Establishing the Feasibility of a Tablet-Based Consent Process with Older Adults: A Mixed-Methods Study

Abstract

The findings suggest that a tablet-based consent process is feasible to implement with older adults and acceptable to this population, but we would underscore that efforts to optimize design of tablet-based consent forms for older adults are warranted.

Implementation of Electronic Informed Consent in Biomedical Research and Stakeholders’ Perspectives: Systematic Review

“…The qualitative studies ranged from satisfying 80% or more of the quality criteria (6 studies) [ 35 - 40 ] to satisfying 50% to 60% of the quality criteria (3 studies) [ 41 - 43 ]. Moreover, 3 mixed methods studies met 80% or more of the quality criteria [ 16 , 44 , 45 ], 6 studies met from 57% to 71% of the quality criteria [ 15 , 46 - 50 ], while 1 met only 43% of the quality criteria [ 51 ]. The only cohort study had a quality score of 7 [ 52 ], while the quality scores of cross-sectional studies were assessed to be 4 [ 53 - 56 ], 5 [ 57 - 61 ], and 6 [ 62 ].…”

“…The majority of research participants, researchers, members of the ethics committee as well as health authorities believed that the ability to incorporate audio, video, or graphics in electronic informed consent is a distinct benefit, especially for vulnerable groups [ 15 , 16 , 28 , 33 , 39 , 43 , 45 , 47 - 49 , 57 ]. Patients who were older adults, for example, expressed the usefulness of graphics and audio [ 45 ]. Research participants mentioned in a focus group that video and graphics may be more effective than written text in conveying information [ 16 ].…”

“…Important to consider is the length of the video, since research participants highlighted that a 5-minute video was too long [ 33 ]. The use of graphics, including icons, was appreciated by all involved stakeholder groups [ 15 , 16 , 28 , 39 , 43 , 45 , 47 - 49 , 57 ]. For instance, the implementation of a progress bar was advised by researchers to indicate the different steps of the electronic informed consent form [ 43 ].…”

“…A similar case with research participants was reported; in this particular study [ 51 ], several participants accidentally removed their signature, which contributed to the majority of errors when using touchscreen devices. Moreover, research participants who were older adults reported that they would need training to be able to use a tablet-based consent process [ 45 ].…”

“…Hence, the pressure to give consent immediately was decreased [ 16 ]. An extensive amount of studies investigated barriers related to the use of electronic informed consent which could prevent research participants from achieving a reasonable level of understanding [ 15 , 25 - 28 , 31 - 34 , 39 , 40 , 44 , 45 , 48 , 49 , 52 , 53 , 55 , 60 , 61 ]. For the majority of studies, no barriers were reported [ 25 - 28 , 31 - 34 , 44 , 48 , 52 ].…”