Objective To determine cross-sectional adherence with the multi-target stool DNA test used for colorectal cancer screening in a large, fully insured Medicare population. Methods All patients aged 65–85 with a valid multi-target stool DNA test order from 1 September 2016 to 31 August 2017 identified from the Exact Sciences Laboratories (Madison, WI; sole-source national multi-target stool DNA test provider) database were evaluated for test adherence. Cross-sectional adherence, defined as multi-target stool DNA test completion within 365 days from order date, was analyzed overall and by time to adherence, as well as by available patient (age, sex, test order date, Medicare coverage type) and provider (specialty, year of first multi-target stool DNA test order, multi-target stool DNA test order frequency, and practice location) factors. Results Among 368,494 Medicare beneficiaries (64% female), overall cross-sectional adherence was 71%. Cumulative adherence rates increased more rapidly at 30 (44%) and 60 (65%) days, followed by more gradual increases at 90 (67%), 180 (70%), and 365 (71%) days. By provider specialty, primary care clinicians represented a higher percentage of multi-target stool DNA orders than gastroenterologists (88% vs. 6%), but had a lower associated patient adherence rate (71% vs. 78%). Conclusions In this large, national sample of Medicare insured older adults, nearly three-quarters of patients adhered with a multi-target stool DNA order for colorectal cancer screening. These real-world data should inform further clinical and population health applications, reimbursement model simulations, and guideline-endorsed colorectal cancer screening strategies adherence.

Major political events now unfold in a hybrid political information cycle: even as millions of citizens tune in to television broadcasts, many also comment -and receive others' comments -over social media. In previous research, we have described how biobehavioral cues spur Twitter discussion of candidates during American presidential debates. Here we extend that research to also account for other elements of the communication environment -in particular, messages from political and media elites reaching them via a 'second screen' such as mobile phone or tablet -and we apply our analyses to debates in both the United States and France. Specifically, we examine the relationship between the Twitter posts of 300 politicians, organizations and media figures from each country and the relevant messages of the larger Twitterverse during the debates. Our findings reveal commonalities in social media response in the two countries, particularly the powerful role of party figures and pundits in spurring social media posting. We also note differences between the social media cultures of the two countries, including the finding that French elites commanded relatively more attention (in the form of retweets) than their American counterparts. Implications for debate evaluations and online expression are discussed.

What determines the re-election of incumbent members of the European Parliament (MEPs)? Using Heckman probit models with sample selection to predict re-election in 2014, this contribution considers the impact of policy leadership, formal leadership, professional dedication, and seniority, and investigates the conditional effect of ballot structures. It finds that formal leadership only has a positive effect for party leaders elected from open lists, while dedication and seniority do not impact incumbents' electoral performance. Instead, policy leadership is most clearly associated with incumbents' electoral fortunes, including an innovative new measure of MEPs' ability to influence the votes of others. The results also suggest that party leaders, when creating electoral lists that are not subject to change by voters, seek to ensure that policy leaders are reelected, but that voters, when given the opportunity to change the rankings of candidates on electoral lists, favor MEPs with greater electoral visibility instead.

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The impact of presidential debates on candidate evaluations remains an open topic. Research has long sought to identify the factors that matter most in citizens’ responses to debate content, including what candidates say, how they say it, and the manner in which they appear. This study uses detailed codings of the first and third 2012 presidential debates to evaluate the impact of candidates’ verbal and nonverbal behaviors on viewers’ “second screen” response—their use of computers, tablets, and mobile devices to express their reactions to the viewing experience. To examine the relationship between candidates’ on-screen behaviors and the social media response, we conduct generalized least squares regression (Prais–Winstein estimation) relating two data sources: (a) a shot-by-shot content analysis coded for rhetorical/functional, tonal, and visual elements of both candidates’ behavior during the debates, and (b) corresponding real-time measures of the volume and valence of online expression about the candidates on Twitter. We find that the nonverbal communication behaviors of candidates—their facial expressions, physical gestures, and blink rate—are consistent, robust, and significant predictors of the volume and valence of public expression during debates, rivaling the power of memes generated by candidates and contributing more than rhetorical strategies and speech tone.