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Facilitators and barriers for parental consent to pediatric emergency research



Obtaining informed consent for clinical research in the pediatric emergency department (ED) is challenging. Our objective was to understand the factors that influence parental consent for ED studies.


This was a cross-sectional survey assessing parents’ willingness to enroll their children into an ED research study. Parents reporting a willingness to enroll in ED studies were presented with two hypothetical scenarios, a low-risk and a high-risk study, and then asked about decision influencers affecting consent. Parents expressing a lack of willingness to enroll were asked which decision influencers impacted their consent decision.


Among 118 parents, 90 (76%) stated they would be willing to enroll their child into an ED study; of these, 86 (96%) would consent for a low-risk study and 54 (60%) would consent for a high-risk study. Caucasian parents, and those with previous research exposure, were more likely to report willingness to participate. Those who would consent to the high-risk study cited “benefits that research would provide to future children” most strongly influenced their decision to agree.


ED investigators should highlight the benefits for future children and inquire about parents’ previous exposure to research to enhance ED research enrollment. Barriers to consent in non-Caucasian families should be further investigated.


  • Obtaining consent for pediatric emergency research is challenging and this study identified factors influencing parental consent for research in EDs.

  • Benefits for future children and parents’ previous research experience were two of the most influential factors in parents’ willingness to consent to ED research studies.

  • These findings will help to improve enrollment in ED research studies and better our understanding of how to promote the health and well-being of pediatric patients.

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Fig. 1: Study procedures flowchart.


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We would like to thank Dr. Daniela Santos for translating the surveys into Spanish and for enrolling patients in the study. We would also like to thank Marissa Garcia, Tate Closson-Niese, Amira Herstic, and Kayla Bell for enrolling patients into this study. Additionally, this study could not have been conducted without the help of Mimi Goodwin and Kathleen Grice. There was no external funding for this manuscript and all authors have indicated they have no financial relationships relevant to this article to disclose.

Author information




R.L.M. conceptualized and designed the study and data collection instruments, collected data, and initiated and revised the manuscript. R.D.M. and R.D.C. conceptualized and designed the study and data collection instruments, supervised the study, reviewed the manuscript for important intellectual content, and revised the manuscript. R.D.M. provided final approval of the version to be published. L.B. conceptualized the study and reviewed and revised the manuscript. L.P. and J.L. made substantial contributions to the analysis and interpretation of data and helped to revise critical manuscript content. All authors are in agreement with the content of the manuscript.

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Correspondence to Reagan L. Miller.

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The authors declare no competing interests.

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Consent was provided through the completion of the survey.

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Miller, R.L., Comstock, R.D., Pierpoint, L. et al. Facilitators and barriers for parental consent to pediatric emergency research. Pediatr Res (2021).

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