cination, the Middlesex Sheriff's Office (MSO) developed and distributed two self-response surveys in December 2020 and January 2021 to assess COVID-19 vaccine willingness among people incarcerated in the jail and one for people who work at the jail. The goal of this study is to characterize vaccine willingness in these two populations of people at the Middlesex House of Correction and Jail with the ultimate goal of informing communication strategies to address concerns and increase acceptance of COVID-19 vaccination. MethodsAn exemption was received from the Tufts Health Sciences Institutional Review Board to analyze deidentified data following the MSO internal analysis. CohortPeople incarcerated in the jail in December 2020 and January 2021 were asked to respond to the survey on tablets prior to accessing educational and entertainment with an option to bypass the survey. Paper surveys were distributed where tablets were unavailable. All staff were emailed a link to an online survey and were encouraged to participate at daily roll call and through follow-up reminder emails. Survey QuestionsPeople were asked if they would be willing to accept the COVID-19 vaccine, and if they said no, they were asked to select their primary reason for refusal. Incarcerated individuals who indicated unwillingness to receive the COVID-19 vaccine were also asked if they would be

SummaryBackground: Despite advances in treatment, patients with inflammatory bowel dis-

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OBJECTIVES: Chronic idiopathic constipation (CIC), like other functional gastrointestinal disorders, has been associated with a high placebo response rate. However, the placebo response in randomized controlled trials has not been described. METHODS: We conducted a search of the medical literature following the protocol outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analysis statement using MEDLINE, EMBASE and EMBASE Classic, Web of Science, and the Cochrane Central Register of Controlled Trials for all drugs used for the treatment of CIC. Two independent reviewers performed eligibility assessment and data extraction. The mean response rate was examined for the following 2 responder endpoints: (i) greater than or equal to 3 complete spontaneous bowel movements (CSBMs)/wk (≥3 CSBMs/wk responders) and (ii) mean increase of ≥1 CSBM/wk compared with baseline (increase in ≥1 CSBM/wk responders). RESULTS: A total of 23 placebo-controlled trials met our inclusion criteria and were included in this meta-analysis. The placebo response in CIC trials ranged from 4% to 44%. The magnitude of the placebo response was 13% (95% confidence interval 11%–16%) with the ≥3 CSBM/wk responder endpoint and 28% (95% confidence interval 21%–30%) with the increase of ≥1 in the CSBM responder endpoint. Higher baseline CSBM, older age, and trials with more male participants were significantly associated with a stronger placebo response for both the ≥3 CSBMs/wk endpoint and increase in the ≥1 CSBM/wk endpoint. Trial characteristics such as location (Europe vs Asia/United States) and laxative class (prokinetic vs secretagogue) revealed key differences in the placebo response for both endpoints. The placebo response was not significantly affected by the number of study visits, study duration, year of publication, number of drop outs, or likelihood of receiving active drug. DISCUSSION: The placebo response in CIC trials ranges from 4% to 44% depending on the endpoint. Modifying factors of the placebo response include multiple subject and trial characteristics.