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      What constitutes good ethical practice in genomic research in Africa? Perspectives of participants in a genomic research study in Uganda

      research-article
      a , b , c , d , e , a
      Global Bioethics
      Routledge
      Consent, feedback, genomic research, Africa, stakeholder engagement

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          ABSTRACT

          Previous research has consistently highlighted the importance of stakeholder engagement in identifying and developing solutions to ethical challenges in genomic research, especially in Africa where such research is relatively new. In this paper, we examine what constitutes good ethical practice in research, from the perspectives of genomic research participants in Uganda. Our study was part of a multi-site qualitative study exploring these issues in Uganda, Ghana and Zambia. We purposively sampled various stakeholders including genomic research participants, researchers, research ethics committee members, policy makers and community members. This paper presents the findings from in-depth interviews with 27 people with diabetes who had participated in a diabetes genomic study. Data were collected using semi-structured interviews. Manual thematic content analysis was conducted using a framework approach. Findings indicate three key requirements that research participants see as vital for genomic research to be more responsive to research participants’ needs and contextual realities: (1) de-emphasising the role of experts and institutions in the consenting process, (2) clarity about the timing and nature of feedback both of findings relevant to the health of individuals and about the broad progress of the study, and (3) more effective support for research participants during and after the study.

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          Qualitative data analysis: the framework approach.

          Qualitative methods are invaluable for exploring the complexities of health care and patient experiences in particular. Diverse qualitative methods are available that incorporate different ontological and epistemological perspectives. One method of data management that is gaining in popularity among healthcare researchers is the framework approach. We will outline this approach, discuss its relative merits and provide a working example of its application to data management and analysis.
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            Community engagement in research: frameworks for education and peer review.

            Community engagement in research may enhance a community's ability to address its own health needs and health disparities issues while ensuring that researchers understand community priorities. However, there are researchers with limited understanding of and experience with effective methods of engaging communities. Furthermore, limited guidance is available for peer-review panels on evaluating proposals for research that engages communities. The National Institutes of Health Director's Council of Public Representatives developed a community engagement framework that includes values, strategies to operationalize each value, and potential outcomes of their use, as well as a peer-review framework for evaluating research that engages communities. Use of these frameworks for educating researchers to create and sustain authentic community-academic partnerships will increase accountability and equality between the partners.
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              Dynamic consent: a patient interface for twenty-first century research networks

              Biomedical research is being transformed through the application of information technologies that allow ever greater amounts of data to be shared on an unprecedented scale. However, the methods for involving participants have not kept pace with changes in research capability. In an era when information is shared digitally at the global level, mechanisms of informed consent remain static, paper-based and organised around national boundaries and legal frameworks. Dynamic consent (DC) is both a specific project and a wider concept that offers a new approach to consent; one designed to meet the needs of the twenty-first century research landscape. At the heart of DC is a personalised, digital communication interface that connects researchers and participants, placing participants at the heart of decision making. The interface facilitates two-way communication to stimulate a more engaged, informed and scientifically literate participant population where individuals can tailor and manage their own consent preferences. The technical architecture of DC includes components that can securely encrypt sensitive data and allow participant consent preferences to travel with their data and samples when they are shared with third parties. In addition to improving transparency and public trust, this system benefits researchers by streamlining recruitment and enabling more efficient participant recontact. DC has mainly been developed in biobanking contexts, but it also has potential application in other domains for a variety of purposes.
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                Author and article information

                Journal
                Glob Bioeth
                Glob Bioeth
                Global Bioethics
                Routledge
                1128-7462
                1591-7398
                24 March 2019
                2020
                : 31
                : 1
                : 169-183
                Affiliations
                [a ]Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine Uganda Research Unit , Entebbe, Uganda
                [b ]Faculty of Health Sciences, University of Cape Town , Cape Town, South Africa
                [c ]Nuffield Department of Population Health, Wellcome Centre for Ethics and Humanities (Ethox), University of Oxford , Oxford, UK
                [d ]Navrongo Health Research Centre , Navrongo, Ghana
                [e ]Department of Health Promotion & Education, School of Public Health, University of Zambia , Lusaka, Zambia
                Author notes
                [CONTACT ] Rwamahe Rutakumwa rwamahe.rutakumwa@ 123456mrcuganda.org Social Aspects of Health Research Programme, Medical Research Council/Uganda Virus Research Institute Uganda Research Unit , P.O. Box 49, Entebbe, Uganda
                Author information
                https://orcid.org/0000-0002-9171-2083
                https://orcid.org/0000-0002-0583-5272
                Article
                1592867
                10.1080/11287462.2019.1592867
                7734109
                f23d17f7-251f-4d1e-b7ab-7f95a9a2d66e
                © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 26, Pages: 15
                Categories
                Research Article
                Consent in genomics research in sub-Saharan Africa

                consent,feedback,genomic research,africa,stakeholder engagement

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