Stephanie Taplin
Human Research Ethics Committees (HRECs) oversee research conducted in Australia in accordance with the National Statement on Ethical Conduct in Human Research (NHMRC, 2007, updated 2018). This ethics review role gives them authority to approve a research study or request modifications. While such safeguards and approvals are appropriate and reasonable, HRECs may be cautious about approving research studies with children about ‘sensitive’ or ‘difficult’ subjects, such as sexuality, or with those who are deemed to be vulnerable, such as children in institutions.
Issues such as payments for children to participate have been controversial for HRECs, with concerns expressed that child participants may be overly influenced or encouraged to take risks they would not take if it were not for the offer of payment. But payments encourage participation and increase recruitment, facilitating children having a say about issues that affect them – even in relation to sensitive issues.
A group of Australian researchers explored how decisions are made about children’s participation in research about sensitive topics via the Managing Ethical Studies on Sensitive Issues (MESSI) study, funded by an Australian Research Council Discovery Grant (DP150100864).
Three papers have now been published from our surveys with children, human research ethics committee members, parents and gatekeepers. Within those surveys we presented hypothetical scenarios describing research studies with child participants using varying sensitivity or risk levels (low, medium to high), study methods (online surveys, face-to face interviews, focus group, or survey in class) and payments (from no payment through to A$30, A$100 a high (A$200) prize draw entry.
From the 151 young people (aged 15-17 years), 43 children (aged 12-14 years) and 183 HREC member responses to the hypothetical scenarios we found:
Risk: The HREC member responses showed they were much more likely to approve a study of low risk or sensitivity than they were to approve a higher risk study. This result held irrespective of the study method or payment level or amount. This finding was also consistent with the responses from the children and young people: children are less likely to participate in the riskier studies.
Payments: HREC members were most likely to approve each of the hypothetical studies if no payment was offered. As payment levels increased, the likelihood of approval by HREC members decreased. Some respondents were so concerned about payments to children that they would not approve any study regardless of the topic or risk level.
In contrast, paying children increases the likelihood they will agree to participate in the studies and, in general, the higher the payments the higher the likelihood they will participate. However, our results also showed payments do not influence them to take unnecessary risks; “undue influence” is unlikely to be as much of a concern as HREC members have previously thought, and should not even be a consideration with low risk studies.
Payments v draws: At the higher risk levels, HREC members approved $200 voucher draws at the same rate as a $30 payment, while for the lower risk studies the $200 voucher draw was preferred to the $30 payment. In contrast, children and young people were equally likely to participate at the different risk levels when offered a $30 payment or entry into a $200 voucher draw. Researchers with more limited research budgets may be encouraged by this finding to offer entry into a $200 voucher draw, as they appear to be acceptable to both HREC members and children and young people.
Methods: Face-to-face interviews conducted at home with children elicited substantially higher rates of approval from HREC members with more sensitive/riskier study topics. However, children may prefer the anonymity of a paper or online survey when providing information about a topic that is sensitive or considered personal, rather than discussing it with a researcher at their home where they may be concerned about being overheard by their parents. Others want to be offered the choice.
These findings may prompt researchers to conclude that to maximize the chance that their study is approved by an HREC, they should avoid the use of a payment for the child participant. However, there are reasons to argue for payments for child participants, as for adults. First, payments increase participation rates and are also appropriate as compensation for time spent on research or reimbursements for expenses. However, there is also a responsibility on the part of research ethics committees to ensure that payments are not too low as to be exploitative. Second, concerns about the “undue influence” of payments are unfounded.
Children and young people can identify risks and are not induced by money to participate in research that they would not have otherwise participated in. On this basis, HREC member concerns can be allayed, and their focus on payments as the reason for denying study approval is unwarranted. Payments of around A$30 may be appropriate for child participants even for high-risk studies. Furthermore, an undue emphasis by HRECs on payment issues rather than managing risks and methodological issues can lead to children and young people being denied that opportunity to consider their own participation.
Research ethics committee members also recognised their lack of expertise in research with children. Both researchers and HRECs would benefit from adopting more transparent, child-inclusive and child-friendly processes, with additional training and guidance for HRECs indicated.
In conclusion, the MESSI study has found that payments can be used to increase the participation of children and young people in research without concerns about undue influence. However, the overriding consideration should always be the level of risk to the children and young people if they participate in the study, as is integral to undertaking such research ethically.
Articles from the MESSI study on which this article is based:
Taplin, S., Chalmers, J., Brown, J., Moore, T., Graham, A. & McArthur, M. (2022 in press) How do Research Ethics Committee members respond to hypothetical studies with children? Results from the MESSI Study. Journal of Empirical Research on Human Research Ethics. https://doi.org/10.1177/15562646221087530
Taplin, S., Chalmers, J., Brown, J., Moore, T., Graham, A. & McArthur, M. (2022) Human Research Ethics committee experiences and views about children’s participation in research: results from the MESSI Study. Journal of Empirical Research on Human Research Ethics. 17(1-2), 70-83. https://doi.org/10.1177/15562646211048294
Taplin, S., Chalmers, J., Hoban, B., McArthur, M., Moore, T. & Graham, A. (2019) Children in social research: Do higher payments encourage participation in riskier studies? Journal of Empirical Research on Human Research Ethics. 14(2), 126-140. https://doi.org/10.1177/1556264619826796
This post may be cited as:
Taplin, S. (21 April 2022) HREC decision-making about social research with children: the influence of payment, risk and method. Research Ethics Monthly. Retrieved from: https://ahrecs.com/hrec-decision-making-about-social-research-with-children-the-influence-of-payment-risk-and-method/