The authors conducted one-on-one interviews with adolescent females, aged 13 to 16, concerning their perception of the confidentiality of sexual health services available to them. Participants were selected from an urban school with a youth health centre (YHC) and also from a rural school without access to a YHC. They typically viewed traditional health services as not confidential and reported concern about disclosure to parents. This qualitative study suggests that adolescent females have an absolute need to maintain positive parental regard by preventing disclosure of sexual activity.
Variation across research ethics boards (REBs) in conditions placed on access to medical records for research purposes raises concerns around negative impacts on research quality and on human subject protection, including privacy.
To study variation in REB consent requirements for retrospective chart review and who may have access to the medical record for data abstraction.
Thirty 90-min face-to-face interviews were conducted with REB chairs and administrators affiliated with faculties of medicine in Canadian universities, using structured questions around a case study with open-ended responses. Interviews were recorded, transcribed and coded manually.
Fourteen sites (47%) required individual patient consent for the study to proceed as proposed. Three (10%) indicated that their response would depend on how potentially identifying variables would be managed. Eleven sites (38%) did not require consent. Two (7%) suggested a notification and opt-out process. Most stated that consent would be required if identifiable information was being abstracted from the record. Among those not requiring consent, there was substantial variation in recognising that the abstracted information could potentially indirectly re-identify individuals. Concern over access to medical records by an outside individual was also associated with requirement for consent. Eighteen sites (60%) required full committee review. Sixteen (53%) allowed an external research assistant to abstract information from the health record.
Large variation was found across sites in the requirement for consent for research involving access to medical records. REBs need training in best practices for protecting privacy and confidentiality in health research. A forum for REB chairs to confidentially share concerns and decisions about specific studies could also reduce variation in decisions.
Recognizing that adolescents providing or withholding information about their activities is a strong predictor of parental knowledge, this article compares several ideas about what prompts adolescents to disclose information or keep secrets from their parents. Using a sample of 874 Northern European adolescents (aged 12-16 years; 49.8 % were girls), modified cross-lagged models examined parental monitoring (solicitation and monitoring rules), adolescent delinquency, and perceived parental support as predictors and consequences of adolescents disclosing to parents or keeping secrets, with adolescents' acceptance of parental authority as a moderator. Results suggest that, when adolescents view their parents as supportive, they subsequently disclose more and keep fewer secrets. Engaging in delinquent behavior was related reciprocally to keeping secrets. By comparison, the results generally did not support the idea that adolescents who are monitored provide information to parents, even when they accept parental authority. These results suggest that relationship dynamics and adolescents' delinquent behaviors play an important role in adolescents' information management.