Perceived barriers to assessing understanding and appreciation of informed consent in clinical trials: A mixed-method study

Erin D. Solomon, Jessica Mozersky, Kari Baldwin, Matthew P. Wroblewski, Meredith V. Parsons, Melody Goodman, James M. Dubois

Research output: Contribution to journalReview articlepeer-review


Introduction: Participants and research professionals often overestimate how well participants understand and appreciate consent information for clinical trials, and experts often vary in their determinations of participant's capacity to consent to research. Past research has developed and validated instruments designed to assess participant understanding and appreciation, but the frequency with which they are utilized is unknown. Methods: We administered a survey to clinical researchers working with older adults or those at risk of cognitive impairment (N = 1284), supplemented by qualitative interviews (N = 60). Results: We found that using a validated assessment of consent is relatively uncommon, being used by only 44% of researchers who had an opportunity. Factors that predicted adoption of validated assessments included not seeing the study sponsor as a barrier, positive attitudes toward assessments, and being confident that they had the resources needed to implement an assessment. The perceived barriers to adopting validated assessments of consent included lack of awareness, lack of knowledge, being unsure of how to administer such an assessment, and the burden associated with implementing this practice. Conclusions: Increasing the use of validated assessments of consent will require educating researchers on the practice and emphasizing very practical assessments, and may require Institutional Review Boards (IRBs) or study sponsors to champion the use of assessments.

Original languageEnglish (US)
Article numbere164
JournalJournal of Clinical and Translational Science
Issue number1
StatePublished - Jun 28 2021


  • Informed consent
  • assessment
  • implementation science
  • research ethics
  • validated assessments

ASJC Scopus subject areas

  • General Medicine


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