Biobank consent preferences and implications for a mixed consent model: biomedical researchers vs. community stakeholders in a semi-urban Yoruba community, Nigeria.

Background: Several consent models have been described in the literature for genomic research, with some focusing specifically on biobanking. Sub-Saharan African scholars reported a preference for broad consent among key stakeholders, identical to narratives from most studies in Europe and the USA. However, there have been reports of a generational shift with divergent views among potential genomic research participants in sub-Saharan Africa due to communitarian ethos and relative solidarity. To avoid ethical conflicts in biobanking research in sub-Saharan Africa, it is imperative to explore the preferences of the various stakeholders. Objective: To explore the opinions of research stakeholders, namely: biomedical clinician-researchers, community elders, and community members, on informed consent models in biobanking research. Methods: This qualitative study employed key-informant semi-structured interviews and focus group discussions to collect data from purposively selected participants. Sample sizes for the stakeholders' categories were determined by theoretical saturation. Thirty clinician-researchers and four community elders were interviewed. Fifteen focus group sessions were held with 50 community members. The methodological design, adapted from grounded theory, used the constant comparative method of data analysis. Data and methodological triangulation, reflexivity, and code-recode reliability index were used to ascertain data quality. Results: Twelve of the biomedical researchers preferred blanket consent, aligning with the preferences of adult community members. Ten of the researchers opted for broad consent. The community elders opined that community members would prefer tiered consent. The youth participants differed from the researchers and community adults, preferring re-consenting. The findings of this study showed discordant views on consent model preferences among the various stakeholders. Conclusion: Discordance in consent preferences among the key stakeholders is a potential source of ethical conflict. A hybrid or mixed-consent model that provides participants with the option to choose the consent model they prefer for every research stage, and flexibility to change their choices as the research progresses, is recommended. This will reflect the fundamental principle of autonomy and demonstrate responsive communitarianism and relative solidarity. It will also provide a robust, culturally sensitive, and context-specific model that reflects the preferences of community stakeholders and addresses the fundamental ethical issues encountered in biobanking.