Authors' Reply: Commentary on "Protecting User Privacy and Rights in Academic Data-Sharing Partnerships: Principles From a Pilot Program at Crisis Text Line".

We appreciate Reierson's thoughtful commentary on our 2019 paper, which described our experiences, ethical process, judgment calls, and lessons from a 2016-2017 data-sharing pilot between Crisis Text Line and academic researchers. The commentary raises important questions about the ethical conduct of health research in the digital age, particularly regarding informed consent, potential conflicts of interest, and the protection of vulnerable populations. Our article focused specifically on the noncommercial use of Crisis Text Line data for research purposes, so we restrict our reply to points relevant to such usage.

TIERED ACCESS TO RESEARCH DATA FOR SECONDARY ANALYSIS.

Research data have expanded in their gradation of the risks associated with both re-identification and harm, which has created a need for multiple levels of access controls beyond public and restricted access. Public-access data have typically been available for download from websites while restricted-access data usually require an application and formal authorization process. The old paradigm of classifying data as public-access or restricted-access is no longer sufficient.

Falls in community-dwelling older adults with heart failure: A retrospective cohort study.

Background: While heart failure (HF) in older adults is associated with fall risk, little is known about this in the U.S.

Objective: To examine the independent effect of functional impairments related to HF on falls among community-dwelling older adults in the U.

Protecting User Privacy and Rights in Academic Data-Sharing Partnerships: Principles From a Pilot Program at Crisis Text Line.

Data sharing between technology companies and academic health researchers has multiple health care, scientific, social, and business benefits. Many companies remain wary about such sharing because of unaddressed concerns about ethics, data security, logistics, and public relations. Without guidance on these issues, few companies are willing to take on the potential work and risks involved in noncommercial data sharing, and the scientific and societal potential of their data goes unrealized.

Reconsidering substitution in long-term care: when does assistive technology take the place of personal care?

Objective: Assistive technology (AT) may improve quality of life and reduce dependence for older persons with disabilities. In this article, we examine tradeoffs between the use of AT and reliance on personal care, with attention to factors that may influence those relationships.

Methods: We jointly modeled hours of formal and informal care with use of AT in order to address the interdependence of these outcomes in ways not taken into account in previous studies.

Disability and home care dynamics among older unmarried Americans.

Objectives: We describe how paid and unpaid home care hours received by older unmarried Americans change in response to disability dynamics. We test whether responses to disability declines and improvements are symmetric; that is, we test whether reductions in care hours that are due to disability improvements are of similar magnitude to increases in care hours that are due to disability declines.

Methods: Using a national sample of older unmarried Americans, we examine changes in total hours, paid hours, and unpaid hours of care in response to declines and improvements in personal care (activities of daily living, or ADLs) and routine care (instrumental ADLs, or IADLs) disability.