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Journal article

Parent and practitioner experiences of opt-out consent in neonatal intensive care: a mixed methods study within a trial

Abstract:

Background In neonatal trials, verbal opt-out consent has been used to reduce burden on families and make recruitment more efficient and representative. It involves information provision through posters and leaflets before randomisation, and parents can verbally ‘opt out’ of their baby being randomised to the trial. There is limited understanding of how opt-out consent is operationalised in a multicentre neonatal trial, and its acceptability to staff and parents.

Objective To explore views and experiences of verbal opt-out consent in neoGASTRIC, a neonatal randomised trial comparing routine and no routine measurements of gastric contents in preterm babies.

Methods A mixed methods (questionnaires, interviews and focus groups) process evaluation within a trial.

Setting Four UK neonatal units.

Participants 253 participants: 167 staff (149 questionnaires; 18 across two focus groups), 86 parents (85 questionnaires; 15 interviews; 14 took part in both).

Results Parents and staff supported opt-out consent in neoGASTRIC as interventions were viewed as low risk and non-invasive. Parents appreciated an appropriately timed research conversation; only 21% noticed study information banners/posters. Operationalisation of opt-out consent varied in terms of when information was provided and randomisation timing. Women approached during labour or within hours of birth reported feeling overwhelmed and lacking capacity to consider research. Some staff operationalised a modified opt-in approach.

Conclusions An appropriately timed verbal opt-out approach to consent was seen acceptable as proportionate in the neonatal context in a low-risk trial comparing different accepted clinical, non-pharmaceutical, practices. Findings informed neoGASTRIC and will guide approaches to consent in this setting.

Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1136/archdischild-2025-328693

Authors

More by this author
Role:
Author
ORCID:
0000-0002-2898-553X
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Sub department:
NPEU
Role:
Author
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
Women's & Reproductive Health
Sub department:
NPEU
Role:
Author
ORCID:
0009-0006-4527-9326


Publisher:
BMJ Publishing Group
Journal:
Archives of Disease in Childhood. Fetal and Neonatal Edition More from this journal
Volume:
111
Issue:
2
Pages:
F162-F168
Publication date:
2025-08-31
Acceptance date:
2025-08-12
DOI:
EISSN:
1468-2052
ISSN:
1359-2998


Language:
English
Pubs id:
2285409
Local pid:
pubs:2285409
Source identifiers:
W4413872872
Deposit date:
2025-09-02
ARK identifier:

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