Examining Guardian Permission Waivers for Pediatric Digital Health Research in the U.S. Since 2020: A Systematic Review
By
Colleen Stiles-Shields
Elyse Shenberger
Ann Bernica
Gabriella Bobadilla
Kandis Fletcher
Jasmine George
Sydney Gordon
Erika L Gustafson
Crystal S Hernandez
Taylor L Hilderbrand
Sarah N Kumi
Christine A Lee
Sarah I Lorduy
Meera Phanse
Lauren M Potthoff
Naomi Quezada
Dale L Smith
Holly J Hudson
Emily E Anderson
September 25, 2026
Clinical Scorecard: Examining Guardian Permission Waivers for Pediatric Digital Health Research in the U.S. Since 2020: A Systematic Review
At a Glance
Category Detail
Condition Youth Mental Health Research Key Mechanisms Guardian permission requirements can limit participation in research, particularly for sensitive topics. Target Population Adolescents under 18 years, especially those identifying as LGBTQIA+ or engaging in risky behaviors. Care Setting Digital health interventions and mental health research.
Key Highlights
Youth mental health crisis exacerbated by provider shortages and policy changes. Digital health interventions proposed to improve access to mental health services. Guardian permission may disproportionately exclude vulnerable youth from research. Nearly 40% of LGBTQIA+-identified youth may decline participation if guardian consent is required. Legal clarity on guardian consent for research participation is inconsistent. Guideline-Based Recommendations
Diagnosis
Management
Monitoring & Follow-up
Risks
Requiring guardian permission can skew research findings and limit access to beneficial interventions. Patient & Prescribing Data
Adolescents, particularly those from marginalized backgrounds.
Confidential and supportive treatment options are crucial for youth participation.
Clinical Best Practices
Consider waiving guardian permission for sensitive research topics to enhance participation. Ensure that digital health interventions are accessible and evidence-based for youth. Related Resources & Content
