Publications by authors named "James Dubois"

Article Synopsis
  • The study explored the acceptability of adolescent online patient portal policies among 18 parents and 18 adolescents, focusing on access, timing of results, and messaging policies.
  • Panelists opposed restrictions on access to medical information for both parents and adolescents and generally supported policies that allow for transparency regarding sensitive information.
  • While there was a preference for immediate access to results and no charges for messaging, there was no consensus on adolescents having control over what parts of their medical records parents could see.
View Article and Find Full Text PDF

Background: Effective leadership and management practices contribute to responsible, high-quality research and the well-being of team members. We describe the development and initial validation of a measure assessing principal investigators' leadership and management practices and a measure of research team practices.

Methods: Using a cross-sectional survey design, 570 postdoctoral researchers funded by the National Institutes of Health reported on the perceived behaviors of their principal investigator (PI) and the research team.

View Article and Find Full Text PDF
The Bioethicist as Healer.

Hastings Cent Rep

September 2024

Combativeness is a social illness. We are surrounded by culture wars over abortion, vaccine mandates, transgender care, how we die, and even how we define death. The problem is not that we disagree, but how we disagree: too often, with anger, aggression, and a sense of urgency to win against the other.

View Article and Find Full Text PDF

Objective: We attempted to conduct a randomized controlled trial of three different informed consent training formats to evaluate their effectiveness. We recruited 503 clinical research professionals, who received $50 for participation. Incidental findings showed unexpectedly low rates of compliance with completing the study training protocols, resulting in insufficient statistical power to test our original hypotheses.

View Article and Find Full Text PDF

Youth prefer to be involved in treatment decisions, yet youth participation is minimally present in decisions like stem cell transplant (SCT) that require frequent medications and social isolation to be successful in curing cancer and chronic illness. The purpose of our study is to identify the barriers and facilitators to youth decision-making involvement in the youth-parent interaction when referred for treatment with SCT. We report qualitative findings from our theory-driven mixed-methods study.

View Article and Find Full Text PDF

: A person's cultural background shapes how they interpret and navigate problems. Given that large numbers of international researchers work and train in the U.S.

View Article and Find Full Text PDF
Article Synopsis
  • The study investigates the views of parents and adolescents on the use of online patient portals, focusing on perceived benefits and challenges.
  • Participants believe that portal access improves health knowledge, autonomy, and communication, while also identifying problems like confusion and emotional distress.
  • Despite recognizing the benefits, many adolescents show a lack of interest or awareness about portal access, indicating that these resources are underused in their healthcare engagement.
View Article and Find Full Text PDF

Background: Web-based patient portals are tools that could support adolescents in managing their health and developing autonomy. However, informatics administrators must navigate competing interests when developing portal access policies for adolescents and their parents.

Objective: We aimed to assess the perspectives of informatics administrators on guiding principles for the development of web-based health care portal access policies in adolescent health care.

View Article and Find Full Text PDF

Background: Apolipoprotein L1 (ApoL1) variants G1 and G2 are associated with a higher risk of kidney disease. ApoL1 risk variants are predominantly seen in individuals with sub-Saharan African ancestry. In most transplant centers, potential organ donors are being selectively genetically tested for ApoL1 risk variants.

View Article and Find Full Text PDF
Article Synopsis
  • A study was conducted through 28 interviews with pregnant women who have chronic medical conditions to explore factors affecting their reproductive decision-making.
  • Key themes identified included the perceived risks and benefits of pregnancy and contraception, influences on contraceptive use, and a sense of reproductive self-agency, showing mixed feelings about pregnancy despite health concerns.
  • The findings suggest that chronic health conditions do not heavily impact reproductive choices, as barriers to contraception stem more from personal beliefs rather than external pressures.
View Article and Find Full Text PDF
Article Synopsis
  • Online patient portals are valuable communication tools in pediatric oncology, offering benefits such as empowering adolescents and enhancing communication efficiency, but they also pose challenges like emotional distress and confidentiality concerns.
  • The study involved interviews with 29 physicians and 24 advanced practice providers, revealing five benefits and eight problems associated with portal use.
  • To optimize the use of these portals, it’s essential to address the identified risks while maintaining their functionality for both adolescent patients and their parents.
View Article and Find Full Text PDF

In January 2023, a new NIH policy on data sharing went into effect. The policy applies to both quantitative and qualitative research (QR) data such as data from interviews or focus groups. QR data are often sensitive and difficult to deidentify, and thus have rarely been shared in the United States.

View Article and Find Full Text PDF

Importance: Many health care systems offer adolescents access to health information through online patient portals, but few studies have explored how to engage adolescents in using and benefiting from online portals.

Objective: To determine how US children's hospitals have attempted to encourage adolescent portal use, barriers to engaging adolescents, and ideal future goals for engagement.

Design, Setting, And Participants: This qualitative study performed structured qualitative interviews with informatics administrators from children's hospitals across the US between February and July 2022.

View Article and Find Full Text PDF
Article Synopsis
  • Many healthcare systems now provide adolescents and parents access to electronic health information via online portals following the 21st Century Cures Act, but few studies have examined the policies surrounding this access.
  • A study involving interviews with 65 informatics leaders from pediatric hospitals across the U.S. found that while the majority offer portal access to both adolescents (86%) and parents (95%), the filtering of sensitive information varies significantly among hospitals.
  • Challenges faced in developing and implementing these policies include legislative issues, balancing confidentiality with usefulness, clinicians' concerns, and technical difficulties, prompting a need for better understanding and consensus on portal policies.
View Article and Find Full Text PDF

Serious and continuing research noncompliance and integrity violations undermine the quality of research and trust in science. When researchers engage in these behaviors, institutional officials (IOs) often develop corrective action plans. Ideally, such plans address the root causes so noncompliance or research integrity violations discontinue.

View Article and Find Full Text PDF

Background: Older adults are at increased risk of cognitive impairments including Alzheimer's disease dementia. Legally authorized representatives (LARs) can provide informed consent when a participant is no longer able to, but little is known about barriers to incorporating them in research.

Objective: Explore reasons for not asking and documenting participant decisions to appoint LARs among researchers conducting clinical intervention trials studying older adults or individuals with cognitive impairments.

View Article and Find Full Text PDF

Introduction: Many women who are solid organ transplant (SOT) recipients wish to have children after transplantation. Contraception is an important component of post-transplant planning and care, given the increased risk associated with post-transplant pregnancies. We sought to understand patient attitudes and concerns about post-transplant contraception and pregnancy.

View Article and Find Full Text PDF

Introduction: Several evidence-informed consent practices (ECPs) have been shown to improve informed consent in clinical trials but are not routinely used. These include optimizing consent formatting, using plain language, using validated instruments to assess understanding, and involving legally authorized representatives when appropriate. We hypothesized that participants receiving an implementation science toolkit and a social media push would have increased adoption of ECPs and other outcomes.

View Article and Find Full Text PDF

Effective communication is integral to patient and family-centered care in pediatric and adolescent and young adult (AYA) oncology and improving healthcare delivery and outcomes. There is limited knowledge about whether AYAs and parents have similar communication preferences and needs. By eliciting and comparing communication advice from AYAs and parents, we can identify salient guidance for how clinicians can better communicate.

View Article and Find Full Text PDF
Article Synopsis
  • Geographical ancestry is linked to an increased risk of genetic conditions, leading some genetic testing to use race or ethnicity as proxies, despite concerns over this approach.
  • Race-based genetic testing raises ethical questions, particularly when targeting Black individuals, such as in the case of APOL1 testing for kidney donors.
  • A systematic review found both facilitators that encourage positive views on race-targeted testing and barriers that cause concern, highlighting the need for more informed policies in genetic research and practice.
View Article and Find Full Text PDF

State Medical Boards (SMBs) can take severe disciplinary actions (e.g., license revocation or suspension) against physicians who commit egregious wrongdoing in order to protect the public.

View Article and Find Full Text PDF