Surveys asking about sensitive topics must include youth to provide accurate prevalence estimates and to guide prevention and intervention efforts. A recent article by Ybarra, et. al. (2009) in the Journal of Adolescent Health however reminds researchers to take great care to understand the impact of the questions and to refer youth to support services, if needed. Researchers are mandated to minimize harm in research, and this article helps understand how questions may bother youth, and how any damage might be mitigated.
To explore these issues, an online survey that included sensitive questions about victimization, violence, and exposure to violence was given to 1,588 youth between the ages of 10 and 15 years old. At the end of the survey the youth were asked whether any of the questions upset them.
One in four of the youth (23 percent), particularly the younger and female participants, reported being upset by the questions, and there was no difference between those youth who had experienced or witnessed violence in real life. Some of the reasons youth were upset included being distressed by questions that included violence to animals or the thought of other youth participating in violence. Some youth just said they did not like thinking about "bad stuff happening."
One suggestion by the researchers is that a question about being upset be included at the end of surveys that contain sensitive material, and that a message be sent to anyone saying the questions upset them that includes something like the following: "You said some of the questions upset you. We want you to know that there is help and we encourage you to reach out to someone if you need to" with a direct contact for the staff. Another idea includes asking participants to rate the emotional upset against seeing the evening news, a violent scene in a movie or video game in order to understand the level of "upset."
Researchers and Institutional Review Board (IRB) members should remember that a fully informed assent process does not assure against having participants upset at the end of a survey. Indeed, emotional distress usually is deemed an acceptable risk that is outweighed by the benefits in most surveys. If the consent procedures explain why the sensitive questions are being asked and the potential benefits of the study, then the participants can make the decision about whether to participate. I like the addition of a contact if the questions upset the youth though, especially in cases of ongoing research projects.