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      Equitable Participation in Biobanks: The Risks and Benefits of a “Dynamic Consent” Approach

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          Abstract

          Participation in biobanks tends to favor certain groups—white, middle-class, more highly-educated—often to the exclusion of others, such as indigenous people, the socially-disadvantaged and the culturally and linguistically diverse. Barriers to participation, which include age, location, cultural sensitivities around human tissue, and issues of literacy and language, can influence the diversity of samples found in biobanks. This has implications for the generalizability of research findings from biobanks being able to be translated into the clinic. Dynamic Consent, which is a digital decision-support tool, could improve participants' recruitment to, and engagement with, biobanks over time and help to overcome some of the barriers to participation. However, there are also risks that it may deepen the “digital divide” by favoring those with knowledge and access to digital technologies, with the potential to decrease participant engagement in research. When applying a Dynamic Consent approach in biobanking, researchers should give particular attention to adaptations that can improve participant inclusivity, and evaluate the tool empirically, with a focus on equity-relevant outcome measures. This may help biobanks to fulfill their promise of enabling translational research that is relevant to all.

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          Most cited references34

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          Applying an equity lens to interventions: using PROGRESS ensures consideration of socially stratifying factors to illuminate inequities in health.

          To assess the utility of an acronym, place of residence, race/ethnicity/culture/language, occupation, gender/sex, religion, education, socioeconomic status, and social capital ("PROGRESS"), in identifying factors that stratify health opportunities and outcomes. We explored the value of PROGRESS as an equity lens to assess effects of interventions on health equity.
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            Diversity in Clinical and Biomedical Research: A Promise Yet to Be Fulfilled

            Esteban Gonzalez Burchard and colleagues explore how making medical research more diverse would aid not only social justice but scientific quality and clinical effectiveness, too.
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              Next generation disparities in human genomics: concerns and remedies.

              Studies of human genetics, particularly genome-wide association studies (GWAS), have concentrated heavily on European populations, with individuals of African ancestry rarely represented. Reasons for this include the distribution of biomedical funding and the increased population structure and reduced linkage disequilibrium in African populations. Currently, few GWAS findings have clinical utility and, therefore, the field has not yet contributed to health-care disparities. As human genomics research progresses towards the whole-genome sequencing era, however, more clinically relevant results are likely to be discovered. As we discuss here, to avoid the genetics community contributing to healthcare disparities, it is important to adopt measures to ensure that populations of diverse ancestry are included in genomic studies, and that no major population groups are excluded.
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                Author and article information

                Contributors
                Journal
                Front Public Health
                Front Public Health
                Front. Public Health
                Frontiers in Public Health
                Frontiers Media S.A.
                2296-2565
                05 September 2018
                2018
                : 6
                : 253
                Affiliations
                [1] 1Melbourne Law School, The University of Melbourne , Carlton, VIC, Australia
                [2] 2Centre for Health, Law and Emerging Technologies, Nuffield Department of Population Health, University of Oxford , Oxford, United Kingdom
                Author notes

                Edited by: Ronald Przygodzki, United States Department of Veterans Affairs, United States

                Reviewed by: Luret Albert Lar, Jos University Teaching Hospital, Nigeria; Jan Fizzell, New South Wales Department of Health, Australia

                *Correspondence: Megan Prictor megan.prictor@ 123456unimelb.edu.au

                This article was submitted to Public Health Policy, a section of the journal Frontiers in Public Health

                Article
                10.3389/fpubh.2018.00253
                6133951
                30234093
                cbaaef39-f525-421b-b4ff-22169a28fc5f
                Copyright © 2018 Prictor, Teare and Kaye.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 28 June 2018
                : 15 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 59, Pages: 6, Words: 5305
                Funding
                Funded by: University of Melbourne 10.13039/501100001782
                Funded by: Wellcome Trust 10.13039/100004440
                Categories
                Public Health
                Perspective

                biobanks,consent,equity,participation,translation,dynamic consent,inclusive,communication

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