{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T16:01:48Z","timestamp":1762185708229,"version":"build-2065373602"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T00:00:00Z","timestamp":1757894400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Matern Child Health J"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction\/Purpose<\/jats:title>\n                    <jats:p>Postpartum opioid prescription rates remain high, leading to increased morbidity and mortality and increased licit opioid medications diverted into communities. This scoping analysis examined the current processes of postpartum opioid prescribing patterns in America and the implications to maternal and public health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      From the databases PubMed, Medline, and Web of Science, a scoping review was performed utilizing the PRISMA-ScR checklist (Tricco et al. in Ann Intern Med 169(7):467\u2013473, 2018,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"10.7326\/M18-0850\" ext-link-type=\"doi\">https:\/\/doi.org\/10.7326\/M18-0850<\/jats:ext-link>\n                      ). The primary objective of the search strategy was to identify studies that focused on the postpartum timeframe (obstetric delivery to one year postpartum) and prescribed opioids.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 26 articles met inclusion criteria. Articles were broken down into four themes: trends or current state of postpartum opioid prescribing practices (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097); postpartum opioid related risk factors (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20096); rates of new persistent opioid use and opioid use disorder (OUD;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095); protocols or research into reducing postpartum opioid use (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20098).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion\/Conclusion<\/jats:title>\n                    <jats:p>A variety of interventions and protocols have been found to be advantageous in reducing postpartum opioid use. Despite many of these successful efforts, postpartum opioid prescription rates remain high. Implementation of any number of interventions and protocols may be beneficial to reducing postpartum opioid use. Initiating a postpartum pain task force protocol (PPTFP) before obstetric delivery is recommended.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s10995-025-04163-x","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T14:53:49Z","timestamp":1757948029000},"page":"1541-1555","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Postpartum Opioid Use in the United States and the Implications to Maternal and Public Health: A Scoping Review"],"prefix":"10.1007","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9306-3682","authenticated-orcid":false,"given":"Allison N.","family":"Miller","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis E. N.","family":"Daniels","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah Cercone","family":"Heavey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,9,15]]},"reference":[{"key":"4163_CR1","doi-asserted-by":"publisher","unstructured":"ACOG Committee Opinion No. 742: Postpartum Pain Management. (2018). Obstetrics and Gynecology, 132(1), e35\u2013e43. https:\/\/doi.org\/10.1097\/AOG.0000000000002683","DOI":"10.1097\/AOG.0000000000002683"},{"key":"4163_CR3","doi-asserted-by":"publisher","unstructured":"Badreldin, N., Grobman, W. A., Chang, K. T., & Yee, L. M. (2018a). Opioid prescribing patterns among postpartum women. American Journal of Obstetrics and Gynecology, 219(1), 103 e101\u2013103 e108. https:\/\/doi.org\/10.1016\/j.ajog.2018.04.003","DOI":"10.1016\/j.ajog.2018.04.003"},{"key":"4163_CR4","doi-asserted-by":"publisher","unstructured":"Badreldin, N., Grobman, W. A., & Yee, L. M. (2018b). Inpatient opioid use after vaginal delivery. American Journal of Obstetrics and Gynecology, 219(6), 608 e601\u2013608 e607. https:\/\/doi.org\/10.1016\/j.ajog.2018.08.039","DOI":"10.1016\/j.ajog.2018.08.039"},{"issue":"1","key":"4163_CR2","doi-asserted-by":"publisher","first-page":"198","DOI":"10.1089\/heq.2021.0130","volume":"6","author":"N Badreldin","year":"2022","unstructured":"Badreldin, N., DiTosto, J. D., Grobman, W. A., & Yee, L. M. (2022). Association between patient-prescriber racial and ethnic concordance and postpartum pain and opioid prescribing. Health Equity, 6(1), 198\u2013205. https:\/\/doi.org\/10.1089\/heq.2021.0130","journal-title":"Health Equity"},{"issue":"1","key":"4163_CR5","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/AOG.0000000000002093","volume":"130","author":"BT Bateman","year":"2017","unstructured":"Bateman, B. T., Cole, N. M., Maeda, A., Burns, S. M., Houle, T. T., Huybrechts, K. F., Clancy, C. R., Hopp, S. B., Ecker, J. L., Ende, H., Grewe, K., Corradini, R., Schoenfeld, B., Sankar, R. E., Day, K., Harris, L. J., Booth, L., Flood, J. L., Bauer, P., ..., Leffert, M. E., L. R (2017). Patterns of opioid prescription and use after cesarean delivery. Obstetrics and Gynecology, 130(1), 29\u201335. https:\/\/doi.org\/10.1097\/AOG.0000000000002093","journal-title":"Obstetrics and Gynecology"},{"key":"4163_CR6","doi-asserted-by":"publisher","first-page":"288","DOI":"10.1016\/j.drugalcdep.2018.04.011","volume":"188","author":"NV Becker","year":"2018","unstructured":"Becker, N. V., Gibbins, K. J., Perrone, J., & Maughan, B. C. (2018). Geographic variation in postpartum prescription opioid use: Opportunities to improve maternal safety. Drug and Alcohol Dependence, 188, 288\u2013294. https:\/\/doi.org\/10.1016\/j.drugalcdep.2018.04.011","journal-title":"Drug and Alcohol Dependence"},{"key":"4163_CR7","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10010007","author":"E Bornstein","year":"2020","unstructured":"Bornstein, E., Husk, G., Lenchner, E., Grunebaum, A., Gadomski, T., Zottola, C., Werner, S., Hirsch, J. S., & Chervenak, F. A. (2020). Implementation of a standardized post-cesarean delivery order set with multimodal combination analgesia reduces inpatient opioid usage. Journal of Clinical Medicine. https:\/\/doi.org\/10.3390\/jcm10010007","journal-title":"J Clin Med"},{"key":"4163_CR8","doi-asserted-by":"publisher","unstructured":"Bryant, A. S., & Miller, R. S. (2021). Pharmacologic stepwise multimodal approach for postpartum pain management: The American College of Obstetricians and Gynecologists Clinical Consensus No. 1. Obstetrics and gynecology, 138(3), 507\u2013517. https:\/\/doi.org\/10.1097\/AOG.0000000000004517","DOI":"10.1097\/AOG.0000000000004517"},{"key":"4163_CR9","doi-asserted-by":"publisher","first-page":"103249","DOI":"10.1016\/j.ijoa.2021.103249","volume":"50","author":"A Cohen","year":"2022","unstructured":"Cohen, A., Xie, X., Zeuner, R., Galperin, S., & Bruney, T. (2022). Predictors of patient post-discharge opioid use after cesarean delivery: A prospective study. International Journal of Obstetric Anesthesia, 50, 103249. https:\/\/doi.org\/10.1016\/j.ijoa.2021.103249","journal-title":"International Journal of Obstetric Anesthesia"},{"key":"4163_CR10","doi-asserted-by":"publisher","unstructured":"Dowell, D., Haegerich, T. M., & Chou, R. (2016). CDC guideline for prescribing opioids for chronic pain\u2014United States, 2016. MMWR Recommendations and Reports, 65(No. RR-1), 1\u201349. https:\/\/doi.org\/10.15585\/mmwr.rr6501e1","DOI":"10.15585\/mmwr.rr6501e1"},{"key":"4163_CR11","doi-asserted-by":"publisher","unstructured":"Dowell, D., Ragan, K. R., Jones, C. M., Baldwin, G. T., & Chou, R. (2022). CDC clinical practice guideline for prescribing opioids for pain\u2014United States, 2022. MMWR. Recommendations and reports: Morbidity and mortality weekly report. Recommendations and reports, 71(3), 1\u201395. https:\/\/doi.org\/10.15585\/mmwr.rr7103a1","DOI":"10.15585\/mmwr.rr7103a1"},{"issue":"1","key":"4163_CR12","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1097\/AOG.0000000000003010","volume":"133","author":"E Holland","year":"2019","unstructured":"Holland, E., Bateman, B. T., Cole, N., Taggart, A., Robinson, L. A., Sugrue, R., Xu, X., & Robinson, J. N. (2019). Evaluation of a quality improvement intervention that eliminated routine use of opioids after cesarean delivery. Obstetrics and Gynecology, 133(1), 91\u201397. https:\/\/doi.org\/10.1097\/AOG.0000000000003010","journal-title":"Obstetrics and Gynecology"},{"key":"4163_CR13","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1745848","author":"A Horn","year":"2022","unstructured":"Horn, A., Adgent, M. A., Osmundson, S. S., Wiese, A. D., Phillips, S. E., Patrick, S. W., Griffin, M. R., & Grijalva, C. G. (2022). Risk of death at 1 year following postpartum opioid exposure. American Journal of Perinatology. https:\/\/doi.org\/10.1055\/s-0042-1745848","journal-title":"American Journal of Perinatology"},{"issue":"3","key":"4163_CR14","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1097\/AOG.0000000000001868","volume":"129","author":"M Jarlenski","year":"2017","unstructured":"Jarlenski, M., Bodnar, L. M., Kim, J. Y., Donohue, J., Krans, E. E., & Bogen, D. L. (2017). Filled prescriptions for opioids after vaginal delivery. Obstetrics and Gynecology, 129(3), 431\u2013437. https:\/\/doi.org\/10.1097\/AOG.0000000000001868","journal-title":"Obstetrics and Gynecology"},{"key":"4163_CR15","doi-asserted-by":"publisher","unstructured":"Macias, D. A., Adhikari, E. H., Eddins, M., Nelson, D. B., McIntire, D. D., & Duryea, E. L. (2022). A comparison of acute pain management strategies after cesarean delivery. American Journal of Obstetrics and Gynecology, 226(3), 407 e401\u2013407 e407. https:\/\/doi.org\/10.1016\/j.ajog.2021.09.003","DOI":"10.1016\/j.ajog.2021.09.003"},{"issue":"1","key":"4163_CR16","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1186\/s12884-021-03954-8","volume":"21","author":"TR McKinnish","year":"2021","unstructured":"McKinnish, T. R., Lewkowitz, A. K., Carter, E. B., & Veade, A. E. (2021). The impact of race on postpartum opioid prescribing practices: A retrospective cohort study. Bmc Pregnancy and Childbirth, 21(1), 434. https:\/\/doi.org\/10.1186\/s12884-021-03954-8","journal-title":"Bmc Pregnancy and Childbirth"},{"issue":"1","key":"4163_CR17","first-page":"5","volume":"18","author":"A Nakahara","year":"2018","unstructured":"Nakahara, A., Ulrich, N. D., & Gala, R. (2018). Opiate prescribing practices in the postpartum unit. Ochsner Journal, 18(1), 5.","journal-title":"Ochsner Journal"},{"issue":"6","key":"4163_CR18","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1111\/ajad.13028","volume":"29","author":"N Nidey","year":"2020","unstructured":"Nidey, N., Carnahan, R., Carter, K. D., Strathearn, L., Bao, W., Greiner, A., Jelliffee-Pawlowski, L., Tabb, K. M., & Ryckman, K. (2020). Association of mood and anxiety disorders and opioid prescription patterns among postpartum women. The American Journal on Addictions \/ American Academy of Psychiatrists in Alcoholism and Addictions, 29(6), 463\u2013470. https:\/\/doi.org\/10.1111\/ajad.13028","journal-title":"The American Journal on Addictions \/ American Academy of Psychiatrists in Alcoholism and Addictions"},{"key":"4163_CR19","doi-asserted-by":"publisher","first-page":"n71","DOI":"10.1136\/bmj.n71","volume":"372","author":"MJ Page","year":"2021","unstructured":"Page, M. J., McKenzie, J. E., Bossuyt, P. M., Boutron, I., Hoffmann, T. C., Mulrow, C. D., et al. (2021). The PRISMA 2020 statement: An updated guideline for reporting systematic reviews. BMJ, 372, n71. https:\/\/doi.org\/10.1136\/bmj.n71","journal-title":"Bmj"},{"issue":"7","key":"4163_CR20","doi-asserted-by":"publisher","first-page":"e197863","DOI":"10.1001\/jamanetworkopen.2019.7863","volume":"2","author":"AF Peahl","year":"2019","unstructured":"Peahl, A. F., Dalton, V. K., Montgomery, J. R., Lai, Y. L., Hu, H. M., & Waljee, J. F. (2019). Rates of new persistent opioid use after vaginal or cesarean birth among US women. JAMA Network Open, 2(7), e197863. https:\/\/doi.org\/10.1001\/jamanetworkopen.2019.7863","journal-title":"JAMA Netw Open"},{"issue":"4","key":"4163_CR21","doi-asserted-by":"publisher","first-page":"566e561","DOI":"10.1016\/j.ajog.2020.03.020","volume":"223","author":"AF Peahl","year":"2020","unstructured":"Peahl, A. F., Morgan, D. M., Dalton, V. K., Zivin, K., Lai, Y. L., Hu, H. M., Langen, E., Low, L. K., Brummett, C. M., Waljee, J. F., & Bauer, M. E. (2020). New persistent opioid use after acute opioid prescribing in pregnancy: A nationwide analysis. American Journal of Obstetrics and Gynecology, 223(4), 566.e561\u2013566.e513. https:\/\/doi.org\/10.1016\/j.ajog.2020.03.020","journal-title":"American Journal of Obstetrics and Gynecology"},{"issue":"3","key":"4163_CR22","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1097\/AOG.0000000000002789","volume":"132","author":"M Prabhu","year":"2018","unstructured":"Prabhu, M., Dubois, H., James, K., Leffert, L. R., Riley, L. E., Bateman, B. T., & Henderson, M. (2018). Implementation of a quality improvement initiative to decrease opioid prescribing after Cesarean delivery. Obstetrics and Gynecology, 132(3), 631\u2013636. https:\/\/doi.org\/10.1097\/AOG.0000000000002789","journal-title":"Obstetrics and Gynecology"},{"issue":"1","key":"4163_CR23","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1097\/AOG.0000000000002094","volume":"130","author":"M Prabhu","year":"2017","unstructured":"Prabhu, M., McQuaid-Hanson, E., Hopp, S., Burns, S. M., Leffert, L. R., Landau, R., Lauffenburger, J. C., Choudhry, N. K., Kaimal, A., & Bateman, B. T. (2017). A shared decision-making intervention to guide opioid prescribing after cesarean delivery. Obstetrics and Gynecology, 130(1), 42\u201346. https:\/\/doi.org\/10.1097\/AOG.0000000000002094","journal-title":"Obstetrics and Gynecology"},{"key":"4163_CR24","doi-asserted-by":"publisher","first-page":"373","DOI":"10.17161\/kjm.vol15.18246","volume":"15","author":"N Ravikanti","year":"2022","unstructured":"Ravikanti, N., Okut, H., Keomany, J., Ablah, E., & Bradley, K. (2022). Variations in postpartum opioid prescribing practices among obstetrician-gynecologists.  Kansas Journal of Medicine, 15, 373\u2013379. https:\/\/doi.org\/10.17161\/kjm.vol15.18246","journal-title":"Kans J Med"},{"issue":"5","key":"4163_CR25","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1097\/AOG.0000000000003512","volume":"134","author":"RG Rogers","year":"2019","unstructured":"Rogers, R. G., Nix, M., Chipman, Z., Breen, M., Dieterichs, C., Nutt, S., Moxham, J., Chang, P., Rathouz, P. J., Robertson, H., & Young, A. (2019). Decreasing opioid use postpartum: A quality improvement initiative. Obstetrics and Gynecology, 134(5), 932\u2013940. https:\/\/doi.org\/10.1097\/AOG.0000000000003512","journal-title":"Obstetrics and Gynecology"},{"issue":"16","key":"4163_CR26","first-page":"5","volume":"72","author":"A Stewart","year":"2023","unstructured":"Stewart, A., Ko, J., Salvesen, B., von Essen, B., Levecke, M., D\u2019Angelo, D. V., Romero, L., Cox, S., Warner, L., & Barfield, W. (2023). Association of mental health conditions, recent stressful life events, and adverse childhood experiences with postpartum substance use\u2014Seven states, 2019\u20132020. Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report, 72(16), 5.","journal-title":"Centers for Disease Control and Prevention Morbidity and Mortality Weekly Report"},{"issue":"7","key":"4163_CR27","doi-asserted-by":"publisher","first-page":"467","DOI":"10.7326\/M18-0850","volume":"169","author":"AC Tricco","year":"2018","unstructured":"Tricco, A. C., Lillie, E., Zarin, W., O\u2019Brien, K. K., Colquhoun, H., Levac, D., Moher, D., Peters, M. D. J., Horsley, T., Weeks, L., Hempel, S., Akl, E. A., Chang, C., McGowan, J., Stewart, L., Hartling, L., Aldcroft, A., Wilson, M. G., Garritty, C., Lewin, S., ..., Straus, S. E. (2018). PRISMA Extension for Scoping Reviews (PRISMA-ScR): Checklist and explanation. Annals of Internal Medicine, 169(7), 467\u2013473. https:\/\/doi.org\/10.7326\/M18-0850","journal-title":"Annals of Internal Medicine"},{"issue":"4","key":"4163_CR28","doi-asserted-by":"publisher","first-page":"376","DOI":"10.1016\/j.whi.2021.03.002","volume":"31","author":"AD Wiese","year":"2021","unstructured":"Wiese, A. D., Osmundson, S. S., Mitchel, E. Jr., Adgent, M., Phillips, S., Patrick, S. W., Horn, A., Samuels, L. R., Griffin, M. R., & Grijalva, C. G. (2021a). Prescription opioid dose after vaginal delivery and the risk of serious opioid-related events: A retrospective cohort study. Womens Health Issues, 31(4), 376\u2013383. https:\/\/doi.org\/10.1016\/j.whi.2021.03.002","journal-title":"Womens Health Issues"},{"issue":"6","key":"4163_CR29","doi-asserted-by":"publisher","first-page":"100475","DOI":"10.1016\/j.ajogmf.2021.100475","volume":"3","author":"AD Wiese","year":"2021","unstructured":"Wiese, A. D., Osmundson, S. S., Mitchel, E. Jr., Adgent, M., Phillips, S., Patrick, S. W., Spieker, A. J., & Grijalva, C. G. (2021b). The risk of serious opioid-related events associated with common opioid prescribing regimens in the postpartum period after cesarean delivery. American Journal of Obstetrics & Gynecology MFM, 3(6), 100475. https:\/\/doi.org\/10.1016\/j.ajogmf.2021.100475","journal-title":"American Journal of Obstetrics & Gynecology MF"},{"issue":"2","key":"4163_CR30","doi-asserted-by":"publisher","first-page":"100304","DOI":"10.1016\/j.ajogmf.2020.100304","volume":"3","author":"Y Zhu","year":"2021","unstructured":"Zhu, Y., Huybrechts, K. F., Desai, R. J., Franklin, J. M., Hernandez-Diaz, S., Krumme, A., Straub, L., Neuman, M., Wunsch, H., Levin, R., Mogun, H., & Bateman, B. T. (2021). Prescription opioid use after vaginal delivery and subsequent persistent opioid use and misuse. American Journal of Obstetrics & Gynecology MFM, 3(2), 100304. https:\/\/doi.org\/10.1016\/j.ajogmf.2020.100304","journal-title":"American Journal of Obstetrics & Gynecology MFM"}],"container-title":["Maternal and Child Health Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10995-025-04163-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10995-025-04163-x\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10995-025-04163-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,3]],"date-time":"2025-11-03T15:23:24Z","timestamp":1762183404000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10995-025-04163-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,15]]},"references-count":30,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["4163"],"URL":"https:\/\/doi.org\/10.1007\/s10995-025-04163-x","relation":{},"ISSN":["1092-7875","1573-6628"],"issn-type":[{"type":"print","value":"1092-7875"},{"type":"electronic","value":"1573-6628"}],"subject":[],"published":{"date-parts":[[2025,9,15]]},"assertion":[{"value":"19 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 August 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 September 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"N\/A.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}},{"value":"N\/A.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval"}},{"value":"N\/A.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent to Participate"}}]}}