■虽然在多个成人和儿科环境中,研究的同意率存在差异,提供儿科重症监护病房(PICU)研究纳入的数据有限.诸如PICU之类的急性护理环境对研究登记提出了独特的挑战,考虑到照顾者的高度压力和情绪环境以及研究的时间敏感性。
■为了确定种族和民族,语言,宗教,在PICU研究中,社会剥夺指数(SDI)与不同的方法和同意率有关。
这项回顾性队列研究于2011年7月1日至2021年12月31日在费城PICU儿童医院进行。参与者包括符合需要前瞻性同意的研究条件的患者。对2022年2月2日至7月26日的数据进行了分析。
■接触包括种族和民族(黑人,西班牙裔,白色,和其他),语言(阿拉伯语,英语,西班牙语,和其他),宗教(基督教,犹太人,穆斯林,无,和其他),和SDI(多个社会经济指标的综合)。
■多变量回归分别测试了4种暴露(种族和种族,语言,宗教,和SDI)和3个结果(符合条件的患者中的接近率,符合条件的患者同意,以及接近者之间的同意)。还评估了黑人儿童中降低同意率之间的关联程度。
■纳入研究的3154名儿童(平均年龄,6[IQR,1.9-12.5]岁;男性1691[53.6%]),黑人和西班牙裔家庭以及其他种族的接近和同意率较低,阿拉伯语和其他语言的人,穆斯林家庭,以及SDI更差的人。在接受研究的儿童中,黑人种族的同意赔率较低(未调整的赔率比[OR],0.73[95%CI,0.55-0.97];调整后OR,0.68[95%CI,0.49-0.93])相对于白种人。中介分析显示,黑人个体同意几率降低的51.0%(95%CI,11.8%-90.2%)是由较低的接近概率介导的。
■在这项PICU研究的同意率队列研究中,多种社会人口统计学因素与较低的同意率相关,部分归因于不同的方法率。这些发现表明有机会减少PICU研究参与的差异。
UNASSIGNED: While disparities in consent rates for research have been reported in multiple adult and pediatric settings, limited data informing enrollment in pediatric intensive care unit (PICU) research are available. Acute care settings such as the PICU present unique challenges for study enrollment, given the highly stressful and emotional environment for caregivers and the time-sensitive nature of the studies.
UNASSIGNED: To determine whether race and ethnicity, language, religion, and Social Deprivation Index (SDI) were associated with disparate approach and consent rates in PICU research.
UNASSIGNED: This retrospective cohort study was performed at the Children\'s Hospital of
Philadelphia PICU between July 1, 2011, and December 31, 2021. Participants included patients eligible for studies requiring prospective consent. Data were analyzed from February 2 to July 26, 2022.
UNASSIGNED: Exposures included race and ethnicity (Black, Hispanic, White, and other), language (Arabic, English, Spanish, and other), religion (Christian, Jewish, Muslim, none, and other), and SDI (composite of multiple socioeconomic indicators).
UNASSIGNED: Multivariable regressions separately tested associations between the 4 exposures (race and ethnicity, language, religion, and SDI) and 3 outcomes (rates of approach among eligible patients, consent among eligible patients, and consent among those approached). The degree to which reduced rates of approach mediated the association between lower consent in Black children was also assessed.
UNASSIGNED: Of 3154 children included in the study (median age, 6 [IQR, 1.9-12.5] years; 1691 [53.6%] male), rates of approach and consent were lower for Black and Hispanic families and those of other races, speakers of Arabic and other languages, Muslim families, and those with worse SDI. Among children approached for research, lower consent odds persisted for those of Black race (unadjusted odds ratio [OR], 0.73 [95% CI, 0.55-0.97]; adjusted OR, 0.68 [95% CI, 0.49-0.93]) relative to White race. Mediation analysis revealed that 51.0% (95% CI, 11.8%-90.2%) of the reduced odds of consent for Black individuals was mediated by lower probability of approach.
UNASSIGNED: In this cohort study of consent rates for PICU research, multiple sociodemographic factors were associated with lower rates of consent, partly attributable to disparate rates of approach. These findings suggest opportunities for reducing disparities in PICU research participation.