Cathy A. Coyne

Literacy, comprehension, and informed consent in clinical research.

Institutional review boards (IRBs) and informed consent have recently come under increasing scrutiny. The provision of appropriate and understandable information and its comprehension are key elements of the informed consent process. This article examines how literacy and other factors might impact on comprehension of the information provided. Better understanding of these issues and how to best address them are crucial to allowing clinical research subjects to participate as well-informed and willing partners in scientific inquiry.

Social and behavioral interventions to increase breast cancer screening.

Over the past 10 years, breast cancer screening has increased greatly among women in the United States. Among women ages 50 and older, more than 56% reported having received a clinical breast exam and mammogram (X-ray images of the breast) in the 2 years preceding the 1994 National Health Interview Survey (NHIS), compared with 25% in 1987 (US. Department of Health and Human Services [DHHS], 1990). Mammography rates doubled or tripled for most ethnic groups over that period. In the past decade, the progress that has been made in breast cancer screening is striking. Although it may be impossible to demonstrate a causal relationship, the increase in screening rates surely is a result of a concerted effort by researchers, clinicians, and practitioners. The investments made by the National Institutes of Health (NIH), the Centers for Disease Control and Prevention, the American Cancer Society, and other organizations to conduct research, promote screening, and deliver services have played an important role in the increase in breast cancer screening. In this review, we examine briefly, and with more emphasis on breadth