Open AccessEthics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda
Author(s) -
Theresa S. Betancourt,
Mary C. Smith Fawzi,
Anne Stevenson,
Fredrick Kanyanganzi,
Catherine M. Kirk,
Lauren C. Ng,
Christina Mushashi,
Justin I. Bizimana,
William R. Beardslee,
Giuseppe Raviola,
Stephanie L. Smith,
Yvonne Kayiteshonga,
Agnès Binagwaho
Publication year - 2016
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0157042
Subject(s) - harm , poverty , medicine , mental health , environmental health , suicide prevention , stigma (botany) , population , occupational safety and health , poison control , alcohol abuse , psychiatry , psychology , political science , social psychology , pathology , law
A “risk of harm” protocol to identify youth in need of immediate emergency assistance in a study on mental health and HIV in Rwanda among 680 youth ages 10–17 is described. Cases are presented that describe the experience in using this protocol to ensure safety of participants, with ethical and logistical challenges considered. Among the population of the study, 3.2% were deemed “risk of harm.” The most prevalent presenting problem was non-fatal suicidal behavior (91% of risk of harm cases), with 36% having a history of a reported previous attempt. Challenges included: acute food insecurity/significant poverty; lack of support/adequate supervision from family members; family violence; alcohol abuse; and HIV-related stigma. Development of a “risk of harm” protocol and collaboration between study staff, community leadership, health authorities, and health workers are critical to ensuring participants’ safety in research among vulnerable populations.
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