The commentary below the article is by Virginia Morrow, Visiting Professor, University College London
Decision-making about children’s participation in research requires consideration of factors such as the risk or sensitivity of the study, payments, study methods and the potential benefits for participants (NHMRC, 2007: Ch: 4.2). Although these issues are generally weighed up by adult decision-makers, including ethics committees, organisational gatekeepers and parents, it is important that children and young people are given the opportunity to make their own decisions about participating in research about issues that affect them (NHMRC, 2007: Ch: 4.2).
In Australia and other developed countries, it is common to provide payments to adult research participants as compensation or reimbursement. However, research payments for children are more contentious, even when research involves low or negligible risk. The general principle is that payments must not be offered at such a level that they become an inducement that is likely to encourage participants to take risks they would not be willing to accept with smaller payments (NHMRC, 2007: Ch: 2.2; Appelbaum, Lidz, & Klitzman, 2009; Wendler, Rackoff, Emanuel, & Grady, 2002; Spriggs, 2010; Singer & Couper, 2008). However, a lack of specific guidance has led some ethics committees to refuse research payments for children (Bagley et al., 2007), which may in turn reduce the likelihood of children participating in research about issues that affect them.
The Managing Ethical Studies on Sensitive Issues (MESSI) study used online surveys to present children and decision-makers with hypothetical scenarios of varying risk (or sensitivity) and payments, and tested their influence on participation.
The scenarios ranged from relatively benign or lower risk to highly sensitive or risky. For the lower risk scenario, we used an internet safety scenario, which asked about their views and the strategies they use in relation to internet safety. For the higher risk scenario, participants were asked about their experiences of sexting (defined as a sexual or sexually suggestive message, photo or video) and for copies be provided to the researchers.
To test the influence of payment amounts on the children and young people’s agreement to the different hypothetical scenarios, each respondent was presented with a range of payments from no payment through to A$30 (an amount commonly used by the research team), A$100 (a high payment unlikely to be approved for research with children) and a high ($200) prize draw entry.
Children and young people were also asked if they had had a “bad experience with this topic” that would affect their decision to participate.
The responses of 151 young people (aged 15-17 years) and 43 children (aged 12-14 years) who completed both the lower risk scenario and the high-risk scenario are reported in the article:
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
We found that:
- Children were able to identify the higher risk studies and respond accordingly. They were more likely to participate in the lower risk study than in the higher risk study.
- Significant numbers of children and young people who were invited to participate in a study will do so for no payment.
- Paying children increased the likelihood that they would agree to participate in the studies and, in general, the higher the payments the higher the likelihood of their participating.
- No evidence of undue influence from payment was detected.
- Children and young people of lower socio-economic status were more likely to participate in research, regardless of whether they were paid, and were no more influenced by higher payments than were those of higher socio-economic status.
- Children with adverse experiences in the research area still generally wanted to participate, and should be given the opportunity to contribute their views and experiences.
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.
Further papers from the MESSI study on the HREC, organisational decision-maker and parent responses to the hypothetical scenarios are in development.
Powell, M., McArthur, M., Chalmers, J., Graham, A., Moore, T., Spriggs, M. & Taplin, S. (2018) Sensitive topics in social research involving children. International Journal of Social Research Methodology.21:6, 647-660. https://doi.org/10.1080/13645579.2018.1462882
Powell, M.A., Graham, A., McArthur, M., Moore, T., Chalmers, J. & Taplin, S. (2019, in press). Children’s participation in research on sensitive topics: addressing concerns of decision-makers, Children’s Geographies. https://doi.org/10.1080/14733285.2019.1639623
Appelbaum, P. S., Lidz, C. W., & Klitzman, R. (2009). Voluntariness of consent to research: A Conceptual Model. Hastings Center Report, 39(1), 30-39. doi:10.1353/hcr.0.0103
Bagley, S. J., Reynolds, W. W., & Nelson, R. M. (2007). Is a “Wage-Payment” Model for Research Participation Appropriate for Children? Pediatrics, 119(1), 46-51. doi:10.1542/peds.2006-1813
NHMRC (2007, updated 2018) National Statement on Ethical Conduct in Human Research 2007. file:///C:/Users/sttaplin/Downloads/national-statement-2018-updated%20(1).pdf
Singer, E., & Couper, M. P. (2008). Do Incentives Exert Undue Influence on Survey Participation? Experimental Evidence. Journal of Empirical Research on Human Research Ethics, 3(3), 49-56. doi: doi:10.1525/jer.2008.3.3.49
Spriggs, M. (2010). Understanding consent in research involving children: The ethical issues. A handbook for human research ethics committees and researchers. Melbourne: Children’s Bioethics Centre.
Wendler, D., Rackoff, J. E., Emanuel, E. J., & Grady, C. (2002). The ethics of paying for children’s participation in research. J Pediatr, 141(2), 166-171. doi: 10.1067/mpd.2002.124381
Funding and Team:
The MESSI study was funded by an Australian Research Council Discovery Grant (DP150100864).
Chief Investigators: Prof Morag McArthur (ACU); A/Prof Stephanie Taplin (ACU); Dr Jenny Chalmers (UNSW); Prof Anne Graham (SCU); A/Prof Tim Moore (ACU/Uni SA)
Project Managers: Dr Bianca Hoban & Dr Mary Ann Powell.
|.||Comments on ‘Should you be worried about paying children to take part in research?’
……Virginia Morrow, Visiting Professor, University College London
Paying anyone to take part in research risks being seen as ‘undue influence’ and contrary to the principle that consent should be ‘freely given’. Adult concerns about protecting children usually mean that research ethics committees tend to err on the side of caution – while reimbursement of expenses or provision of snacks and beverages is seen as acceptable, paying children cash, or even saying thank you with gift vouchers, are highly contested..
Whether or not children should be paid is rarely discussed in the research literature, so it is very welcome to see this systematic attempt by Stephanie Taplin and colleagues to explore children’s opinions about whether or not payment influences their participation in low- or high-risk research..
The findings are useful and reassuring for researchers wanting to undertake research with children. It is notable that children and young people say they will participate in research for no payment, which demonstrates their altruism. Also interesting is that children and young people of lower socio-economic status were more generally likely to participate in research, regardless of whether they were paid. The findings about children’s altruism and reasonableness about participation in research reflect the results of a consultation on involving children in clinical research undertaken for Nuffield Council on Bioethics in UK (Spencer et al. 2015). This found that children themselves wanted their contributions to research to be valued and respected, to be thanked for their time, rather than induced to participate via ‘bribery’. Children and young people said that expressions of gratitude included providing information about what happens as a result of the research and how their contributions have been taken up more broadly in policy and practice..
Stephanie’s research (reported in full in Taplin et al. 2019) did raise a couple of questions that I think warrant further discussion. First, I wondered about using online surveys as a way to gather data from children – a good way to reach a lot of children quickly but limited in the depth to which the research can go. The questions of payment for research participation would be interesting to explore too in qualitative research, and perhaps a useful topic for group discussions..
.Second, the authors used a cash prize draw/lottery to attract children to participate in the online survey for the research, with a prize of A$200. This in itself raises questions, again rarely discussed in the research literature – one question being a perennial one for online research with children about proof of age, another question being, how much is too much? These questions are for ethics committees to discuss, and Taplin et al.’s paper will be helpful for research ethics committee members. However, online cash draws are also often used by NGO researchers, with no recourse to ethics support. I once advised a researcher from a large NGO that had used a prize draw to encourage children to complete an online survey about mental well-being; the survey had not indicated a lower age limit and the researchers did not know what to do when seven-year-olds had entered sensitive data..
.Third, discussions about payments, compensation, reciprocity and reimbursement for children and young people (and indeed adults) in low and middle-income countries also merit much more systematic attention from the research community than they have received to date. Looking forward to reading more about this on the pages of Research Ethics Monthly in due course.
Spencer, G., Boddy, J. and Rees, R. (2015) “What we think about what adults think”: Children and young people’s perspectives on ethics review of clinical research with children. Nuffield Council on Bioethics. http://nuffieldbioethics.org/wp-content/uploads/Report_young_peoples_perspectives_on_ethics_review.pdfwww.nuffieldbioethics/org
This post may be cited as:
Taplin, S. (30 July 2019) Should you be worried about paying children to take part in research?. Research Ethics Monthly. Retrieved from: https://ahrecs.com/human-research-ethics/should-you-be-worried-about-paying-children-to-take-part-in-research