Background: Recruitment of health research participants through social media is becoming more common. In the United States, 80% of adults use at least one social media platform. Social media platforms may allow researchers to reach potential participants efficiently. However, online research methods may be associated with unique threats to sample validity and data integrity. Limited research has described issues of data quality and authenticity associated with the recruitment of health research participants through social media, and sources of low-quality and fraudulent data in this context are poorly understood. Objective: The goal of the research was to describe and explain threats to sample validity and data integrity following recruitment of health research participants through social media and summarize recommended strategies to mitigate these threats. Our experience designing and implementing a research study using social media recruitment and online data collection serves as a case study. Methods: Using published strategies to preserve data integrity, we recruited participants to complete an online survey through the social media platforms Twitter and Facebook. Participants were to receive $15 upon survey completion. Prior to manually issuing remuneration, we reviewed completed surveys for indicators of fraudulent or low-quality data. Indicators attributable to respondent error were labeled suspicious, while those suggesting misrepresentation were labeled fraudulent. We planned to remove cases with 1 fraudulent indicator or at least 3 suspicious indicators. Results: Within 7 hours of survey activation, we received 271 completed surveys. We classified 94.5% (256/271) of cases as fraudulent and 5.5% (15/271) as suspicious. In total, 86.7% (235/271) provided inconsistent responses to verifiable items and 16.2% (44/271) exhibited evidence of bot automation. Of the fraudulent cases, 53.9% (138/256) provided a duplicate or unusual response to one or more open-ended items and 52.0% (133/256) exhibited evidence of inattention. Conclusions: Research findings from several disciplines suggest studies in which research participants are recruited through social media are susceptible to data quality issues. Opportunistic individuals who use virtual private servers to fraudulently complete research surveys for profit may contribute to low-quality data. Strategies to preserve data integrity following research participant recruitment through social media are limited. Development and testing of novel strategies to prevent and detect fraud is a research priority.

Work is a major contributor to our health and well-being. Workers’ thriving is directly influenced by their job design, work environment and organization. The purpose of this report is to describe the qualitative methods used to develop the candidate items for a novel measure of Thriving from Work through a multi-step iterative process including: a literature review, workshop, interviews with experts, and cognitive testing of the candidate items. Through this process, we defined Thriving from Work as the state of positive mental, physical, and social functioning in which workers’ experiences of their work and working conditions enable them to thrive in their overall lives, contributing to their ability to achieve their full potential in their work, home, and community. Thriving from Work was conceptualized into 37 attributes across seven dimensions: psychological, emotional, social, work–life integration, basic needs, experience of work, and health. We ultimately identified, developed and/or modified 87 candidate questionnaire items mapped to these attributes that performed well in cognitive testing in demographically and occupationally diverse workers. The Thriving from Work Questionnaire will be subjected to psychometric testing and item reduction in future studies. Individual items demonstrated face validity and good cognitive response properties and may be used independently from the questionnaire.

The COVID-19 pandemic has resulted in more than 800 000 deaths in the US, 77% of which were among people 65 years or older and 33% among African American and Hispanic individuals.¹ Many of these patients faced emergency decisions about the use of life-sustaining treatments, an eventuality for which they and their families were often unprepared.² Advance care planning (ACP) seeks to help patients receive care that reflects what matters most to them.³ This process anchors on educating patients about the medical care they may receive and elucidating their informed preferences through iterative conversations and discussions.^3,4 In addition, ACP often includes choosing and preparing another trusted person to make medical decisions in the event that an individual no longer can do so themselves.^3-5

In 2013–2014, nearly 28% of adults in the United States (U.S.) were current tobacco users with cigarettes the most common product used and with nearly 40% of tobacco users using two or more tobacco products. We describe overall change in prevalence of tobacco product use and within-person transitions in tobacco product use in the U.S. between 2013–2014 and 2014–2015 for young adults (18–24 years) and older adults (25+ years). Data from Wave 1 (W1, 2013–2014) and Wave 2 (W2, 2014–2015) of the Population Assessment of Tobacco and Health (PATH) Study were analyzed (N = 34,235). Tobacco product types were categorized into: (1) combustible (cigarettes, cigars, pipe tobacco, hookah), (2) noncombustible (smokeless tobacco, snus pouches, dissolvable tobacco), and (3) electronic nicotine delivery systems (ENDS). Transitions for individual combustible-product types, and for single- and multiple-product use, were also considered. Overall prevalence of current tobacco use decreased from 27.6% to 26.3%. Among W1 non-tobacco users, 88.7% of young adults and 95.8% of older adults were non-tobacco users at W2. Among W1 tobacco users, 71.7% of young adults transitioned, with 20.7% discontinuing use completely, and 45.9% of older adults transitioned, with 12.5% discontinuing use completely. Continuing with/transitioning toward combustible product(s), particularly cigarettes, was more common than continuing with/transitioning toward ENDS. Tobacco use behaviors were less stable among young adults than older adults, likely reflecting greater product experimentation among young adults. Relative stability of cigarette use compared to other tobacco products (except older adult noncombustible use) demonstrates high abuse liability for cigarettes.

More than half of adult tobacco users in the United States (U.S.) transitioned in tobacco product use between 2013–2014 and 2014–2015. We examine how characteristics of adult tobacco users in the U.S. relate to transitions in tobacco product use. Population Assessment of Tobacco and Health (PATH) Study data were analyzed from 12,862 adult current tobacco users who participated in Wave 1 (W1, 2013–2014) and Wave 2 (W2, 2014–2015). Three types of transitions were examined—(1) adding tobacco product(s); (2) switching to non-cigarette tobacco product(s); and (3) discontinuing all tobacco use—among those currently using: (1) any tobacco product; (2) cigarettes only (i.e., exclusive cigarette); and (3) cigarettes plus another tobacco product(s) (i.e., poly-cigarette). Multinomial logistic regression analyses determined relative risk of type of transition versus no transition as a function of demographic and tobacco use characteristics. Transitions in tobacco product use among adult tobacco users were common overall, but varied among different demographic groups, including by age, sex, sexual orientation, race/ethnicity, educational attainment, and poverty level. Further, cigarette smokers with higher dependence scores were more likely to add product(s) and less likely to discontinue tobacco use compared to those with low dependence scores. That high nicotine dependence is a barrier to discontinuing tobacco use adds evidence to support policy to lower nicotine content of cigarettes and to evaluate new products for their potential to reduce cigarette use.