Importance Twitter has recently been explored as a data source by researchers in multiple fields, though, as a whole, the research remains nascent. Even less is known about using Twitter to study cardiovascular disease. Objective We sought to characterize the volume and content of tweets related to cardiovascular disease, and the characteristics of Twitter users. Design We used the Twitter Application Programming Interface (API) to access a random sample of tweets from July 2009 to February 2015. We filtered approximately 10 billion tweets for keywords related to cardiovascular disease. We included only English tweets originating from US counties. We characterized each tweet relative to estimated user demographics. A random subset of 2,500 tweets was hand-coded for tweet content and modifiers. Setting Twitter, a social media platform Participants Twitter users tweeting about cardiovascular disease Exposures None Main outcomes and measures Our main outcomes included the volume of tweets about cardiovascular disease on Twitter and the content of these tweets. Results Diabetes (n=239,989) and myocardial infarction (269,907) terms were used more frequently than heart failure (9,414) terms. Users tweeting about cardiovascular disease were more likely to be older than the average Twitter population (mean age= 28.68 vs. 25.36, p<0.01), and less likely to be male (47% vs. 49%, p <0.01). Most tweets (94%) were health related. Common themes included tweets related to risk factors (42%), awareness (23%) and management (23%). Conclusions and relevance Twitter offers promise to characterize public understanding and communication about heart disease.

This trial successfully demonstrated that a physical therapy led strength training program for breast cancer survivors can be implemented in a community setting while retaining the effectiveness and safety of the clinical trial. However, during the translation process, strategies to reduce barriers to implementation are required. This new program can inform larger scale dissemination and implementation efforts.

Introduction The most common and conceptually sound ethical concerns with financial incentives for research participation are that they may (1) represent undue inducements by blunting peoples’ perceptions of research risks, thereby preventing fully informed consent; or (2) represent unjust inducements by encouraging enrollment preferentially among the poor. Neither of these concerns has been shown to manifest in studies testing the effects of incentives on decisions to participate in hypothetical randomized clinical trials (RCTs), but neither has been assessed in real RCTs. Methods and analyses We are conducting randomized trials of real incentives embedded within two parent RCTs. In each of two trials conducted in parallel, we are randomizing 576 participants to one of three incentive groups. Following preliminary determination of patients’ eligibility in the parent RCT, we assess patients’ research attitudes, demographic characteristics, perceived research risks, time spent reviewing consent documents, ability to distinguish research from patient care, and comprehension of key trial features. These quantitative assessments will be supplemented by semi-structured interviews for a selected group of participants that more deeply explore patients’ motivations for trial participation. The trials are each designed to have adequate power to rule out undue and unjust inducement. We are also exploring potential benefits of incentives, including possible increased attention to research risks and cost-effectiveness.