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There are potentially many strategies for improving consent rates to healthcare studies.
Based on the open-ended questions, the following major thematic areas were suggested by the survey respondents as ways of improving consent process.
Trials should be built into surveys to test different interventions, in different contexts to expand the evidence base for improving consent rates in health surveillance programmes.
Participants' reflections on this were varied, ranging from improving consent (across all stakeholders) through to increasing recruitment (mentioned by Clinical Principal Investigators and Research Nurses) and retention (highlighted by Research Nurses, Clinical Principal Investigators and Trial Managers) in the trial.
However, these costs can be offset in the long term as dynamic consent is not simply a system for improving consent; it also tracks and stores participant information (including preferences), facilitates engagement and provides a range of additional benefits as set out in subsequent sections of this paper.
Ongoing research is needed to test methods of improving consent rates in school-based research and health surveillance programmes, and nested trials similar to the one reported here, but testing different interventions, should be built into future dental surveys, and surveys conducted to investigate other diseases and conditions.
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11 12 Coordinated organisation and appropriate policies and staff training would also improve consent to donation of other organs.
This could improve consent rates or, as found here, the acceptability of research without informed consent for "the greater good" of the National Health Service.
Therefore, we suggest some best practices that can improve consent forms and facilitate harmonised and yet contextualised approaches to ethical norms in paediatric research.
In this trial none of the interventions designed to improve consent out-performed usual practice (control), which was a simple letter sent home via the child.
A generic approach to information in the AVPI was adopted to focus on the concept of randomization, which was effective in terms of improving patient knowledge and understanding as hoped, but did not improve consent rates.
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