Skip to main content
Log in

Development of Plain Language Supplemental Materials for the Biobank Informed Consent Process

  • Published:
Journal of Cancer Education Aims and scope Submit manuscript

Abstract

The US Department of Health and Human Services addresses clear communication in the informed consent process as part of the Notice of Proposed Rulemaking for revisions to the Common Rule. However, prior research has shown that participants may not fully comprehend research studies despite completion of an informed consent process. Our main goal was to provide plain language information about donation processes to a cancer biobank to supplement an informed consent form. We developed and conducted cognitive testing with supplemental brochures that clearly communicated information about three different models for consent (notice, broad and study-specific) to future use of biospecimens. During the brochure development process, we conducted qualitative, semi-structured, individual, in-person cognitive interviews among 14 women to examine participants’ perceptions of the brochures. Each participant provided feedback regarding the understandability, graphics and layout, and cultural appropriateness of the brochures. Our findings demonstrate that these methods may be used to tailor consent form brochures, such as the ones developed here, to other populations. This study therefore adds to our understanding of how best to present content to help women from two different racial groups make informed decisions about participation in a cancer biobank.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Servies', U.D.o.H.a.H. (2011) Human subjects research protection: enhancing protections for research subjects and reducing burden, delay and ambiguity for investigators

  2. Services', U.D.o.H.a.H. (2009) Code of Federal Regulations: 45 C.F.R. § 46 Retrieved from http://www.hhs.gov/ohrp/policy/ohrpregulations.pdf

  3. Cambon-Thomsen A (2004) The social and ethical issues of post-genomic human biobanks. Nat Rev Genet 5(11):866–873

    Article  CAS  PubMed  Google Scholar 

  4. Hansson MG et al (2006) Should donors be allowed to give broad consent to future biobank research? Lancet Oncol 7(3):266–269

    Article  PubMed  Google Scholar 

  5. Services', U.D.o.H.a.H. (2015) Federal policy for the protection of human subjects. Docket Number: HHS-OPHS-2015-0008. Federal Register. 80(173)

  6. Falagas ME et al (2009) Informed consent: how much and what do patients understand? Am J Surg 198(3):420–435

    Article  PubMed  Google Scholar 

  7. Paasche-Orlow MK, Taylor HA, Brancati FL (2003) Readability standards for informed-consent forms as compared with actual readability. N Engl J Med 348(8):721–726

    Article  PubMed  Google Scholar 

  8. Davis TC et al (1998) Informed consent for clinical trials: a comparative study of standard versus simplified forms. J Natl Cancer Inst 90(9):668–674

    Article  CAS  PubMed  Google Scholar 

  9. Sheridan SL et al (2011) Interventions for individuals with low health literacy: a systematic review. J Health Commun 16(Suppl 3):30–54

    Article  PubMed  Google Scholar 

  10. Nielsen-Bohlman L, Panzer A, Kindig D (eds) (2004) Health literacy: a prescription to end confusion. National Academies Press, Washington, DC

    Google Scholar 

  11. Chen DT et al (2005) Research with stored biological samples: what do research participants want? Arch Intern Med 165(6):652–655

    Article  PubMed  Google Scholar 

  12. Helft PR et al (2007) Cancer patients’ attitudes toward future research uses of stored human biological materials. J Empir Res Hum Res Ethics 2(3):15–22

    Article  PubMed  Google Scholar 

  13. Huber J et al (2013) Two decades’ experience with a prospective biobank for urologic oncology: research, clinical care, and the patients’ view. Urol Oncol 31(7):990–996

    Article  PubMed  Google Scholar 

  14. Pentz RD, Billot L, Wendler D (2006) Research on stored biological samples: views of African American and White American cancer patients. Am J Med Genet A 140(7):733–739

    Article  PubMed  Google Scholar 

  15. Luque JS et al (2012) Formative research on perceptions of biobanking: what community members think. J Cancer Educ 27(1):91–99

    Article  PubMed  PubMed Central  Google Scholar 

  16. Donovan-Kicken E et al (2012) Health literacy, self-efficacy, and patients’ assessment of medical disclosure and consent documentation. Health Commun 27(6):581–590

    Article  PubMed  Google Scholar 

  17. U.S. Department of Health and Human Services (2000) Healthy people 2010 Retrieved from http://www.healthypeople.gov/2010/

  18. Eagleson R (2014) Short definition of plain language. Improving communication from the federal government to the public. from http://www.plainlanguage.gov/whatisPL/definitions/eagleson.cfm

  19. Jefford M, Moore R (2008) Improvement of informed consent and the quality of consent documents. Lancet Oncol 9(5):485–493

    Article  PubMed  Google Scholar 

  20. Ridpath JR, Wiese CJ, Greene SM (2009) Looking at research consent forms through a participant-centered lens: the PRISM readability toolkit. Am J Health Promot 23(6):371–375

    Article  PubMed  Google Scholar 

  21. Services', U.D.o.H.a.H. (2013) Guidelines for the conduct of research involving human subjects at the National Institutes of Health. Washington DC: Retrieved from http://ohsr.od.nih.gov/ohsr/public/SOP_12_v3_3-12-14_508.pdf

  22. Schnitzer A, Rosenzweig M, Harris B (2011) Health literacy: a survey of the issues and solutions. Journal of Consumer Health on the Internet 15(2):164–179

    Article  Google Scholar 

  23. Walters K, Hamrell M (2008) Consent forms, lower reading levels, and using Flesch-Kincaid readability software. Drug Inf J 42(4):385–394

    Article  Google Scholar 

  24. Tait A et al (2013) Informing the uninformed: optimizing the consent message using a fractional factorial design. JAMA pediatrics 167(7):640–646

    Article  PubMed  PubMed Central  Google Scholar 

  25. Enama ME et al (2012) Randomization to standard and concise informed consent forms: development of evidence-based consent practices. Contemp Clin Trials 33(5):895–902

    Article  PubMed  PubMed Central  Google Scholar 

  26. Coyne CA et al (2003) Randomized, controlled trial of an easy-to-read informed consent statement for clinical trial participation: a study of the Eastern Cooperative Oncology Group. J Clin Oncol 21(5):836–842

    Article  PubMed  Google Scholar 

  27. McGraw S et al (2012) Clarity and appeal of a multimedia informed consent tool for biobanking. IRB: A Review of Human Subjects Reserach 34(1):9–19

    Google Scholar 

  28. Campbell H et al (2008) Impact of a clinical trials information handbook on patient knowledge, perceptions, and likelihood of participation. IRB: Ethics & Human Research 30:6–14

    Google Scholar 

  29. Juraskova I et al (2008) Improving informed consent: pilot of a decision aid for women invited to participate in a breast cancer prevention trial (IBIS-II DCIS). Health Expect 11(3):252–262

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Kass NE et al (2015) A pilot study of simple interventions to improve informed consent in clinical research: feasibility, approach, and results. Clin Trials 12(1):54–66

    Article  PubMed  Google Scholar 

  31. Mancini J et al (2011) Consent for biobanking: assessing the understanding and views of cancer patients. J Natl Cancer Inst 103(2):154–157

    Article  PubMed  Google Scholar 

  32. Robinson JO et al (2013) Participants’ recall and understanding of genomic research and large-scale data sharing. J Empir Res Hum Res Ethics 8(4):42–52

    Article  PubMed  PubMed Central  Google Scholar 

  33. Ormond KE et al (2009) Assessing the understanding of biobank participants. Am J Med Genet A 149A(2):188–198

    Article  CAS  PubMed  Google Scholar 

  34. Klima J et al (2014) Understanding of informed consent by parents of children enrolled in a genetic biobank. Genet Med 16(2):141–148

    Article  PubMed  Google Scholar 

  35. Beskow LM et al (2010) Developing a simplified consent form for biobanking. PLoS One 5(10), e13302

    Article  PubMed  PubMed Central  Google Scholar 

  36. Mello MM, Wolf LE (2010) The Havasupai Indian tribe case—lessons for research involving stored biologic samples. N Engl J Med 363(3):204–207

    Article  CAS  PubMed  Google Scholar 

  37. Brown KM et al (2015) Differences in preferences for models of consent for biobanks between Black and White women. J Community Genet

  38. The Plain Language Action and Information Network (PLAIN)(2011) federal plain language guidelines. Washington D.C.: Retrieved from http://www.plainlanguage.gov/howto/guidelines/bigdoc/fullbigdoc.pdf

  39. Doak CC, Doak LG, Root JH (1996) Teaching patients with low literacy skills, 2nd edn. J.B. Lippincott Company, Philadelphia

    Google Scholar 

  40. Institute', N.C. (2003) Clear & simple: developing effective print materials for low-literate readers

  41. Prevention', C.f.D.C.a. (2009) Simply put: a guide for creating easy-to-understand materials. Atlanta, Georgia: Strategic and Proactive Communication Branch Retrieved from http://www.cdc.gov/healthliteracy/pdf/Simply_Put.pdf

  42. Strauss A, C. J (1998) Basics of qualitative research: Second edition: techniques and procedures for developing grounded theory. Sage Publications, Inc

  43. Schillinger D et al (2003) Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med 163(1):83–90

    Article  PubMed  Google Scholar 

  44. Delp C, Jones J (1996) Communicating information to patients: the use of cartoon illustrations to improve comprehension of instructions. Acad Emerg Med 3(3):264–270

    Article  CAS  PubMed  Google Scholar 

  45. Houts PS et al (2006) The role of pictures in improving health communication: a review of research on attention, comprehension, recall, and adherence. Patient Educ Couns 61(2):173–190

    Article  PubMed  Google Scholar 

  46. Mansoor LE, Dowse R (2003) Effect of pictograms on readability of patient information materials. Ann Pharmacother 37(7–8):1003–1009

    Article  PubMed  Google Scholar 

  47. Pentz RD, Theriault RL (2001) Research ethics: clinical trial abuse and the public trust. Breast diseases: A year book quarterly 12:141–144

    Article  Google Scholar 

  48. Randall V (1995) Slavery, segregation and racism: trusting the health care system ain’t always easy—an African American perspective on bioethics. St Louis University Public Law Review 15:191

    Google Scholar 

  49. Branson RD, Davis K Jr, Butler KL (2007) African Americans’ participation in clinical research: importance, barriers, and solutions. Am J Surg 193(1):32–39, discussion 40

    Article  PubMed  Google Scholar 

  50. Field LA et al (2012) Identification of differentially expressed genes in breast tumors from African American compared with Caucasian women. Cancer 118(5):1334–1344

    Article  CAS  PubMed  Google Scholar 

  51. Murphy J et al (2009) Public perspectives on informed consent for biobanking. Am J Public Health 99(12):2128–2134

    Article  PubMed  PubMed Central  Google Scholar 

  52. Platt J et al (2014) Public preferences regarding informed consent models for participation in population-based genomic research. Genet Med 16(1):11–18

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

This project was supported by grant number U54CA153460-03S1, a supplement to the Program for the Elimination of Cancer Disparities grant from the National Cancer Institute, Washington University School of Medicine, the Barnes-Jewish Hospital Foundation, and Siteman Cancer Center. We thank all of our community partners, The Breakfast Club, Inc., Siteman Cancer Center and Women’s Health Repository. We thank the 60 women who participated in the study and shared their opinions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Bettina F. Drake.

Ethics declarations

All study procedures were approved by the Washington University Institutional Review Board.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Drake, B.F., Brown, K.M., Gehlert, S. et al. Development of Plain Language Supplemental Materials for the Biobank Informed Consent Process. J Canc Educ 32, 836–844 (2017). https://doi.org/10.1007/s13187-016-1029-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13187-016-1029-y

Keywords

Navigation