Spotlight Articles

This month our spotlight section focuses on the practical development of approaches to obtain assent from persons who may not be able to provide full informed consent. Assent is of particular interest to the GE2P2 Global Foundation and we welcome any thoughts or engagement our readers may want to share.

In the Psychology in the Schools research article Review of participatory research assent procedures in school psychology, Flowers et al. point out that ‘[t]ransparency in research is vital for advancing science and safeguarding research participants’ and provide the following recommendations for practitioners:

• Given the findings that only a small percentage of reviewed articles provided a detailed account of how assent was obtained from children and adolescent participants, it is crucial for practitioners in school psychology research to prioritize and transparently document their assent procedures.
• While the current review did not identify novel methods for obtaining assent in school psychology research, practitioners should consider looking to related fields for potentially innovative approaches. Engaging participants in a way that enhances their understanding and buy‐in can lead to more accurate and valid research outcomes.
• Researchers and practitioners in school psychology should advocate for clear reporting standards regarding assent procedures in publications. Providing detailed information about the assent process should be seen as essential to ethical research, and authors and journal editors should consider the value of including this information in their manuscripts.

In Maureen Dykinga’s University of Arizona PhD Dissertation Promoting Health Literacy by Operationalizing a Developmental Approach to Assent, the author finds that in the University of Arizona context, there is a ‘need for operationalized resources that already contain simplified language for PIs to use when assenting youth’. Dykinga notes this research is important for ‘deepening our understanding of the effect age has on interventions and the course of diseases [as this] is dependent upon youth-specific data’.

Review of participatory research assent procedures in school psychology
Research Article
Jaime Flowers, Daniel McCleary, Jillian Dawes, Hunter Marzolf
Psychology in the Schools, 5 December 2023
Abstract
In the realm of psychology and related fields, like school psychology, obtaining informed consent from clients or participants who are 18 years old or older is mandatory for researchers. However, if the individuals are below 18 years old or under a conservatorship, their assent is crucial even if their parent or legal guardian has provided formal consent. Despite the widespread recognition of the importance of assent during research, there is a lack of research and guidelines on how to obtain it effectively. To bridge this gap, we conducted a review and created a summary of research published in school psychology journals on gaining assent during research studies. The articles were categorized based on the experimental design, population, and level of assent described. Our findings offer a comprehensive overview of the current state of research on gaining assent in school psychology, which will enhance transparency in research methods.

Promoting Health Literacy by Operationalizing a Developmental Approach to Assent
PhD Dissertation
Maureen Dykinga
PhD Thesis, 2023 [University of Arizona]
Open Access
Abstract
Background
Since 1991, The Common Rule has provided regulation to protect humans participating in biomedical or social research. Despite clear protocols to obtain informed consent from adults, there is limited information on how to incorporate developmental factors such as simplified language, formative assessment, and feedback into youth assent practices. Adolescence, an important period for developing behaviors that impact health throughout the lifespan, is also a time when developmental capabilities vary greatly among peers of the same chronological age. Meaningfully engaging youth in research begins with an assent that integrates developmental factors and promotes the health literacy of youth. Operationalizing this approach narrows the gap between regulation and research practices.
Methods
To quantify the language complexity of two assent templates, 3 trained speech-language pathologists used Language Sample Analysis; the results were compared. To assess the usefulness of incorporating development into assent, a developmental approach to assent was designed. This approach was implemented with a randomized sample of 50 youth participating in the Children And Teens Study (CATS). A data capture system was utilized to present simplified assent language in segments and ask 6 questions assessing comprehension. For individuals with incorrect answers, feedback was provided, and the same question was presented a second time. To incorporate youth priorities, values, and strengths into assent resources, demographics, educational experiences, exposure to racism, and resiliency data were analyzed. To evaluate the feasibility of shifting institutional assent practices, semi-structured interviews were conducted, assessing the importance of assent, understanding of a developmental approach, its acceptability, the practicality of requiring it, and the resources needed for Principal Investigators (PIs), to be successful. To design a toolkit of operational resources, the knowledge from implementing a developmental approach, analyzing youth data, and conducting the feasibility study was applied.
Results
The simplified assent conveyed the same number of key study details as the more complex assent. 100% of the 6 questions were answered accurately by participants. The cross-section of the youth represented a diverse mix of demographics with 72% reporting comorbidities that impact language, learning, mental, and chronic health. Ninety-eight percent indicated an awareness of racism while 16% had encountered it directly. Youth valued education/knowledge and prioritized flexibility, agency, and autonomy. They demonstrated strengths such as cooperation, connection, and belonging. PIs indicated that assent was important and incorporating a developmental approach was acceptable. They did not believe it would be practical to require this approach. Key barriers were identified as securing buy-in from researchers, addressing time constraints, and gaining institutional support. Resources that strengthen capacity, provide examples, and allow for flexibility, were identified as a need by researchers. A toolkit of resources that reflected youth awareness, priorities, values, and strengths while meeting researcher requests was developed and made available in the resources section of the University of Arizona (UArizona) Institutional Review Board (IRB) website.
Conclusion
The results suggest that integrating a developmental approach was useful in communicating key study elements and reinforced the necessity for inclusive assent practices that align with youth awareness. Incorporating developmental factors into assent empowers youth to exercise health literacy. Providing operational assent resources that reflect the values of diverse youth communities and strengthen the capacity of PIs is the first of many strategies to meaningfully engage youth in research.