In a recent paper, Hein et al. (2015) reported that more than fifty percent of eligible children did not participate in a study that sought out to understand children’s non-participation in research. In this study and others, researchers demonstrated that those less likely to participate in studies are of minority status and lower SES, suggesting a potential bias in studies with children and parents.
As I’ve discussed in the past, the nudge comes in many forms. Given humans inherent preference for inertia, one type of nudge includes the transition from ‘opt-in’ to ‘opt-out’. For example, instead of providing individuals with the option to ‘opt-in’ to an annual savings plan with the default option as ‘opt-out’, reversing the options (i.e., make the default option is ‘opt-in’) is likely to facilitate individuals in making the “smarter” decision. In a recent commentary, Bloomfield (2015) ponders the following thought: for true comparative effectiveness trials (i.e., clinical equipoise is assumed), why not reverse families’ options to opt-out of participation, rather than opt-in? Although special consideration for ethical principles would have to be granted, such a change would likely increase children’s participation in research, improve equal access to possible benefits of research, and reduce representative bias of children and their families in research.