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BACKGROUND: Achieving meaningful consent can be challenging, particularly in contexts of diminished literacy, yet is a vital part of participant protection in global health research. METHOD: We explored the challenges and potential solutions of achieving meaningful consent through a qualitative study in a predominantly hill tribe ethnic minority population in northern Thailand, a culturally distinctive population with low literacy. Semi-structured interviews were conducted with 37 respondents who had participated in scrub typhus clinical research, their family members, researchers and other key informants. A thematic analysis was conducted. RESULTS: Our analysis identified four interrelated themes surrounding participants' ability to give consent: varying degrees of research understanding, limitations of using informal translators, issues impacting decisions to join research, and voluntariness of consent. Suggestions for achieving more meaningful consent included the use of formal translators and community engagement with research populations. CONCLUSIONS: Participant's agency in decision making to join research should be supported, but research information needs to be communicated to potential participants in a way that they can understand. We found that improved understanding about the study and its potential benefits and harms goes beyond literacy or translation and requires attention to social and cultural factors.

Original publication

DOI

10.1186/s12910-023-00991-0

Type

Journal article

Journal

BMC Med Ethics

Publication Date

19/12/2023

Volume

24

Keywords

Agency, Decision making, Ethnic minority, Hill tribe, Informed consent, Literacy, Research ethics, meaningful consent, Thailand, Translators, Humans, Thailand, Ethnicity, Minority Groups, Informed Consent, Biomedical Research, Qualitative Research