Need For Parental Consent Research Articles

"When you get the HPV vaccine, it will prevent cervical cancer; it will act as a shield": adolescent girls' knowledge and perceptions regarding the human papillomavirus vaccine in Zambia.

The human papillomavirus (HPV) vaccination is an important preventive measure for HPV-related conditions such as cervical cancer. In 2019, Zambia introduced a free national HPV vaccination program for 14-year-old girls. However, the adolescents' knowledge and perceptions regarding the HPV vaccine are not well understood. Therefore, this study aimed to understand adolescent girls' knowledge and perceptions regarding the HPV vaccine and discuss its acceptability and uptake implications. We conducted a qualitative study in the Lusaka district between June 2021 and November 2021 using semi-structured interviews with adolescent girls aged 15-18 years regardless of their HPV vaccination status. Interviews were transcribed verbatim, and NVIVO 12 was used for data management and analysis. We coded transcripts deductively and inductively based on emerging themes. Perceptions were coded using the health belief model constructs. We interviewed 30 adolescent girls to reach saturation. Seventeen girls reported having received at least one dose of the HPV vaccine. Participants expressed variable knowledge and awareness about HPV and the HPV vaccine. Participants exhibited positive attitudes towards the HPV vaccine and perceived it as beneficial. However, there were multiple perceived barriers to vaccination, such as the need for parental consent, not being in school, concerns about vaccine side effects, and belief in myths and misinformation. The adolescent girls in this study showed variable knowledge and positive attitudes toward the HPV vaccine despite the many perceived barriers. To support increased HPV vaccine acceptability and uptake among adolescent girls in Zambia, it is critical to actively engage stakeholders involved in HPV vaccination, such as adolescents and their parents, and debunk myths and misconceptions about HPV vaccination. Health education in schools and communities should be implemented to increase knowledge about HPV and HPV vaccination among adolescents and their parents.

COMMENT: Age and autonomy: An ethical dilemma in community mental health.

Mental illnesses are proven to have their onset in the mid-teens, making early mental healthcare interventions necessary among adolescents. While school-based mental health awareness programmes have gained prominence in recent years, adolescents identify issues around confidentiality, privacy and the need for parental consent impinging on their autonomy, as barriers to accessing mental healthcare, for their perceived needs. We aim to discuss the various ethical dilemmas faced by community mental health providers in using age as a sole marker for determining autonomy for adolescents, focusing on the potential impact of these challenges on adolescent mental healthcare and wellbeing.

The unfinished democratisation of family service systems: parental consent and children’s viewpoints on receiving support in child and family welfare in Sweden

ABSTRACT This article addresses the predicament of family service systems being built on parents’ voluntary participation and the need for parental consent, which may block children’s right to services. It examines parental consent and the impact of parental non-consent for children’s opportunities to receive protection and support in Swedish child and family welfare. We analysed 264 child assessments randomly selected from 12 municipalities in Sweden in order to investigate how parents’ voluntary participation exerts an influence on the assessment process. The results show that nearly half of the parents declined support from the social services on behalf of themselves and/or their child, directly blocking their children’s access to services. One implication of parents’ voluntary participation is that it may indirectly prevent children at risk from being asked about their view on support; another is that social workers do not always assess the child’s need in cases when the parents do not want any type of support at all. Children are arguably the principal users of family services, but it is parents who define the frames when their children are at risk of abuse and neglect. Support risks becoming a service for parents only, and so a democratisation of child protection specifically aimed at children must be considered in its own right.

Inciting Events in the High Risk Post-Operative Pediatric Cardiac Patients – A Novel Three Hit Model for Bacteremia Prediction

Background: Blood stream infections (BSI) are well described in pediatric cardiac intensive care units (PCICU). We noted that postoperative high-risk patients may develop BSI after an inciting event. The aim of this study was to investigate whether high risk patients who developed bacteremia experienced more inciting events than a similar group of high-risk patients. Methods: In this retrospective case-control study, we enrolled patients who developed bacteremia from March 2010 to November 2019, after undergoing open-heart surgery at a referral pediatric center. The control group was comprised of case-matched patients with the immediate consecutive same surgery. The following were recorded: operative data, common risk factors, postoperative severity of illness parameters, mortality, and inciting events 72-24 hours before bacteremia emerged. Findings: A total of 200 patients were included (100 with bacteremia, and 100 controls). Main demographic and operative parameters were matched. Bacteremia emerged on average postoperative day (POD) 12·8. Gram-negative bacteria were cultured in 84%, and skin associated gram-positive bacteria in 10% of the patients. Average central-venous lines (CVL) duration was 9·5±8·4 days. Postoperatively (72 hours), severity of illness parameters were significantly worse in patients with bacteremia, with a higher rate of postoperative complications during PCICU length-of-stay (LOS). In the bacteremia group, 72-24 hours prior to development of bacteremia, 92(92%) inciting events were recorded, compared to 21 (21%) in controls during their entire LOS. (OR 43·3,CI 18·2-103·1, p<0·0001). Interpretation: We propose a three hit model demonstrating that high-risk patients undergoing open heart surgery have significant higher risk for bacteremia after an inciting event. Funding Statement: No funding was procured for this work. Declaration of Interests: Mrs· Shochat disclosed work for hire at Rabin Medical Center as a statistical consultant. The remaining authors have disclosed that they do not have any potential conflicts of interest. Ethics Approval Statement: The Institutional Review Board reviewed and approved the study, and waived the need for parental consent.

Who calls the shots? The ethics of adolescentself-consent for HPV vaccination

While the human papillomavirus (HPV) vaccine is medically indicated to reduce the risk of genital warts and certain types of cancer, rates of HPV vaccination repeatedly fall short of public...

Plan B

INTRODUCTION: To discover if there are barriers for accessing over-the-counter emergency contraception. If barriers exist, to determine if those barriers vary based on the gender of the person making the purchasing request. METHODS: Richmond, VA pharmacies listed as Plan B One Step® suppliers were interviewed via phone by both male and female callers. Eight standardized script questions regarding emergency contraception were asked including availability, age restrictions, parental consent, counseling requirements, and gender restrictions for purchase. The statistical data was analyzed using Fisher's exact test. RESULTS: Pharmacy employees provided incorrect information to both men and women regarding age restrictions for purchasing Plan B One Step® 51% of the time. There was no statistical difference based on the gender of the caller. Only one of the 153 pharmacies polled by our male consumer would have denied a male from purchasing Plan B One Step® (P=.127). Both male and female callers were given correct information, as a whole, regarding the lack of need for parental consent and in-store counseling at the time of purchase. Males were 21 times as likely (P=.001) to have been transferred upon calling the pharmacy to another employee when asking “Can I get Plan B One Step®” compared to females, of whom none were transferred. CONCLUSION: Men and women requesting Plan B One Step® received incorrect information in one half of phone encounters. Given the inconsistent data provided to the public regarding emergency contraception, clinicians are obligated to convey accurate, up-to-date information to patients about over-the-counter contraceptive options.

Ethical Considerations When Including Lysosomal Storage Disorders in Newborn Screening Programs

There is essentially unanimous agreement that newborn screening saves lives. Nevertheless, newborn screening—rated as one of the top 10 successes in public health in the first decade of the twenty-first century by the Centers for Disease Control and Prevention (Koppaka in JAMA 306(5):484–487, 2003)—faces multiple challenges, including questions about how conditions are added to the list of disorders for which screening is done in each state, about the need for parental consent for use of dried blood spots after screening, and the roles of parents in expansion of newborn screening. Such questions figure prominently in controversy surrounding Pennsylvania’s recent passage of House Bill1654, also called Hannah’s Law, which institutes newborn screening and follow-up for 6 lysosomal storage disorders including Krabbe, Fabry, Pompe, Niemann–Pick, types A and B, Gaucher diseases, and mucopolysaccharidosis type I, also called Hurler disease. This review article provides an historical perspective on newborn screening including discussion of how conditions came to be added to the Recommended Uniform Screening Panel, and an overview of current issues and concerns for key stakeholders including parents, healthcare providers, laboratorians, and legislators.

Factors Associated with Clinical Research Recruitment in a Pediatric Academic Medical Center--A Web-Based Survey.

BackgroundOne of the most difficult aspects of conducting clinical research is the ability to successfully recruit participants. Pediatric clinical research presents unique recruitment challenges that relate to the need for parental consent on behalf of a minor, child assent, and school attendance. Yet, this has been less well studied. We conducted a survey of investigators performing human subjects research in a single large academic pediatric hospital to better understand characteristics of studies with successful recruitment.MethodsWe conducted a web-based survey from September 2011 to December 2011 of all principal investigators with an Institutional Review Board approved human subjects protocol at Boston Children’s Hospital, a pediatric Academic Medical Center. The survey captured various characteristics of the protocols including study design, staffing, resources, and investigator experience and training as well as respondents’ perceived barriers and facilitators to recruitment. We used chi square tests and Mantel-Haenszel test for linear trend to examine the relationship between selected predictor variables and the binary outcome of successful vs. unsuccessful recruitment and multivariable logistic regression analyses to examine the simultaneous influence of potential predictors on each outcome.ResultsAmong the 349 eligible investigators, 52% responded to the survey, and 181 with valid data were included in the analyses. Two-thirds of the 87 protocols closed to enrollment reached 80% or more of their target enrollment, whereas, only one-third of the 94 protocols actively recruiting were meeting 80% of their target. Recruitment method appeared to be the only significant and independent factor associated with achieving 80% or more of target enrollment in closed to enrollment protocols. Closed to enrollment protocols that used recruitment in person were 4.55 times (95% CI 1.30 to 15.93; p = 0.02) more likely to achieve 80% or more of their target enrollment when compared to those that used other recruitment methods. Other potentially modifiable factors such as number of study visits, study duration and investigator experience were suggestive of being meaningfully related to recruitment.ConclusionRecruiting in person may promote reaching an acceptable target enrollment in pediatric as well as adult clinical research. Future research is needed on larger and more diverse samples to gain a better understanding of how the characteristics and qualifications of the individuals who conduct recruitment influence participant enrollment as well as how best to approach patient and families for their participation.

Inclusion of adolescent girls in HIV prevention research – an imperative for an AIDS‐free generation

Recent scientific advances centred on the use of anti-retrovirals (ARVs) – both prophylactically to prevent HIV acquisition (pre-exposure prophylaxis, or PrEP) and for treatment to minimize onward transmission (treatment as prevention, or TasP) – have led to a new-found optimism for control of the HIV/AIDS epidemic and the possibility of creating an “AIDS-free generation”. In order to translate this optimism into reality, large and sustained reductions in incident HIV infections are required. Several models have projected that with substantial programmatic scale-up of the new prevention agenda, such requirements can be satisfied. However, these models typically assume a uniform efficiency for interventions in reducing incident infections across populations, and neglect to consider their current unavailability to a key population driving the epidemic at its epicentre: adolescent girls. (Published: 8 March 2014) Citation: Abdool Karim Q and Dellar R. Journal of the International AIDS Society 2014, 17 :19075 http://www.jiasociety.org/index.php/jias/article/view/19075 | http://dx.doi.org/10.7448/IAS.17.1.19075

Primary Care Gains Popularity as MH Screening Site

Primary Care Gains Popularity as MH Screening Site

Missteps, Misunderstandings, and Missed Opportunities: HIV Testing Among Young African Americans

Missteps, Misunderstandings, and Missed Opportunities: HIV Testing Among Young African Americans

Vaccination in Juvenile Correctional Facilities: State Practices, Hepatitis B, and the Impact on Anticipated Sexually Transmitted Infection Vaccines

Juvenile correctional facilities are an ideal setting to provide preventive vaccines to adolescents who are at risk. In many instances of incarceration, facilities overcome the need for parental consent by making young people wards of the state and the state providing consent. The authors investigated current state practices for administering hepatitis B vaccine to incarcerated adolescents. These may impact the delivery of anticipated sexually transmitted infection (STI) vaccines to incarcerated adolescents. From June to August 2004, interviews were conducted with state Immunization Program Managers by telephone about hepatitis B vaccination and consent policies in juvenile correctional facilities. Forty-five states were able to provide information about hepatitis B immunization in publicly funded juvenile correctional facilities. Forty-one of the 45 states offered hepatitis B vaccine to adolescents who were sentenced and thereby considered to be wards of the state. Of those 41 states, 20 also made hepatitis B vaccine easily accessible to detained adolescents (no parental consent required). Those 20 states considered detained adolescents as wards of the state (n=13), or allowed them to self-consent for the vaccine (n=7). Most states offer hepatitis B vaccination to sentenced adolescents in correctional facilities. Just over half of these states also vaccinate detained adolescents. Juvenile correctional facilities have experience administering vaccines, and this might allow for expansion of vaccination services when new STI vaccines become available. Still, there are major barriers to universal vaccination of incarcerated adolescents, including the issue of consent.

Adolescent and Parent Perceptions on Youth Participation in Risk Behavior Research

To assess and compare parent and adolescent views on the importance of risk behavior research and the need for parental consent and to identify predictors of views. Confidential survey. Adolescent, general pediatrics clinics. Adolescents aged 14 to 17 years presenting alone (solo) or with a parent or guardian (paired) and parents or guardians. Of 265 eligible pairs (199 solo adolescents), 134 (93) had useable surveys. The proportion of females in the parent or guardian, paired adolescent, and solo adolescent groups was 92%, 59%, and 75%, respectively; and the proportion of African Americans in these groups was 67%, 69%, and 91%, respectively. Views on the importance of and requirement of parental consent for confidential risk behavior research. Most parents (98%), paired adolescents (99%), and solo adolescents (100%) believed confidential risk behavior research surveys with teenagers were important; greater than 90% of all groups believed surveys should be conducted. The proportion of parents, paired adolescents, and solo adolescents that endorsed requiring parental permission was 84%, 53%, and 19%, respectively. Parents were less likely to endorse requiring permission if they had confidential health concerns as teenagers and were more likely to endorse requiring permission if their child was younger or female, if they believed their child had sex, and if they were a parent vs a guardian. Adolescents were more likely to endorse requiring permission if they were younger, not African American, and had more educated parents. Adolescents presenting with parents were more likely to endorse requiring permission. Parents and adolescents believed risk behavior research with adolescents was important. Most parents believed parental permission is needed for participation. Compared with parents, fewer adolescents believed parental consent was necessary. It is not clear what effect requirement of parental permission would have on participation or validity. Further research is needed to elucidate views on adolescent risk behavior research.

Parent and adolescent perceived need for parental consent involving research with minors.

To assess parents' and adolescents' perceived need for parental consent for minor adolescents to participate in minimal risk research studies based on procedural invasiveness (anonymous surveys, interviews, and blood or urine testing) and sensitivity of the topics (sexuality, drug and alcohol use, and sexually transmitted diseases and human immunodeficiency virus [HIV]). An anonymous self-report questionnaire was administered to 100 adolescent-parent pairs at 2 clinical sites (urban and suburban) of Children's Hospital of Michigan in Detroit. By invasiveness of the research procedure, the proportions of parents and adolescents who perceived a need for parental consent were as follows: face-to-face interviews, 62% vs 48%; telephone interviews, 72% vs 46%; blood or urine testing, 77% vs 62%; and blood testing for HIV status, 78% vs 59%. These differences were only significant for telephone interviews and HIV blood testing. For anonymous surveys, a minority of parents (33%) and adolescents (26%) reported that parental consent was needed. Based on sensitivity of the research topics, the proportions of parents and adolescents who perceived a need for parental consent were as follows: sexuality, 60% vs 34%; drug and alcohol use, 56% vs 44%; contraception, 62% vs 46%; and sexually transmitted diseases and HIV testing, 56% vs 52%. These differences were only significant for sexuality. Parents with higher education believed that teens could give their own consent (P < .05). Fifty-seven percent of parents and their teens agreed that parental consent for anonymous surveys was not necessary. For more invasive procedures and more sensitive topics, the percentage of disagreement ranged from 28% to 55.5%. There is a greater perceived need for parental consent to adolescent participation in research studies among parents than among teens for more invasive procedures and more sensitive topics. These results suggest the need for sensitivity to differing adolescent and parental perceived need for parental consent for a minor adolescent to participate in such studies. Further studies with larger samples are needed to determine what factors influence diverse parent and adolescent opinions.

Parent and adolescent perceived need for parental consent involving research with minors

Objective: To assess parents' and adolescents' perceived need for parental consent for minor adolescents to participate in minimal risk research studies based on procedural invasiveness (anonymous surveys, interviews, and blood or urine testing) and sensitivity of the topics (sexuality, drug and alcohol use, and sexually transmitted diseases and human immunodeficiency virus [HIV]). Methods: An anonymous self-report questionnaire was administered to 100 adolescent-parent pairs at 2 clinical sites (urban and suburban) of Children's Hospital of Michigan in Detroit. Results: By invasiveness of the research procedure, the proportions of parents and adolescents who perceived a need for parental consent were as follows: face-to-face interviews, 62% vs 48%; telephone interviews, 72% vs 46%; blood or urine testing, 77% vs 62%; and blood testing for HIV status, 78% vs 59%. These differences were only significant for telephone interviews and HIV blood testing. For anonymous surveys, a minority of parents (33%) and adolescents (26%) reported that parental consent was needed. Based on sensitivity of the research topics, the proportions of parents and adolescents who perceived a need for parental consent were as follows: sexuality, 60% vs 34%; drug and alcohol use, 56% vs 44%; contraception, 62% vs 46%; and sexually transmitted diseases and HIV testing, 56% vs 52%. These differences were only significant for sexuality. Parents with higher education believed that teens could give their own consent ( P Conclusions: There is a greater perceived need for parental consent to adolescent participation in research studies among parents than among teens for more invasive procedures and more sensitive topics. These results suggest the need for sensitivity to differing adolescent and parental perceived need for parental consent for a minor adolescent to participate in such studies. Further studies with larger samples are needed to determine what factors influence diverse parent and adolescent opinions. Arch Pediatr Adolesc Med. 1997;151:603-607