Securing genuine informed consent can be difficult, especially where literacy levels are low, yet it remains a crucial safeguard for individuals participating in global health studies. This paper examines the specific barriers to obtaining meaningful consent when recruiting research participants from mainly hill-tribe communities in northern Thailand. We examined the obstacles and possible ways forward to obtaining meaningful consent by conducting a qualitative investigation among a predominantly hill-tribe ethnic minority community in northern Thailand. This group is culturally distinct and has generally low literacy. Semi-structured interviews were conducted with 37 participants in a scrub typhus clinical study, along with their relatives, the research team, and additional key informants. A thematic analysis was then applied to the data.
Four interconnected themes emerged from our review regarding participants’ ability to provide consent: varying levels of comprehension of the research, problems arising from reliance on informal interpreters, various influences on the decision to take part, and the degree of free will in giving consent. Proposed ways to reach more meaningful consent involved bringing in professional interpreters and building stronger links with the wider community involved in the research. People’s ability to make informed choices about joining research projects requires active support. At the same time, details about the study must be shared with potential participants using language and methods they can clearly follow. Our findings showed that helping people gain a solid grasp of the research, including its possible advantages and drawbacks, goes far beyond simply improving literacy skills or providing translations. It also calls for close attention to the surrounding social and cultural context.
