Comparing a Multimedia Digital Informed Consent Tool With Traditional Paper-Based Methods: Randomized Controlled Trial

Fuad Abujarad, Peter Peduzzi, Sophia Mun, Kristina Carlson, Chelsea Edwards, James Dziura, Cynthia Brandt, Sandra Alfano, Geoffrey Chupp, Fuad Abujarad, Peter Peduzzi, Sophia Mun, Kristina Carlson, Chelsea Edwards, James Dziura, Cynthia Brandt, Sandra Alfano, Geoffrey Chupp

Abstract

Background: The traditional informed consent (IC) process rarely emphasizes research participants' comprehension of medical information, leaving them vulnerable to unknown risks and consequences associated with procedures or studies.

Objective: This paper explores how we evaluated the feasibility of a digital health tool called Virtual Multimedia Interactive Informed Consent (VIC) for advancing the IC process and compared the results with traditional paper-based methods of IC.

Methods: Using digital health and web-based coaching, we developed the VIC tool that uses multimedia and other digital features to improve the current IC process. The tool was developed on the basis of the user-centered design process and Mayer's cognitive theory of multimedia learning. This study is a randomized controlled trial that compares the feasibility of VIC with standard paper consent to understand the impact of interactive digital consent. Participants were recruited from the Winchester Chest Clinic at Yale New Haven Hospital in New Haven, Connecticut, and healthy individuals were recruited from the community using fliers. In this coordinator-assisted trial, participants were randomized to complete the IC process using VIC on the iPad or with traditional paper consent. The study was conducted at the Winchester Chest Clinic, and the outcomes were self-assessed through coordinator-administered questionnaires.

Results: A total of 50 participants were recruited in the study (VIC, n=25; paper, n=25). The participants in both groups had high comprehension. VIC participants reported higher satisfaction, higher perceived ease of use, higher ability to complete the consent independently, and shorter perceived time to complete the consent process.

Conclusions: The use of dynamic, interactive audiovisual elements in VIC may improve participants' satisfaction and facilitate the IC process. We believe that using VIC in an ongoing, real-world study rather than a hypothetical study improved the reliability of our findings, which demonstrates VIC's potential to improve research participants' comprehension and the overall process of IC.

Trial registration: ClinicalTrials.gov NCT02537886; https://ichgcp.net/clinical-trials-registry/NCT02537886.

Keywords: digital consent; digital health; e-consent; informed consent; mobile phone.

Conflict of interest statement

Conflicts of Interest: None declared.

©Fuad Abujarad, Peter Peduzzi, Sophia Mun, Kristina Carlson, Chelsea Edwards, James Dziura, Cynthia Brandt, Sandra Alfano, Geoffrey Chupp. Originally published in JMIR Formative Research (https://formative.jmir.org), 19.10.2021.

Figures

Figure 1
Figure 1
Virtual Multimedia Interactive Informed Consent features screenshot.
Figure 2
Figure 2
Flow diagram of participant enrollment in the Virtual Multimedia Interactive Informed Consent trial CONSORT (Consolidated Standards of Reporting Trials) diagram. VIC: Virtual Multimedia Interactive Informed Consent.
Figure 3
Figure 3
Perceived participant comprehension and satisfaction by the type of informed consent (IC) based on a 7-point Likert scale of levels of comprehension, satisfaction, perceived importance, perceived length, participation in clinical trials, and IC process difficulty. Mean (SD) values are plotted in the figure along with Cochran–Mantel–Haenszel test P values. CT: clinical trial; IC: informed consent; PHI: personal health information; VIC: Virtual Multimedia Interactive Informed Consent.

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