Ethics in Community-Based Research with Vulnerable Children: Perspectives from Rwanda

Area of Science:

• Global Health
• Mental Health Research
• Adolescent Health

Background:

• Research involving vulnerable youth requires robust safety protocols.
• Mental health and HIV are significant concerns for adolescents in low-resource settings.

Purpose of the Study:

• To describe the development and implementation of a "risk of harm" protocol.
• To ensure the safety of adolescent participants in a mental health and HIV study in Rwanda.

Main Methods:

• A "risk of harm" protocol was developed and applied to 680 youth (ages 10-17).
• Ethical and logistical challenges were documented during protocol implementation.

Main Results:

• 3.2% of participants were identified as "risk of harm."
• Non-fatal suicidal behavior was the primary concern (91% of risk cases), with 36% having prior attempts.
• Challenges included poverty, lack of family support, violence, substance abuse, and HIV stigma.

Conclusions:

• A "risk of harm" protocol is crucial for participant safety in vulnerable populations.
• Collaboration among researchers, community leaders, and health authorities is essential for effective safety implementation.