367 - Permission to Approach for Research at Registration in the Pediatric Emergency Department

Poster Number: 367
Publication Number: 367.539

Background: Obtaining consent for participation in pediatric Emergency Department (ED) research can be challenging. The high-volume, unpredictable environment, combined with the unscheduled nature of ED visits poses specific recruitment challenges. Prior to being approached about a specific study, caregivers must give “permission-to-approach for research” in general. Little is known about caregiver, patient and environmental factors associated with permitting contact for research, yet this is an essential first step for understanding potential selection bias of studies, as well as initiatives to mitigate these limitations.

Objective: 1. Determine the proportion of ED caregivers that give permission to contact for research at ED registration (% yes/asked). 2. Determine the association between permission to contact for research and a priori selected variables: time of day, weekday vs weekend, language interpretation, chronic disease, chief complaint type, CTAS (Canadian Triage Acuity Scale), disposition and patient age.

Design/Methods: Cross-sectional study of all caregivers/patients registering for care in an an urban, tertiary care pediatric ED between May 2021-May 2022. Participants were excluded if a chart was erroneously created, or their child passed away in the ED. De-identified EPIC reports were generated with the aforementioned variables as well as whether permission to contact for research was granted at registration (yes/no, primary outcome). Permission to contact allowed research teams to approach while in the ED and/or after discharge. Waiver of informed consent was granted from the Ethics Board. Logistic regression was used to analyze the degree of association between a ‘No’ response, and potential predictors.

Results: Seventy-four percent (58,674/79,647) of caregivers/patients were asked about permission to contact for research at registration. Of those asked, 49,238/58,674 (83.9%) said yes and 15.2% said no. Weekend presentation (OR 1.16, 95%CI 1.11-1.22), interpreter need (OR 1.91, 95%CI 1.71-2.13), presenting after 6pm (OR 1.38, 95%CI 1.34-1.43), mental health complaint (OR 1.17, 95%CI 1.02-1.34), and a lower acuity CTAS score (OR 1.07, 95%CI 1.04-1.10) were independently associated with saying 'No' to research at ED registration.

Conclusion(s): Embedding permission to contact for research into the ED Registration workflow resulted in >80% of asked caregivers/patients saying yes, both to research approach in the ED, as well as after discharge. Knowledge of factors associated with ‘No’ response can inform targeted initiatives as well as future studies assessing barriers to research participation.