Does an interactive trust-enhanced electronic consent improve patient experiences when asked to share their health records for research? A randomized trial

Chris Harle, Elizabeth H. Golembiewski, Kiarash P. Rahmanian, Babette Brumback, Janice L. Krieger, Kenneth W. Goodman, Arch G. Mainous, Ray E. Moseley

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: In the context of patient broad consent for future research uses of their identifiable health record data, we compare the effectiveness of interactive trust-enhanced e-consent, interactive-only e-consent, and standard e-consent (no interactivity, no trust enhancement). Materials and Methods: A randomized trial was conducted involving adult participants making a scheduled primary care visit. Participants were randomized into 1 of the 3 e-consent conditions. Primary outcomes were patient-reported satisfaction with and subjective understanding of the e-consent. Secondary outcomes were objective knowledge, perceived voluntariness, trust in medical researchers, consent decision, and time spent using the application. Outcomes were assessed immediately after use of the e-consent and at 1-week follow-up. Results: Across all conditions, participants (N734) reported moderate-To-high satisfaction with consent (mean 4.3 of 5) and subjective understanding (79.1 of 100). Over 94% agreed to share their health record data. No statistically significant differences in outcomes were observed between conditions. Irrespective of condition, black participants and those with lower education reported lower satisfaction, subjective understanding, knowledge, perceived voluntariness, and trust in medical researchers, as well as spent more time consenting. Conclusions: A large majority of patients were willing to share their identifiable health records for research, and they reported positive consent experiences. However, incorporating optional additional information and messages designed to enhance trust in the research process did not improve consent experiences. To improve poorer consent experiences of racial and ethnic minority participants and those with lower education, other novel consent technologies and processes may be valuable. (An Interactive Patient-Centered Consent for Research Using Medical Records; NCT03063268).

Original languageEnglish (US)
Pages (from-to)620-629
Number of pages10
JournalJournal of the American Medical Informatics Association
Volume26
Issue number7
DOIs
StatePublished - Apr 11 2019
Externally publishedYes

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Keywords

  • Broad consent
  • Common Rule
  • E-consent
  • Electronic health record
  • Information systems design
  • Research informatics

ASJC Scopus subject areas

  • Health Informatics

Cite this

Does an interactive trust-enhanced electronic consent improve patient experiences when asked to share their health records for research? A randomized trial. / Harle, Chris; Golembiewski, Elizabeth H.; Rahmanian, Kiarash P.; Brumback, Babette; Krieger, Janice L.; Goodman, Kenneth W.; Mainous, Arch G.; Moseley, Ray E.

In: Journal of the American Medical Informatics Association, Vol. 26, No. 7, 11.04.2019, p. 620-629.

Research output: Contribution to journalArticle

Harle, Chris ; Golembiewski, Elizabeth H. ; Rahmanian, Kiarash P. ; Brumback, Babette ; Krieger, Janice L. ; Goodman, Kenneth W. ; Mainous, Arch G. ; Moseley, Ray E. / Does an interactive trust-enhanced electronic consent improve patient experiences when asked to share their health records for research? A randomized trial. In: Journal of the American Medical Informatics Association. 2019 ; Vol. 26, No. 7. pp. 620-629.
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AU - Brumback, Babette

AU - Krieger, Janice L.

AU - Goodman, Kenneth W.

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AU - Moseley, Ray E.

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AB - Objective: In the context of patient broad consent for future research uses of their identifiable health record data, we compare the effectiveness of interactive trust-enhanced e-consent, interactive-only e-consent, and standard e-consent (no interactivity, no trust enhancement). Materials and Methods: A randomized trial was conducted involving adult participants making a scheduled primary care visit. Participants were randomized into 1 of the 3 e-consent conditions. Primary outcomes were patient-reported satisfaction with and subjective understanding of the e-consent. Secondary outcomes were objective knowledge, perceived voluntariness, trust in medical researchers, consent decision, and time spent using the application. Outcomes were assessed immediately after use of the e-consent and at 1-week follow-up. Results: Across all conditions, participants (N734) reported moderate-To-high satisfaction with consent (mean 4.3 of 5) and subjective understanding (79.1 of 100). Over 94% agreed to share their health record data. No statistically significant differences in outcomes were observed between conditions. Irrespective of condition, black participants and those with lower education reported lower satisfaction, subjective understanding, knowledge, perceived voluntariness, and trust in medical researchers, as well as spent more time consenting. Conclusions: A large majority of patients were willing to share their identifiable health records for research, and they reported positive consent experiences. However, incorporating optional additional information and messages designed to enhance trust in the research process did not improve consent experiences. To improve poorer consent experiences of racial and ethnic minority participants and those with lower education, other novel consent technologies and processes may be valuable. (An Interactive Patient-Centered Consent for Research Using Medical Records; NCT03063268).

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