Implementing a Novel Consent Process for Biospecimen Research after Newborn Screening in Hospitals Serving Diverse Patients

项目总结 生物库对于基因组研究来说是一种非常有价值的资源。然而，各国之间的多样性不足 标本捐赠者限制了他们对翻译研究的概括。缺乏代表性的问题 生物样本有可能限制精准医学在代表性不足的地区的应用 这可能会在不经意间加剧健康差距。使用存储的新生儿创建的生物库 在旨在解决以下需要的努力中，筛查血斑可能是特别宝贵的资源 来自不同人群的样本：他们几乎代表了某个州的整个婴儿群体，以及 与较小的存储库相比，可以由范围更广的研究人员和机构访问 研究目标。然而，新生儿血斑的储存和未来的研究使用本身经历了一个 鉴于国家新生儿筛查项目没有获得知情的信息，国家争议的历史由来已久 同意收集和检测，只有少数几个州后来增加了对研究的同意 使用残留的血迹。一些州项目之间正在进行的诉讼和两个州的政策辩论 联邦政府进一步阻碍了推广新生儿血斑筛查的任何进展 重要的健康研究，包括评估健康差距的研究。同意的执行 为了继续利用这一重要资源，州一级的进程可能成为必要的。这个 R01的拟议更新将通过以下方式解决这些关切：确定决定因素、战略、 机制、障碍和促进者为不同和服务不足的医院提供一致的质量 为密歇根健康生物信托保留和研究使用剩余干血斑的人群 (目标1)；让密歇根州代表性不足和非英语社区的成员参与 支持在不同的医院环境中实施电子知情同意干预(EICI)(AIM 2)；以及在全州四家主要医院内实施和评估EICI同意方法 密歇根州服务代表人数不足的人，讲西班牙语和阿拉伯语的参与者，以及将军 人口(目标3)。

PROJECT SUMMARY Biobanks are an enormously valuable resource for genomic research. However, inadequate diversity among specimen donors limits their generalization for translational research. The lack of representativeness of biosamples has the potential to limit the application of precision medicine within underrepresented communities and may inadvertently exacerbate health disparities. Biobanks created using stored newborn screening bloodspots can be particularly valuable resources in efforts aimed at addressing the need for samples from diverse populations: they represent virtually the whole population of infants in a given state, and can be accessed by a wider range of researchers and institutions than smaller repositories with narrower research goals. However, the storage and future research use of newborn bloodspots has itself experienced a long history of national controversy given that state newborn screening programs do not obtain informed consent for collection and testing, and only a few states have subsequently added consent for the research use of leftover bloodspots. Ongoing lawsuits among some state programs and policy debates at both the state and federal levels have further mired any progress to promote the use of newborn screening bloodspots for important health research, including studies that assess health disparities. The implementation of consent processes at the state level may become necessary for the continued utilization of this important resource. The proposed renewal of our R01 will address these concerns by: identifying determinants, strategies, mechanisms, barriers, and facilitators of consenting quality across hospitals serving diverse and underserved populations for the retention and research use of residual dried bloodspots for the Michigan Biotrust of Health (Aim 1); engaging members of underrepresented and non-English speaking communities in Michigan to support implementation of an electronic informed consent intervention (EICI) in diverse hospital settings (Aim 2); and implementing and evaluating the EICI consent approach within four major hospitals across the state of Michigan serving underrepresented persons, Spanish and Arabic speaking participants, and the general population (Aim 3).