Sweet tweets! Evaluating a new approach for probability-based sampling of Twitter.

As survey costs continue to rise and response rates decline, researchers are seeking more cost-effective ways to collect, analyze and process social and public opinion data. These issues have created an opportunity and interest in expanding the fit-for-purpose paradigm to include alternate sources such as passively collected sensor data and social media data. However, methods for accessing, sourcing and sampling social media data are just now being developed. In fact, there has been a small but growing body of literature focusing on comparing different Twitter data access methods through either the elaborate firehose or the free Twitter search or streaming APIs. Missing from the literature is a good understanding of how to randomly sample Tweets to produce datasets that are representative of the daily discourse, especially within geographical regions of interest, without requiring a census of all Tweets. This understanding is necessary for producing quality estimates of public opinion from social media sources such as Twitter. To address this gap, we propose and test the Velocity-Based Estimation for Sampling Tweets (VBEST) algorithm for selecting a probability based sample of tweets. We compare the performance of VBEST sample estimates to other methods of accessing Twitter through the Search API on the distribution of total Tweets as well as COVID-19 keyword incidence and frequency and find that the VBEST samples produce consistent and relatively low levels of overall bias compared to common methods of access through the Search API across many experimental conditions.

Resident identification of feedback and teaching on rounds.

Feedback and teaching occur regularly on teaching hospital wards. Although feedback has important implications for resident learning, residents often report that they receive little feedback. The significant overlap of teaching and feedback in clinical education may contribute to resident difficulty with feedback identification. We sent a survey with seven scenarios to internal medicine residents across the country. Two of the scenarios contained teaching, two contained feedback, and three contained combined teaching and feedback. From October 2017 to April 2018, 17% of residents (392/2346) from 17 residency programs completed the survey. Participating residents correctly identified both feedback scenarios 89% of the time, both teaching scenarios 64% of the time, and all three combined teaching and feedback scenarios 38% of the time. Interns were less likely than upper-level residents to correctly identify combined teaching and feedback scenarios (P = 0.005). Residents may have difficulty identifying feedback in the context of teaching. This confusion may contribute to residents' perceptions that they receive little feedback.

Telephone health survey estimates: Effects of nonresponse and sample limitations.

OBJECTIVE: The objective of this study was to assess nonresponse error in telephone health survey data based on an address-based sample. DATA SOURCES: Telephone and in-person interviews in Greater Boston. STUDY DESIGN/DATA COLLECTION: Interviewers attempted telephone interviews at addresses that were matched to telephone numbers using questions drawn from federal health surveys. In-person household interviews were carried out with telephone nonrespondents and at addresses without matching telephone numbers. PRINCIPAL FINDINGS: After adjusting for demographic differences, only eight of 15 estimates based on the telephone interviews lay within two standard errors of the estimates when data from all three groups were included. CONCLUSIONS: For health surveys of address-based samples, many estimates based on telephone respondents differ from the total population in ways that cannot be corrected with simple demographic adjustments.

Organizational factors related to the adoption of an injury prevention program by U.S. children's hospitals.

Most childhood injuries can be prevented with the correct use of safety devices and appropriate supervision. Children's hospitals are well positioned to promote these behaviors with evidence-based programming; however, barriers exist to adopting such programs. The purpose of this study was to describe organizational and administrative factors related to the adoption of an efficacious injury prevention (IP) program by children's hospitals in the USA. IP specialists at 232 U.S. children's hospitals were invited to complete a baseline survey, and then offered Safe N' Sound (SNS), an efficacious computer IP program targeting parents of young children. Following this promotion period, specialists were surveyed again to assess their level of SNS adoption. Organizational and administrative factors associated with SNS adoption were identified using conditional random forest models (n = 93). Random forests identified a set of six predictors with potential utility for classifying hospitals as having SNS adoption activity or not; the final pruned classification tree indicated that four of these were best able to differentiate hospitals with and without adoption activity-having a medical director, having other hospital units that provided IP programming, the number of requests the IP unit received within the past year, and the belief of administrative leaders in their responsibility to develop programming all influence decisions. Hospitals without a medical director were most likely to demonstrate adoption activity. Medical directors, or other organizational leaders, can facilitate the adoption process for evidence-based intervention, but may need to be engaged intentionally when disseminating new products, tools, or approaches.

Assessing Community-Based Injury Prevention Services in U.S. Children's Hospitals.

OBJECTIVE: Not-for-profit hospitals are required to meet federal reporting requirements detailing their community benefit activities, which support their tax-exempt status. Children's hospitals have long provided community injury prevention (IP) programming and thus can inform public health outreach work in other areas. This work describes IP programming as a community service offered by children's hospitals in the U.S. METHODS: The IP specialist at 232 US-based member institutions of the Children's Hospital Association were invited to complete an assessment of their hospital's IP outreach programming. RESULTS: 47.7 percent of hospitals request financial data from IP programming for tax reporting purposes. Almost all offer injury prevention (IP) services; the majority are in the community (60.3%) and 34.5% are hospital-based. Most IP units are independent (60.3%) and 71.8% are responsible for their own budgets. CONCLUSIONS: By integrating dissemination and implementation sciences and community health needs assessments, these findings can help advance community services provided by hospitals to impact public health.

Disparities by race and ethnicity in cancer survivor stories available on the web.

BACKGROUND: The rapid growth of eHealth could have the unintended effect of deepening health disparities between population subgroups. Most concerns to date have focused on population differences in access to technology, but differences may also exist in the appropriateness of online health content for diverse populations. OBJECTIVE: This paper reports findings from the first descriptive study of online cancer survivor stories by race and ethnicity of the survivor. METHODS: Using the five highest-rated Internet search engines and a set of search terms that a layperson would use to find cancer survivor stories online, we identified 3738 distinct sites. Of these, 106 met study criteria and contained 7995 total stories, including 1670 with an accompanying photo or video image of the survivor. Characteristics of both websites and survivor stories were coded. RESULTS: All racial minority groups combined accounted for 9.8% of online cancer survivor stories, despite making up at least 16.3% of prevalent cancer cases. Also notably underrepresented were stories from people of Hispanic ethnicity (4.1%), men (35.7%), survivors of colon cancer (3.5%), and older adults. CONCLUSIONS: Because racial/ethnic minority cancer survivors are underrepresented in survivor stories available online, it is unlikely that this eHealth resource in its current form will help eliminate the disproportionate burden of cancer experienced by these groups.

Worksite Opportunities for Wellness (WOW): effects on cardiovascular disease risk factors after 1 year.

OBJECTIVE: To evaluate the effectiveness of a worksite health promotion program on improving cardiovascular disease risk factors. METHODS: In St Louis, Missouri from 2005 to 2006, 151 employees (134 F, 17 M, 81% overweight/obese) participated in a cohort-randomized trial comparing assessments + intervention (worksite A) with assessments only (worksite B) for 1 year. All participants received personal health reports containing their assessment results. The intervention was designed to promote physical activity and favorable dietary patterns using pedometers, healthy snack cart, WeightWatchers(R) meetings, group exercise classes, seminars, team competitions, and participation rewards. Outcomes included BMI, body composition, blood pressure, fitness, lipids, and Framingham 10-year coronary heart disease risk. RESULTS: 123 participants, aged 45+/-9 yr, with BMI 32.9+/-8.8 kg/m(2) completed 1 year. Improvements (P< or =0.05) were observed at both worksites for fitness, blood pressure, and total-, HDL-, and LDL-cholesterol. Additional improvements occurred at worksite A in BMI, fat mass, Framingham risk score, and prevalence of the metabolic syndrome; only the changes in BMI and fat mass were different between worksites. CONCLUSION: A multi-faceted worksite intervention promoted favorable changes in cardiovascular disease risk factors, but many of the improvements were achieved with worksite health assessments and personalized health reports in the absence of an intervention.

Influenza vaccination concerns among older blacks: a randomized controlled trial.

CONTEXT: Vaccination can decrease the morbidity and mortality caused by influenza, yet vaccination rates remain low, especially among minority groups. Previous studies have found that important barriers to vaccination include the fear of adverse reactions and concern that the vaccine causes influenza. BACKGROUND: This research aimed to assess the effects of messages designed to address concerns about the safety and effectiveness of vaccination among blacks aged >or=50 years. DESIGN: In a randomized controlled trial conducted in 2007 with pre-exposure and post-exposure measurements, participants were randomly assigned to read either the vaccine safety messages (VSM) developed for the study (treatment condition) or the vaccine information statement (VIS) currently given to those getting the vaccine (control condition). SETTING/PARTICIPANTS: A total of 108 participants participated in the study. Data were collected in either participants' residences, community settings, or university conference rooms. MAIN OUTCOME MEASURES: Influenza vaccine-related beliefs and intention to receive vaccination were assessed. RESULTS: Data analysis in 2007 and 2008 found that the randomization hypotheses of equal groups were retained. Participants exposed to the VSM showed greater improvement in post-exposure beliefs about how the vaccine works (p=0.0006) and the transmission of the flu (p=0.0034) as well as greater post-exposure disagreement with the belief that the vaccine causes influenza (p=0.0411). CONCLUSIONS: The VSM affected beliefs about vaccine safety and effectiveness to a greater degree than did the VIS. These findings show that VSM are effective in changing beliefs empirically linked with influenza vaccination and vaccination disparities. The dissemination of VSM to older blacks may increase vaccination rates and reduce vaccination disparities.

What makes cancer survivor stories work? An empirical study among African American women.

INTRODUCTION: Cancer survivors play a vital role in cancer control as messengers of hope and information, and advocates for prevention and screening. Understanding what makes survivor stories effective can enhance survivor-delivered programs and interventions. METHODS: By random assignment and using a cross-classified design, 200 African American women viewed videotaped stories (n = 300) from 36 African American breast cancer survivors. Analyses examined effects of story attributes (narrative quality, health message strength), participant characteristics (ways of knowing, experience with breast cancer) and identification with the survivor on women's: (1) level of engagement in the story; (2) positive thoughts about the story; and, (3) remembering key messages about breast cancer and mammography in the story. RESULTS: Participant characteristics were significant predictors of all three study outcomes, accounting for 27.8, 2.6 and 22.2% of their total variance, respectively. In comparison, the variability in these outcomes that could be attributed to differences in the stories was small (0.6, 1.1 and 2%, respectively). The effects of participant characteristics on level of engagement and positive thoughts were mediated by identification with the survivor. CONCLUSIONS: The best predictor of a woman becoming engaged in a breast cancer survivor's story and having positive thoughts about the story was whether she liked the survivor and viewed her as similar to herself (i.e., identification). IMPLICATIONS FOR CANCER SURVIVORS: Survivor stories may be most effective when audience members identify with the survivor. Finding key characteristics that can reliably match the two will advance cancer communication science and practice.

Telephone vs. mail survey gives different SF-36 quality-of-life scores among cancer survivors.

OBJECTIVE: To assess whether SF-36 quality-of-life (QOL) subscale scores varied across two survey modes controlling for cancer type and diagnosis cohort. STUDY DESIGN AND SETTING: Stratified random samples of 720 cancer survivors from six cancer types and three time-since diagnosis cohorts were selected from two state cancer registries. Selected survivors were randomly assigned to mail, telephone, or choice of these for survey administration. This study analyzes completed questionnaires obtained from 140 and 155 survivors who were assigned to telephone and mail, respectively. RESULTS: A significant multivariate effect for survey mode was noted. Mean levels for each subscale controlling for age and accounting for cancer type were higher for telephone compared to mail respondents; significant differences were noted for vitality, role physical, and mental health. The impact of cancer type on QOL subscales was not significant, and the effect of mode was consistent across cancer type. CONCLUSIONS: Previous findings in mode effects for the SF-36 are reproduced here among cancer survivors who may feel more comfortable revealing physical and emotional deficits via mail rather than by telephone. For cancer survivors, it may be that "social desirability" favors responses implying more functioning be it perceived, mental, or physical.

Traditional and virtual microscopy compared experimentally in a classroom setting.

The technology known as virtual microscopy is now widely available to medical students. A number of medical school histology and pathology course directors, including those at the Eastern Virginia Medical School, are exploring the question of how best to make use of this new tool. The current study compared the efficacy of teaching and testing one unit of histology, bone and cartilage, using two technologies, namely, virtual microscopy and traditional microscopy. Additionally, the study examined whether low, moderate, high moderate, or high achieving students perform more effectively in any of the learning/testing formats. In a completely randomized block design, 96 first semester, first-year medical students were grouped by previous exam quartiles then subsequently randomly assigned to one of four groups. Using identical laboratory exercises with highly comparable slides for each experimental group, half of the subjects learned the exercise with traditional microscopy and half learned with virtual microscopy. Subjects were further randomly subdivided into virtual or actual testing groups. The authors found no significant differences in test scores when they examined effects by learning group or by testing group, nor were there significant interaction effects. Student performance evaluated by previous exam quartile was significant (P < 0.001). That is, students who had scored in a particular quartile on a previous test tended to score in the same quartile on the bone and cartilage test regardless of learning or testing method. In a short opinion survey, students were polled to evaluate their experience. Student preferences for both learning and testing method varied widely.