Highlights from #EAST2015 - Research and violence

The group in Philadelphia studied the effect of violence and socioeconomic status on willingness to participate in research with exception to informed consent. 

The good news is:  there is no difference.  People in violent areas are willing to participate in these necessary studies on traumatic injuries.

DOES PROXIMITY TO VIOLENCE NEGATIVELY INFLUENCE ATTITUDES TOWARD EXCEPTION FROM INFORMED CONSENT IN EMERGENCY RESEARCH?

Zoë Maher, MD*, Elena Grill, Brian P. Smith, MD*, Carrie A. Sims, MD* Hospital of the University of Pennsylvania

Objectives: Trauma research has been limited by perceived patient reluctance to participate in exception from informed consent (EFIC) studies. We hypothesized that race, socioeconomic status and proximity to violence influence willingness to participate in, and perception of, EFIC research among at risk populations.

Methods: Trauma patients, families and community members ranked statements regarding EFIC and willingness to participate in emergency research using a 5-point Likert scale during an EFIC community consultation. Higher total scores reflected a more positive attitude regarding EFIC (range 6-30; neutral = 18) and willingness (range 23-115, neutral = 69). Subject zip code was used to calculate median income, as an estimate for socioeconomic status, and proximity to the 5 most violent city zip codes. Linear regression, Pearson correlation and omnibus tests (p<0.05) were used to evaluate relationships between estimated socioeconomic status, race, mechanism of injury, proximity to violence, and attitudes toward EFIC.

Results: 179 subjects participated including trauma patients (n=99), families (n=33) and community members (n=47). Overall, participants were supportive of EFIC and reported high willingness to participate scores (median 24, IQR 13-30 and median 89, IQR 52-115). Estimated median income and race did not correlate with perception of, or willingness to participate in, EFIC. Proximity to violence did correlate with violent mechanism of injury (p=0.021), but was not associated with perception of EFIC or willingness to participate in emergency research.

Conclusions: Based on our data, there is no correlation between either proximity to violence or estimated socioeconomic status and willingness to participate in EFIC research. Given this lack of correlation, researchers should partner with at risk communities to conduct EFIC studies without concern for limited participation.