Showing papers by "Karen L. Dugosh published in 2013"

Overview of: “Moving beyond BAC in DUI: Identifying Who Is at Risk of Recidivating”

Abstract: Research Summary Driving under the influence (DUI) represents a significant threat to public safety in the United States, and a significant proportion of first-time DUI offenders go on to become repeat offenders. Substantial resources have been expended to identify variables that predict DUI recidivism, but less progress has been made in developing clinically useful tools to predict recidivism accurately. In the current study, we developed a brief empirically based tool containing markers of recidivism risk and treatment need and conducted a small study to examine the ability of items to discriminate between first-time and repeat DUI offenders. Analyses identified several criminal risk and treatment need variables that discriminated between the two groups; however, blood alcohol concentration (BAC) did not. Policy Implications Further validation of these findings and the refinement of the triage tool could provide a practical, evidence-based means of screening and triaging first-time DUI offenders and help to inform and refine policy and sentencing guidelines.

Practical Strategies to Improve Informed Consent

Abstract: Informed consent is a key component of ethical research. The informed consent process helps to ensure that individuals understand study procedures, their rights and protections as research participants, the risks and benefits of participation, and that their decision to participate is voluntary. Regrettably, research has demonstrated that research participants generally have poor rates of comprehension and recall of consent information (Flory & Emanuel, 2004). Some individuals fail to remember important details about the study and their protections as soon as a week after they have agreed to participate in a study. Some may not even recall that they entered a research study. Research suggests that poor comprehension and recall of consent information is heightened among vulnerable populations, such as those seeking treatment for substance abuse (e.g., McCrady & Bux, 1999). These individuals may have temporary or sustained impaired cognitive functioning as a result of the toxic effects of drugs and the maladaptive lifestyles that often accompany drug use (e.g., poor nutrition, physical trauma). Our own research conducted with individuals who have substance use issues (Festinger, Dugosh, Croft, et al., 2010; Festinger, Marlowe, Croft, et al., 2009) found that they failed to recall 60% of the consent information just two weeks after their initial consent — often before study procedures have even started, calling into question whether such participants can make informed decisions about their initial and continued involvement in research. Although informed consent has historically been conceived of as a one-time event similar to signing a contract or a lease agreement, our research, as well as federal guidelines (e.g., National Bioethics Advisory Committee, 2001), underscores the need to treat consent as an ongoing process in which researchers must ensure that participants continue to be informed throughout the course of the study. If one of the aims of informed consent is to make individuals aware of potential risks that may occur as a result of study participation and what actions they can or should take, researchers have an obligation to ensure that participants retain this information throughout the study. For example, if a research participant who is now experiencing severe hypertension does not recall that this was one of the potential risks of an experimental drug taken several months ago, he or she may not know to inform his or her healthcare provider about the experimental drug or to inform the researcher about this adverse event. A great deal of research has been conducted to identify ways to improve consent understanding and recall (Festinger & Dugosh, 2012; Flory & Emanuel, 2004). The majority of this research has focused on either the structure and content of the consent document or the process of presenting the information. Approaches that address the structure and content of the consent form include simplifying the language, shortening the form, using larger fonts, and including visual aids. Strategies that address the consent process include incorporating consent quizzes, providing corrected feedback to incorrect responses, and using neutral participant advocates to obtain consent. Both types of approaches are remedial in nature and are primarily focused on simplifying the cognitive task. Given the demonstrably poor recall of consent information among research participants who have substance use disorders, we (Festinger et al., 2010) conducted a study to examine the effects of providing monthly consent quizzes with corrected feedback. In the study, clients completed an open-ended consent quiz two weeks following consent to the host study and again at months 1, 2 and 3 post-consent. Findings indicated that participants who received