Research with Special Populations - Institutional Review Board Research with Special Populations This section of the Investigator Manual discusses the inclusion of participants with impaired decision-making, prisoners, children, pregnant women and neonates, and other special populations. Click on the links below to learn more about what is required for each of the populations. Such groups may include: Employees . Vulnerable and Other Populations Requiring Additional Protections The Code of Federal Regulations outlines specific requirements to enhance protections for three groups. Institutional Review Board (IRB) The Institutional Review Board (IRB) is the research oversight committee charged with ensuring that human subjects research is conducted in compliance with the applicable federal, state, and institutional policies and procedures. ): Cognitive or communicative vulnerability Institutional vulnerability Deferential vulnerability Medical vulnerability IRB will consider the level of risk, the potential benefits, and the degree of cognitive impairment of the participant. The research must be appropriate for the prison population being studied. The most common vulnerable populations are: Research Involving Vulnerable Populations (Video) . In accordance with FDA. Students recruited as research participants are vulnerable to coercion because of the possibility that they may perceive grades or other benefits as dependent upon their participation in research. Populations in Research Requiring Additional Considerations and/or Protections. ); The prospect of direct benefit for the woman or the fetus. They are legally incompetent to give valid informed consent. Vulnerable Populations; Vulnerable Populations. The IRB requires at least one or more knowledgeable individuals or have experience in working with these populations to be part of the review process. Pregnant women, fetuses, neonates or human in vitro fertilization: Economically or educationally disadvantaged individuals may be particularly vulnerable to the risks of research. Investigators interested in enrolling children are required to complete the assocaited questions in the Cayuse IRB submission. IRB #1Description and Meeting Schedule IRB #2Description and Meeting Schedule The National Bioethics Advisory Committee (NBAC 2001) defines vulnerable subjects as persons who "have difficulty providing voluntary, informed consent arising from limitations in . Institutional Commitment and Authority Children. When the IRB reviews research involving vulnerable populations, Requires researcher form Population . Children who are research subjects possess special vulnerabilities. OHRP specifically names the following groups as vulnerable populations: Children Prisoners Individuals with impaired decision-making capacity If you are studying a vulnerable population, the IRB will often require you to have specific procedures in place to protect your participants. Vulnerable population. 1) A vulnerable population is part of the aim of the research project. The IRB evaluates whether additional safeguards have been included project to protect the rights and welfare of participants who may be vulnerable to undue influence. The Northwest IRB must give special consideration when evaluating an IRB application to ensure that subjects from vulnerable populations do not feel coerced and that consent is legitimately obtained. The committee will review the proposed research, considering all applicable IRB Policies and Procedures. Content Authors Jeremy N. Block, PhD, MPP Baruch College Bruce Gordon, MD The University of Nebraska Medical Center Introduction. Eight/16 IRBs required changes to the informed consent documents; two IRBs recommended an amendment of the protocol. If research involves vulnerable populations as defined by 45 CFR 46, this worksheet must accompany your IRB application and other supporting materials. There are a number of research populations described in the Federal regulations as "vulnerable" or that require additional consideration or protection. Examples include research directed at children, pregnant women, or the elderly. SOP 6 Vulnerable Populations Page 1 of 18 Approved: July 2016 Updated Revised: February 2019 6. For example, the IRB may require the use of a witness to the consent process or videotaping the consent process. For instance, if you are studying children, you will need to have procedures for obtaining assent from the child, as well as consent from their parent or legal guardian. They may also include research populations, or be associated with populations, that are simply unable or have limited capacity to provide consent. in making this assessment the irb should take into account the purposes of the research and the setting in which the research will be conducted and should be particularly cognizant of the special problems of research involving vulnerable populations, such as children, prisoners, pregnant women, handicapped, or mentally disabled persons, or enrolled research subject becomes a prisoner and the relevant research protocol was NOT reviewed and approved by the institutional review board (IRB) in accordance with the requirements of HHS regulations at 45 CFR46, subpart C, the principal investigator should promptly notify the IRB of . If no Authority and institutional commitment. The IRB will attempt to safeguard every subject's rights and welfare by making sure that any possible coercion or undue influence is eliminated (e.g., compensation that is not commensurate with risk, discomfort, or inconvenience involved, or recruiting in institutional settings where voluntary participation might be compromised). In making their determination, the IRB considers protocol specific issues, including the context of the research, purpose, relevance of research to possible vulnerable population, eligibility criteria, study design, relationship between investigator and subject, risks, measures to minimize risks, additional protections, benefits, compensation . Prisoners, therefore, constitute a vulnerable population for which additional protections are warranted. There are several definitions available for the term "vulnerable population", the words simply imply the disadvantaged sub-segment of the community[] requiring utmost care, specific ancillary considerations and augmented protections in research.The vulnerable individuals' freedom and capability to protect one-self from intended or inherent risks is variably . For IRB purposes, research is defined as a systematic investigation, inquiry, or analysissuch as scholarly or critical study or inquiry or scientific investigation, development, testing, or evaluationdesigned to develop or contribute to generalizable knowledge. Subpart A, also known as the Common Rule, provides a robust set of protections for research subjects; subparts B, C, and D provide additional protections for certain populations in research; and subpart E provides requirements for IRB registration. No exemption will be granted. POLICY . 2) A vulnerable group is likely to be enrolled based on the type of research being performed. Vulnerable Populations 6.1 Policy It is the responsibility of the IRB to ensure that procedures are in place in a research activity to protect the subjects taking part. 3.1. Pregnant women, human fetuses, and neonates Children Prisoners There are unique consent requirements as well as some other special regulatory requirements for research that involves certain vulnerable populations: Children and minors: Federal regulations include requirements for parental permission (consent) and assent from children. The inclusion of certain groups of participants who may be vulnerable to undue influence or coercion may require additional protections. IRB SOP 501: Vulnerable Populations in Research Version C0819 Page 1 of 1 501: VULNERABLE POPULATIONS IN RESEARCH. Research with Pregnant Women & Fetuses When the IRB reviews research involving pregnant women and fetuses, it must evaluate the following: Preclinical studies to assess potential risks (i.e., low birth weight, deformities, reduced survival, etc. Vulnerable populations include individuals who may be vulnerable to coercion or undue influence to participate in research projects, or who may be at greater risk when participating in research. Institutional Review Board (IRB) Faculty Center 173. The most common vulnerable populations are: Pregnant Women, human fetuses, and neonates. Vulnerable Populations The University of Illinois at Urbana-Champaign IRB ensures that additional safeguards are included in the research design to protect the rights and welfare of research participants who have limited autonomy and are at risk for coercion and undue influence. . 361.825.3057; irb@tamucc.edu; Apply Now . Aug 2001. The IRB-HSR shall determine whether proposed studies with prisoners also satisfy the conditions under 45 CFR 46, Subpart C, "Additional Protections Pertaining to Biomedical and Behavioral Research Involving Prisoners as Subjects." Approval for research involving vulnerable population is permissible only through either expedited or full committee review. Children are considered a vulnerable research population because their intellectual and emotional capacities are limited. No informed consent waiver will be granted although waiver for signature will be granted if a case is made by the PI that such a signature waiver is required to protect the participants Two IRBs accepted a previous IRB decision and did not conduct an independent review. The IRB-SBS identifies eight categories where the potential for vulnerability exists in research ( modified from National Bioethics Advisory Committee, Ethical and Policy Issues in Research Involving Human Participants. Under FDA regulations, an Institutional Review Board is group that has been formally designated to review and monitor biomedical research involving human subjects. However, Illinois policy also requires the IRB to have additional protections for research involving other groups who may be subject to coercion or undue influence, either temporarily or permanently. Prisoners. Individuals in these groups may be considered potentially vulnerable because they may not be able to make informed decisions for themselves, they may be in situations in which they can easily be manipulated . The involvement of vulnerable populations as research subjects Full Board Review Federal regulations and institutional policy require an IRB Full Board Review for applications where the research involves more than minimal risk to human subjects or has been referred to the committee by an expedited reviewer or the Chair. Please check all applicable fields. Some populations are inherently vulnerable due to a lack of autonomy or ability to understand research procedures. The HHS regulations for the protection of human subjects in research at 45CFR 46 include five subparts. General Information. This is especially true when a research activity involves a An exemption may not be granted if the research involves interaction with prisoners (including obtaining consent). 3. The federal regulations require that IRBs give special consideration to protecting the welfare of particularly vulnerable subjects, such as children, prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons. Vulnerable populations require special considerations and additional safeguards to protect the rights and welfare of these participants. Single IRB Exception Determinations has sub items, about Single IRB Exception Determinations Subpart C Certification Request to OHRP Regulations & Policy Archived Materials Vulnerable Populations Certificates of Confidentiality - Privacy Protection for Research Subjects: OHRP Guidance (2003) Children as Research Subjects and the HHS "407" Process Pregnant Women (Subpart B) Prisoners (Subpart C) Children (Subpart D) Economically or Educationally Disadvantaged Students Employees Non-English Speaking Individuals Decisionally Impaired Refugees . IRB workflows and decision times varied . Vulnerable Populations Under the Former Common Rule, they were referred to as vulnerable populations and the revised Common Rule uses the term categories of subjects who are vulnerable to coercion or undue influence. "Vulnerable" or "special" classes of subjects include: Pregnant women, human fetuses and neonates, Prisoners, Children, Surrogate Consent/Use of a Legally Authorized Representative (LAR) Enrolling these population in prospective research requires specific IRB approval. Conclusion: Both clinical research protocols involving vulnerable populations were well accepted. These vulnerabilities relate to the increased susceptibility of children to harm (e.g., anxiety due to separation from parents or inexperience with medical procedures), as well as their limited or absent ability to make informed and voluntary decisions about research participation. The IRB may consult with the IRB prisoner representative before making the determination to review as Flex-Exempt. Participants with Impaired Decision-Making Prisoners Children Though there are no federal regulations that provide explicit protections for Students and Employees, the involvement of students and . The IRB may require additional protections. Vulnerable and Special Populations. IRB Vulnerable Populations Worksheet. Procedure: Each research study is evaluated for inclusion of possible vulnerable populations. Depending on the study, some of the vulnerable participants (participants who are unable to or have limited capacity to consent) in the previous section could also be considered "risk sensitive" participants, though the inability to consent does not always equate to a study where the probability of harm is high for a participant. Research includes activities that aim . . The IRB must ensure that additional safeguards are in place to protect the rights and welfare of this vulnerable population. In reviewing research studies, the Carilion IRB will ascertain that the inclusion of the vulnerable population(s) is adequately justified and that safeguards are implemented to minimize risks unique to each population. IRB Forms Vulnerable Populations Requirements When Children are Research Participants Prisoners as Subjects Pregnant Women, Fetuses and Neonates Students, Employees, or Faculty as Research Subjects Cognitively Impaired Research Subjects Resources for Researchers & Families OHRP 45 CFR 46 Subpart B (Pregnant Women, Fetuses, Neonates) 45 CFR 46.111(a)(3) (Common Rule). The Institutional Review Board's policy manual details its institutional commitment, membership requirements, review of research, informed consent, recruitment, vulnerable population protection, biologics, confidentiality policy and more. Although the regulation does not define the term vulnerable they do provide examples of research subjects "that are likely to be vulnerable to coercion or undue influence." This is different from the special populations traditionally referred to as "vulnerable populations" description of sub parts B, C, and D. The IRB may also require additional protections for any other group not specified but determined, by the IRB, to be vulnerable.