al. (2018) Adolescent-Parent Dyad Descriptions of the Decision to Start the HPV Vaccine Series. J Pediatr Adolesc Gynecol 31:28-32
Morris, Marilyn C; Rosenthal, Susan L (2017) Pregnancy Testing of Adolescents during Clinical Research: Managing the Process. IRB 39:14-7
Catallozzi, Marina; de Roche, Ariel M; Hu, Mei-Chen et al. (2017) Adolescent and Parent Willingness to Participate in Microbicide Safety Studies. J Pediatr Adolesc Gynecol 30:82-87
Rosenthal, Susan L; de Roche, Ariel M; Catallozzi, Marina et al. (2016) Parents' and Adolescents' Attitudes about Parental Involvement in Clinical Research. J Pediatr Adolesc Gynecol 29:372-7
Chávez, Noé Rubén; Williams, Camille Y; Ipp, Lisa S et al. (2016) Altruistic reasoning in adolescent-parent dyads considering participation in a hypothetical sexual health clinical trial for adolescents. Res Ethics 12:68-79
Hoffman, Lily F; Francis, Neferterneken K; Catallozzi, Marina et al. (2016) Inclusion of Adolescents in Clinical Trials for Sexually Transmitted Infections: A Review of Existing Registered Studies. J Adolesc Health 58:576-8

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