Ch and the delivery of online interventions. As in most pediatric e-health research, both studies presented here faced ethical Aprotinin web dilemmas surrounding best practice for recruitment, consent, debriefing, participant safety, confidentiality, the conduct and delivery of online interventions, and the reporting of online research with children. Discussion of solutions to these dilemmas provides opportunities for knowledge transfer, with potential use of these and other strategies by other pediatric investigators.Henderson, Law, Palermo, and EcclestonRecruitmentPD325901 web recruitment to psychological studies through the Internet has been achieved with varied methods. Similar to off-line studies, one approach is to recruit participants from the community by posting flyers in public locations (e.g., libraries, community centers), online publicly available message boards, or via study recruitment websites hosted by the researcher’s hospital or university. Ethical concerns regarding the type of recruitment strategy used in online research centres primarily on confirmation of participant identities because the researcher may never have a face-to-face encounter with research participants. This is of particular concern in pediatric research that requires parent consent for participation. One approach to the problem of confirming participant identities is to use a gatekeeper in the recruitment process. The ethical implications of the use of gatekeepers in e-health research are similar to pediatric psychological research conducted offline (Briggs-Gowan, Horwitz, Schwab-Stone, Leventhal, Leaf, 2000). In Web-MAP, for example, the gatekeepers to participant recruitment are health care providers, which allow the research team to confirm the identities of recruited participants, and to corroborate other information (e.g., child age, gender, etc.). The use of gatekeepers can raise additional ethical concerns, however, particularly regarding coercion. In Web-MAP, concerns about coercion are addressed by using health care providers for referrals only; all other study procedures are conducted by the research team via email and telephone. In addition, participants are informed during their participation that it is entirely voluntary and will not impact their relationship with their local health care provider. Furthermore, health care providers do not receive monetary incentives for making referrals. Similar recommendations apply when recruiting from community-based settings, such as schools or other organizations where coercion to enroll in the study is of concern. Researchers need to be mindful of their choice of gatekeepers in e-health research and implement best practice procedures to address any potential influence gatekeepers may have on participant freedom to participate or withdraw from the study. The Let’s Chat Pain study used a novel recruitment strategy, which involved contacting the moderators of pre-existing message boards who then sent emails to all their members informing them of the study and asking them to participate. This type of recruitment is new to internet research and presents ethical challenges. Frequent users of message boards may feel more obligated to participate because of demand effects. Paradoxically,previous studies indicate that gatekeepers who send circulatory emails, such as those used in Let’s Chat Pain, may recruit those members of their message board who are less frequent contributors (van Uden-Kraan, Drossaert, Taal, Seydel, van de L.Ch and the delivery of online interventions. As in most pediatric e-health research, both studies presented here faced ethical dilemmas surrounding best practice for recruitment, consent, debriefing, participant safety, confidentiality, the conduct and delivery of online interventions, and the reporting of online research with children. Discussion of solutions to these dilemmas provides opportunities for knowledge transfer, with potential use of these and other strategies by other pediatric investigators.Henderson, Law, Palermo, and EcclestonRecruitmentRecruitment to psychological studies through the Internet has been achieved with varied methods. Similar to off-line studies, one approach is to recruit participants from the community by posting flyers in public locations (e.g., libraries, community centers), online publicly available message boards, or via study recruitment websites hosted by the researcher’s hospital or university. Ethical concerns regarding the type of recruitment strategy used in online research centres primarily on confirmation of participant identities because the researcher may never have a face-to-face encounter with research participants. This is of particular concern in pediatric research that requires parent consent for participation. One approach to the problem of confirming participant identities is to use a gatekeeper in the recruitment process. The ethical implications of the use of gatekeepers in e-health research are similar to pediatric psychological research conducted offline (Briggs-Gowan, Horwitz, Schwab-Stone, Leventhal, Leaf, 2000). In Web-MAP, for example, the gatekeepers to participant recruitment are health care providers, which allow the research team to confirm the identities of recruited participants, and to corroborate other information (e.g., child age, gender, etc.). The use of gatekeepers can raise additional ethical concerns, however, particularly regarding coercion. In Web-MAP, concerns about coercion are addressed by using health care providers for referrals only; all other study procedures are conducted by the research team via email and telephone. In addition, participants are informed during their participation that it is entirely voluntary and will not impact their relationship with their local health care provider. Furthermore, health care providers do not receive monetary incentives for making referrals. Similar recommendations apply when recruiting from community-based settings, such as schools or other organizations where coercion to enroll in the study is of concern. Researchers need to be mindful of their choice of gatekeepers in e-health research and implement best practice procedures to address any potential influence gatekeepers may have on participant freedom to participate or withdraw from the study. The Let’s Chat Pain study used a novel recruitment strategy, which involved contacting the moderators of pre-existing message boards who then sent emails to all their members informing them of the study and asking them to participate. This type of recruitment is new to internet research and presents ethical challenges. Frequent users of message boards may feel more obligated to participate because of demand effects. Paradoxically,previous studies indicate that gatekeepers who send circulatory emails, such as those used in Let’s Chat Pain, may recruit those members of their message board who are less frequent contributors (van Uden-Kraan, Drossaert, Taal, Seydel, van de L.
