Published online January 2, 2007
PEDIATRICS Vol. 119 No. 1 January 2007, pp. 46-51 (doi:10.1542/peds.2006-1813)
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ARTICLE

Is a "Wage-Payment" Model for Research Participation Appropriate for Children?

Stephen J. Bagleya, William W. Reynolds, PhDb,c and Robert M. Nelson, MD, PhDb,c

a College of Arts and Sciences, University of Pennsylvania, Philadelphia, PA
b Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
c Center for Research Integrity, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

OBJECTIVE. Our goal was to evaluate the applicability of a "wage-payment" model to inducements for children to participate in research.

SUBJECTS AND METHODS. We interviewed 42 children and adolescents between the ages of 4 and 16 years who had diabetes, asthma, seizures, or no chronic medical condition. The interview explored hypothetical participation decisions for up to 4 research scenarios. To evaluate factors that would influence children and adolescents' decision-making for research participation, we probed for the impact of monetary and other incentives. The interviews were transcribed and coded for specific themes related to money or other rewards and incentives.

RESULTS. Older children, mainly those >9 years of age, showed an appreciation for the role and value of money through (a) an accurate concept of the material value of money in society or (b) asking for a realistic amount of money in exchange for their research participation. Younger children, primarily those <9 years of age, showed an inability to appreciate the role and value of money by: (a) asking for excessive monetary amounts that bore no relationship to the sum warranted by participation; (b) having no concept of what that money could buy; (c) not comprehending the meaning of a wage as earning a reward for working; or (d) justifying proposed amounts with reasons unrelated to the time and effort involved.

CONCLUSIONS. An age-appropriate token of appreciation as an inducement for research participation is appropriate for the younger child who is <9 years old, because they generally have an inadequate understanding of the value of money and, therefore, the meaning of a wage. A wage-payment model for compensating older children (>9 years of age) and adolescents for the time and effort of research participation is appropriate because they generally understand the meaning and value of a wage.

Key Words: research • biomedical • research ethics • pediatric research • subject recruitment • child assent • payment

Abbreviations: BD—single blood draw • PK—pharmacokinetic study • RPCT—randomized placebo-controlled trial • NTB— nontherapeutic bronchoscopy • PPVT—Peabody Picture Vocabulary Test

Accepted Sep 15, 2006.




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