Objective To explore parents' attitudes to children's participation in
randomized controlled trials. Study design Qualitative analysis of focus group discussions involving 33
parents from a pediatric teaching hospital and local school in Australia.
Parents varied in age, gender, ethnicity, level of education, research
experience, and child's health status. The transcribed discussions were analyzed
by theme linkage using the constant comparative method. Results Parents balance risks and benefits when deciding about trial
participation for their child. Perceived benefits include the offer of hope,
better care of their child, the opportunity to access new treatments, healthcare
professionals and health information, meeting others in similar circumstances,
and helping others. Perceived risks include potential side effects, being
randomized to ineffective treatments, and the inconvenience of participation.
The decision for trial participation is also influenced by parental factors
(parents' knowledge, beliefs, and emotional responses), child factors (the
child's health status and preference about participation), trial factors (the
use of placebos and uncertainties of participation), and doctor factors
(doctor's recommendations and communication of trial information). Conclusions Educating parents about trials, improving communication
between trialists, pediatricians, and parents, increasing incentives while
decreasing inconveniences, and providing decision aids for parents may increase
parents' willingness to participate in trials. (J Pediatr 2003;142:554-9)
From the Centre for Kidney Research,
the Children's Hospital at Westmead, Westmead, the Department of
Paediatrics and Child Health, Medical Psychological Research Unit and
Surgical Outcomes Research Centre, and the School of Public Health,
University of Sydney, Sydney, Australia.
Supported by the University of Sydney
Postgraduate Award Scholarship (to P. C.). The Centre for Kidney Research
at the Children's Hospital at Westmead also contributed to the funding of
this research.
Reprint requests: Patrina H. Y.
Caldwell, BMed, DipPaeds, Centre for Kidney Research, The Children's
Hospital at Westmead, Locked Bag 4001, Westmead NSW 2145, Sydney,
Australia. E-mail:Patrinac@chw.edu.au .
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