Table 2.

Narrative and relationally driven questions to interrogate the use of screening in intervention studies

1. To whom am I morally obligated? Who are the individuals and who matters to them? Who is screening intended for? Is the group in question vulnerable? Do we understand who the people are who might participate in the intervention? Do we understand what matters to them and how this will shape their perceived obligations? Will the individuals be likely to feel stigmatized? Will there be worry and concern about whether to tell others about a potential diagnosis or their situation? 2. Whose interests are being represented? Whose voice is prominent in the research findings? Do we hear about those who may not wish to participate as much as those who do? What happens to the people who are identified as at-risk but do not receive further supports, follow up or interventions? What happens to participants when an intervention is not effective? 3. What environmental and socio-cultural factors need to be accounted for? Who is involved in delivery and receipt of screening tools? What cultural values are expressed about the practice of screening and the conditions being screened for? What is the nature of the relationships of those involved in screening? What are the environmental features that are likely influence decision-making? Is the tool culturally appropriate? What social factors are important to consider? What cultural understandings about conditions being screened for are important to know about in advance? 4. Which study design and which tools do we use? Which study designs are ethically justifiable with vulnerable populations? Which screening tools do we select from and how do we account for their shortfalls? Which processes can be incorporated to ensure that we focus on who our participants are instead of the symptoms revealed by diagnostic and identification tools?