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PubMed2003

Cellular telephone use and time trends for brain, head and neck tumours.

AIM: The objective of this study was to determine whether incidence rates of head and neck malignancies in New Zealand have varied since the introduction of cellular telephones in 1987. In particular, we sought to compare trends in tumour rates in anatomical sites that receive high, medium and low levels of cellular telephone radiation (based on dosimetry data). METHODS: We investigated whether trends in tumour incidence rates in New Zealand have varied since the introduction of cellular telephones in 1987. The exposure measure used was the proportion of cellular telephone subscribers within the national population, calculated using the number of subscribers over the study period. RESULTS: The graphs for high, medium and low exposure sites did not display any significant changes in trend patterns for either gender over the years 1986 to 1998. CONCLUSIONS: Incidence rates for malignancies arising in the head and neck, including those sites that hypothetically receive the highest levels of radio frequency radiation during cellular telephone use, have not changed materially since the introduction of cellular telephones to New Zealand. However, ecological studies of this nature are limited in many ways and a stronger study design is clearly needed to establish more exactly any elevation in risk.

Adult↗
PubMed2004

Blood pressure monitoring by cellular telephone in patients on continuous ambulatory peritoneal dialysis.

We have developed a new telemedicine system that uses a cellular telephone and Internet Web site to monitor changes of blood pressure (BP) in patients on continuous ambulatory peritoneal dialysis (CAPD). An I-converter data collection system directly transmits all data on BP and heart rate (HR) measured by a fully automatic device (HEM-705IT: Omron Life Science, Tokyo, Japan) to a cellular telephone. The cellular telephone then sends the data directly to the main server at the NTT DoCoMo data center. All data, including BP and HR from each patient, are accumulated in the server. Application service provider technology (ASP) connects that system directly to the Internet. Any time and anywhere, each patient can use a cellular telephone or the Internet Web site to monitor, in graph form, changes in their data. The average data at each collection point are calculated and shown on the Web site. All data collected by cellular telephone are also calculated and sent directly, in real time, to the physician's office. Currently, we are using this telemedicine system for 44 hypertensive patients on CAPD at our center. In the present study, we used the telemedicine system to evaluate changes in 24-hour BP. We followed 20 CAPD patients, monitoring changes in BP for 3 months. At the end of study, we found that the average daytime home BP was 137 +/- 8 mmHg over 80 +/- 4 mmHg and that the average nighttime BP was 128 +/- 7 mmHg over 72 +/- 4 mmHg. The overall average home BP was 132 +/- 7 mmHg over 76 +/- 3 mmHg. The average outpatient clinic BP was 155 +/- 9 mmHg over 86 +/- 5 mmHg. The measured systolic and diastolic BP at the out-patient clinic were significantly higher than those measured at home. As measured at the outpatient clinic, BP indicated that 7 CAPD patients (35%) were hypertensive (> 160/95 mmHg). However, as measured at home, BP indicated that only 4 CAPD patients (20%) were truly hypertensive (> 135/85 mmHg). We were therefore able to determine that 43% of our hypertensive patients had "white coat" hypertension. Our new telemedicine system that monitors BP by cellular telephone provides great advantages in monitoring BP at home in patients on CAPD.

Adult↗
PubMed1995

Telephone management training in internal medicine residencies: a national survey of program directors.

BACKGROUND: Little is known about how internal medicine residents train for and practice telephone management. To address this deficiency, a national survey of program directors at accredited internal medicine training sites was conducted to evaluate residents' training for and practice of telephone medicine. METHOD: A 43-item questionnaire was mailed in December 1993 to all program directors at the 416 accredited internal medicine training sites in the United States. A limited questionnaire, regarding the most essential training questions, was mailed to all non-responders. RESULTS: The response rate was 60% (250) for the full questionnaire. Only 15 (6%) of the programs offered formal training in telephone management to their residents. This training usually consisted of single lectures (nine programs) or reading materials (seven programs). The respondents felt that formal training in telephone management was very important (155, 62%) and that such training should be a part of every internal medicine curriculum (150, 60%). CONCLUSION: Few internal medicine programs offered training in telephone management. When training occurred, it was usually limited and informal. Most program directors felt that training was important and that current training efforts were unsatisfactory, emphasizing the need for curriculum development and implementation in telephone management.

Humans↗
PubMed1999

Comparison of numerical and experimental methods for determination of SAR and radiation patterns of handheld wireless telephones.

Some recent developments in both the numerical and experimental methods for determination of SARs and radiation patterns of handheld wireless telephones are described, with emphasis on comparison of results using the two methods. For numerical calculations, it was possible to use the Pro-Engineer CAD Files of cellular telephones for a realistic description of the device. Also, we used the expanding grid formulation of the finite-difference time-domain (FDTD) method for finer-resolution representation of the coupled region, including the antenna, and an increasingly coarser representation of the more-distant, less-coupled region. Together with the truncation of the model of the head, this procedure led to a saving of computer memory needed for SAR calculations by a factor of over 20. Automated SAR and radiation pattern measurement systems were used to validate both the calculated 1-g SARs and radiation patterns for several telephones, including some research test samples, using a variety of antennas. Even though widely different peak 1-g SARs were obtained, ranging from 0.13 to 5.41 W/kg, agreement between the calculated and the measured data for these telephones, five each at 835 and 1900 MHz, was excellent and generally within +/-20% (+/-1 dB). An important observation was that for a maximum radiated power of 600 mW at 800/900 MHz, which may be used for telephones using AMPS technology, the peak 1-g SARs can be higher than 1.6 W/kg unless antennas are carefully designed and placed further away from the head.

Adult↗
PubMed2007

Detection of memory impairment in the general population: screening by questionnaire and telephone compared to subsequent face-to-face assessment.

BACKGROUND: Development of efficient methods for identifying subjects with Mild Cognitive Impairment (MCI) from the general population is warranted, because these subjects represent an important group for (epidemiological) research purposes. OBJECTIVES: (1) To describe a two-step population screening for identifying adults with MCI from the general population for research purposes, by questionnaire and telephone; (2) to compare screening by telephone (method 1) to a subsequent face-to-face assessment (method 2). METHODS: In method 1, subjects with memory complaints were identified from the general population (n = 5491) by a postal questionnaire. Subsequently, cognitive status and memory were assessed in a telephone interview using the Telephone Interview for Cognitive Status and the Ten Word Learning Test. Next, subjects with MCI according to method 1 were subjected to a face-to-face assessment for method 2, in which cognitive status and memory were assessed using the Mini Mental State Examination (MMSE) and the Auditory Verbal Learning Test (AVLT). RESULTS: Two hundred and twenty-seven subjects completed both the telephone interview and the face-to-face assessment. Ninety-three subjects (41%) had MCI according to both methods. Seven subjects (3%) failed to meet MCI criteria according to method two because of an MMSE score <24; 127 subjects (56%) failed because of normal AVLT scores. CONCLUSION: (1) The two-step population screening was able to detect a considerable number of MCI-subjects in the general population; (2) agreement between both methods was moderate. Therefore, the method of recruiting subjects for (epidemiological) studies has to be taken into consideration when interpreting results of these studies.

Aged↗
PubMed1992

A computer-based, automated, telephonic system to monitor patient progress in the home setting.

In this report we describe an automated, telephonic system to monitor the progress of patients convalescing at home. The system includes a computerized central station that is capable of automated voice communication over the telephone, using voice reproduction, and touch-tone recognition. Peripheral hardware in multiple monitored homes need include only a touch-tone telephone, but may also be augmented by inexpensive, rudimentary diagnostic aids, such as a scale for body weight, a thermometer, or a blood pressure cuff and manometer. Current central hardware includes a NeXT computer, a fax modem, and a specialized telecommunications modem developed specifically for voice telecommunication using the NeXT. The central station acts like a robotic nurse in that it asks patients a series of questions and records the responses. The subjective questions to be asked are patient individualized and pre-selected by the physician from a question menu including items targeted specifically for the patient's disease or condition. In addition, clinical data such as body weight, blood pressure, and body temperature obtained from in-home diagnostic aids may be transmitted to the central station over the telephone using touch tones. The time-of-day and frequency of calling are pre-selectable, according to the patient's preference and clinical status. Data obtained by the central station can be easily accessed by the duty nurse via menu driven software. Reports depicting significant responses as a function of time are generated in graphical format to facilitate rapid identification of adverse trends. Hard copy reports can be dispersed directly by fax. Results from a pilot study show patients with cardiac disease readily use the system without difficulty or complaints. In one patient a five pound increase in body weight was detected, which prompted the patient's cardiologist to adjust his medication. In this way automated telephone follow-up can provide early detection of complications before they become severe, making the home environment safer and more secure for convalescence and contributing to reduced health-care costs.

Computer Systems↗
PubMed2004

Review of telephone follow-up experience at the Rapid Response Radiotherapy Program.

PURPOSE: To review the feasibility of telephone follow-up following a 3-year experience from 1999 to 2001 at the Rapid Response Radiotherapy Program as a prospective radiotherapy outcome assessment of symptom palliation. METHODS AND MATERIALS: Patients referred for palliative radiotherapy for symptom control from 1999 to 2001 were asked to rate symptom distress using the Edmonton Symptom Assessment System (ESAS) at initial consultation. Patient demographics and analgesic consumption were recorded. Telephone follow-up interviews were conducted with all patients who received radiotherapy during weeks 1, 2, 4, 8, and 12 after radiotherapy using the ESAS and an analgesic diary. Clinic follow-up visits were conducted only if necessary. RESULTS: Between January 1999 and December 2001, 830 patients received palliative radiotherapy. Of these patients, 260 (31.3%) died during the 12-week follow-up period. The percentage of surviving patients responding to the telephone interview ranged from 48.2% (week 12) to 56.6% (week 4) during the 12-week study. CONCLUSION: Telephone follow-up is a feasible tool for prospective outcome assessment of symptom palliation in metastatic cancer patients. Telephone follow-up is recommended for outcome assessment of symptom relief when it can achieve the same purpose as clinic follow-up. Data collection remains a challenge in the palliative patient population. Further studies are required to determine how well other methods of maximizing data collection, such as through the use of caregivers, can provide reliable and accurate information.

Adult↗
PubMed2005

Impact of a telephone counseling intervention on transitions in stage of change and adherence to interval mammography screening (United States).

BACKGROUND: Interventions to improve adherence to regular mammography screening have had conflicting results. Many studies have depended on women's self-report rather than clinical evidence of a mammography encounter. METHODS: We tested the impact of two interventions on a population-based sample of NH women who were not receiving routine mammography to determine if adherence to screening could be improved. The interventions included a mailing of women's health information and a telephone counseling intervention based on the Transtheoretical Model. Participant eligibility and outcome measures were based on clinical events obtained from a population-based mammography registry. RESULTS: Two hundred and fifty eight women completed all aspects of the intervention study. The women were randomly assigned to one of two study groups: 51% received the mail intervention and 49% received the telephone intervention. Among women who received the telephone counseling intervention, 67% percent reported being in either an action or maintenance stage at Call 1, which increased to 84% at Call 2 (p<0.001). Seventy-six percent of women identified barriers to screening mammography at Call 1, which decreased to 44% at Call 2 (p<0.01). The most frequently identified barrier was confusion over the guidelines for screening mammography. At the first assessment time interval, greater than 60% of women were up-to-date for screening mammography in the group that received telephone counseling versus 48% in the group that received health information by mail (p = 0.04). However, women's status as up-to-date fell for both groups between the first and second assessment time intervals. CONCLUSIONS: Tailored telephone counseling based on the Transtheoretical Model can improve adherence to screening mammography, though the duration of this effect is in question.

Adult↗
PubMed1987

Acquisition of generalized telephone use by students with moderate and severe mental retardation.

This study examines the effects of one approach for selecting teaching examples on the development of generalized telephone skills with moderately and severely mentally retarded high school students. Four subjects were taught to make and receive telephone calls within a counterbalanced multiple baseline design. The primary dependent variable was generalization of telephone skills to nontrained telephone situations in home, school, and community settings. Results document the effectiveness and efficiency of the training approach. An eighteen-month validation assessment also shows that telephone use continued as a regular part of each student's lifestyle. The instructional implications of these results are discussed as well as methodological implications for applied research on generalization.

Activities of Daily Living↗
PubMed1996

[Telephonic advice by an emergency department given in a simulated pediatric case].

BACKGROUND: Emergency departments (ED) are requested everyday to dispense medical telephone advice for children. To evaluate the quality of telephone management, a mock scenario simulating a febrile 4 month-old-girl with signs compatible with septicemia was used. METHODS: One hundred randomly selected French emergency departments were called on. Half of the hospitals had a pediatric department with more than 20 beds; the other half did not have a pediatric department. A research technician called and said: "My baby has got fever and I do not know what to do". Additional information was given only on request. RESULTS: Ninety-four ED gave medical advice by telephone: 65% of the cases by a physician, 24.5% by a nurse, 9.5% by a nurse technician and 1% by a secretary. In hospitals without a pediatric department, physicians took calls in 76.5% of the cases, whereas in hospitals with a pediatric department they only took calls in 53% of the cases. The mean number of questions asked per ED was 3.1. The age of the child was requested by 87.2% of the respondents. Advice was given by 36.1% of the ED without asking either the age of the patient or grade of the fever. The advice given by the respondents was: come to the ED immediately (30.9%), see a community physician immediately (51%), come to the ED tomorrow (2.1%), see a community physician tomorrow (8.5%), and manage at home (7.5%). CONCLUSIONS: This study has shown important inadequacies in pediatric telephone advice given by some ED. It suggests that the respondents do not use a protocol to handle the calls; development of such protocols to guide the histories taken and advice given for the most common telephone queries is urged.

Attitude of Health Personnel↗
PubMed1994

Relative validity of multiple telephone versus face-to-face 24-hour dietary recalls.

The relative validity of multiple telephone 24-hour dietary recalls was evaluated in a feasibility study within the framework of a large prospective investigation on the cause of chronic disease in women. Forty-nine women were interviewed four times both face-to-face and by telephone. Comparison of the total number of calories and intake of protein, carbohydrate, total and saturated fats, cholesterol, fiber, sodium, potassium, calcium, vitamin A, and vitamin C as estimated by multiple face-to-face and telephone interviews revealed an acceptable relative validity for the telephone procedure. Analysis of the position variation in the distribution (percent agreement) comparing the two procedures showed that a change in the distribution of none or one quintile occurs in more than 70% of individuals for all nutrients but vitamin C (69.4%), cholesterol (61.2%), and vitamin A (51.4%). Correlation coefficient analysis showed similar results. Adjustment for nutrient densities did not affect the overall results. Multiple 24-hour telephone dietary recalls appear to be a valid alternative to face-to-face interviews in population studies.

Adult↗
PubMed2006

Inter-disciplinary focus groups on telephone medicine: a quality improvement initiative.

OBJECTIVE: To identify opportunities for quality improvement in long-term care telephone medicine using a model of interdisciplinary focus groups. DESIGN: Descriptive pilot project. SETTING: Extended Care and Rehabilitation Center (ECRC), Durham VA Medical Center, Durham, North Carolina. PARTICIPANTS: Eight of 20 registered or licensed practical nurses and 4 of 6 geriatric medicine fellows voluntarily participated in this quality improvement project. MEASUREMENTS: In two 45-minute focus groups, participants were asked to discuss 3 open-ended questions related to telephone medicine. Comments were recorded during the discussions; topical themes were identified by the authors. RESULTS: Participant comments could be categorized into 4 domains describing the characteristics of nurses and physicians who practice the best telephone medicine: (1) provides the appropriate medical component of patient care; (2) appreciates contextual issues; (3) respects the other party's time and resources; and (4) possesses a collaborative attitude. The focus groups identified 5 quality improvement goals: (1) better nursing assessment and provision of patient information; (2) minimization of non-urgent calls after hours; (3) more decisive physician action (or explanation of inaction); (4) better physician familiarity with facility policies/logistics; and (5) better communication/paging system. The discussion format allowed nurses and physicians to identify and respond to potential barriers to improving quality in each area. CONCLUSION: Nurses and physicians appreciate unique aspects of long-term care telephone medicine and identify distinct barriers to improving practice. Interdisciplinary focus groups were a productive step toward understanding the telephone medicine experience in our facility and developing quality improvement interventions for both nurses and physicians.

After-Hours Care↗
PubMed1998

Telephone vs face-to-face interviews for quantitative food frequency assessment.

OBJECTIVE: To develop and test a quantitative food frequency method for administration by telephone. DESIGN: A comparison study of telephone and face-to-face interviews was conducted among a representative sample of the five major ethnic groups in Oahu, Hawaii. Two interviews were administered 4 to 6 months apart by trained interviewers using identical questionnaires and color photographs of food items showing three different portion sizes. The order of the interviewing methods was randomly assigned. The questionnaire included 115 food items selected to estimate 80% or more of usual dietary intakes. Frequencies and quantities of each item consumed during the past year were obtained. SUBJECTS/SETTING: Subjects were recruited from the Health Surveillance Program of the Hawaii State Department of Health and consisted of 167 men and 158 women, aged 45 to 74 years, who provided a telephone number. Eighty percent of the face-to-face interviews were conducted in the subjects' homes and 20% were conducted at the workplace or the University of Hawaii Cancer Research Center, if requested. STATISTICAL ANALYSES: The paired t test was used to compare the mean daily intakes obtained by the telephone and face-to-face methods. Agreement was measured by the intraclass correlation coefficient (ICC), Pearson correlation coefficient and weighted kappa statistic. RESULTS: The means of energy and each nutrient were slightly higher in the first interview than the second, regardless of the interviewing method. Because of close correspondence among all 3 statistical measures of agreement, only the ICCs are reported. The ICCs ranged from .61 for protein and vitamin A to .69 for dietary cholesterol among men, and from .61 for vitamin C to .74 for saturated fat among women. Agreement was not significantly affected by age, gender, ethnicity, order of interview, or educational level. APPLICATIONS: Telephone interviews to obtain quantitative food frequencies are cost-efficient methods for estimating usual dietary intakes among persons in widely scattered geographic areas. Photographs of the foods in 3 portion sizes mailed in advance help the respondents estimate amounts eaten.

Aged↗
PubMed1996

Intermodal agreement of follow-up telephone functional assessment using the Functional Independence Measure in patients with stroke.

OBJECTIVE: To examine the intermodal agreement of Functional Independence Measure (FIM) ratings when obtained by two commonly used approaches: telephone interview and in-person assessment of functional performance. DESIGN: A random sample of 40 persons with hemiparesis was tested by two registered nurses trained in FIM definitions and telephone interview techniques. The two assessments occurred within 5 days of each other. The raters were blind to previous assessments. The administration of assessments was alternated to minimize bias and order effects. SETTING: All subjects were assessed at home, between 3 and 10 months after discharge from rehabilitation. PATIENTS: The criteria for inclusion were: (1) diagnosis of cerebral vascular accident (CVA); (2) completion of a minimum of 2 weeks in an acute rehabilitation program; (3) currently living at home; (4) living within a 30-mile radius of the hospital; and (5) cognitive and verbal skills adequate to complete a telephone interview. From a population of 103 patients, 40 subjects were randomly selected, 18 women and 22 men ranging in age from 37 to 90 years. MAIN OUTCOME MEASURES: The intermodal agreement between FIM ratings obtained by telephone interview and in-person assessment was examined using the intraclass correlation (ICC). FIM item scores were analyzed for agreement using the Kappa coefficient. The stability of the responses was determined by computing the coefficient of variation and plotting the data to visually examine the relationship between the two methods of administration. RESULTS: Data analysis revealed that there was no statistically significant difference (p > .05) between the two methods of administration for total FIM score. The total FIM ICC was .97. ICC values for FIM subscales ranged from .85 to .98, except for social cognition. Kappa scores for noncognitive items ranged from .49 (bowel movement) to .93 (grooming). The coefficient of variation computed to examine cognitive and communication items with reduced variability indicated good stability across all items. CONCLUSION: The results indicated good intermodal agreement for follow-up telephone assessment using the Functional Independence Measure. The findings were limited to persons with effective communication skills.

Activities of Daily Living↗
PubMed2003

Diagnosing major depression in medical outpatients: acceptability of telephone interviews.

OBJECTIVE: To assess the acceptability to patients of a diagnostic interview for depression (Structured Clinical Interview for DSM-IV; SCID) conducted over the telephone to their homes. METHOD: Postal questionnaire survey of patients who had attended an oncology outpatient clinic where they had scored high on a screening questionnaire and had subsequently undergone an SCID interview over the telephone. RESULTS: Of the 224 patients telephoned, five refused the diagnostic interview. Of the 219 who were interviewed, 184 satisfactorily completed and returned the postal questionnaire (84% response rate). Only 17% reported the interview to be distressing. Ninety-four percent of all questionnaire respondents and 84% (n=31) of those who reported the interview to have been distressing endorsed the item "Had I known in advance what answering the questions would have been like for me, I would still have agreed to take part". Perceiving the interview as distressing was associated with having major depression (P<.001). Forty-seven percent said that, given the choice, they would have preferred a face-to-face interview. CONCLUSION: Telephone-administered diagnostic interviews are acceptable to most cancer patients and may even be preferred to face-to-face interviews at the hospital. This finding, together with the existing evidence of its validity, should encourage the use of telephone diagnostic interviews for depression, particularly when face-to-face interviews are impracticable, in both research studies and clinical practice. Indeed, a substantial proportion of patients may actually prefer them.

Depressive Disorder↗
PubMed2000

After-hours telephone calls to obstetrician-gynecologists.

OBJECTIVE: To characterize the pattern, content, and management of after-hours telephone interactions between obstetrician-gynecologists and patients. METHODS: In a prospective observational study, 12 resident and nine private physicians practicing obstetrics and gynecology completed data cards for after-hours telephone interactions with patients. Chief complaints were categorized as related to either women's health or primary care and on whether women were pregnant, postpartum, or not pregnant. Triage dispositions (evaluate now, office follow-up, or home care) were compared between groups. Women also were asked what they would have done if they had been unable to contact their physicians by telephone. RESULTS: One hundred ninety-two of 276 calls evaluated (69. 6%) were from pregnant women, 20 (7.2%) were from postpartum women, and 64 (23.3%) were from nonpregnant women. Calls were related to primary care health issues in 24.1% (n = 45) of pregnant women, 40% (n = 8) of postpartum women, and 28.1% (n = 18) of nonpregnant women. There were no differences between residents and private physicians in the proportion of women triaged to immediate evaluation for pregnancy (35.1% [n = 40] versus 41.9% [n = 31], P =.74) or postpartum (11.1% [n = 1] versus 10% [n = 1],P =.96) problems. Among 139 women triaged to office follow-up, 41% (n = 57) would have come to the hospital for emergency evaluation if they had been unable to reach their physicians. CONCLUSION: Resident and private obstetrician-gynecologists provide primary care and women's health care advice during after-hours telephone calls from patients. More than one third of after-hours telephone calls from pregnant women are triaged to immediate evaluation.

Adult↗
PubMedDate not supplied

[Telephone versus face-to-face household interviews in the assessment of health behaviors and preventive practices].

OBJECTIVE: This study examines the influence of the interview method (telephone or face-to-face in households) on the assessment of health behaviors and preventive practices. MATERIAL AND METHOD: The same questionnaire was completed by two independent samples of the population aged 18-64 years living in the municipality of Madrid. One sample (n = 1,391 subjects) completed the questionnaire by telephone interview and the other (n = 739) by face-to-face interview in households. The results of the two samples for 28 variables related to anthropometry, physical activity, food consumption, tobacco and alcohol use, preventive practices and injuries were compared. RESULTS: The telephone sample had a higher rate of failed contact (31.8% vs. 22.2%) but a greater degree of cooperation than the sample for the face-to-face interview (83.0% vs. 74.0%). In total, 19 of the 28 variables showed a relative variation of less than 10% between the two surveys; the differences found were between 10 and 20% for eight variables and were higher than 20% for one variable. Differences were statistically significant for only four variables (sedentary leisure time, consumption of vegetables, giving up smoking and cholesterol measurement), with a relative variation of 6.1% (p < 0.01), 10% (p < 0.001), 36.7% (p < 0.01) and 8.6% (p < 0.01), respectively. The total cost of the telephone interview was half that of the face-to-face household interview. CONCLUSIONS: The results of both surveys were very similar. Because of its lower cost, the telephone interview is a good option in public health research when data collection by interview is required.

Adolescent↗
PubMedDate not supplied

[Estimation of the use of seat belts: an observational study and a telephone survey].

OBJECTIVE: To estimate the prevalence of safety-belt use in a telephone survey and an observational survey. PATIENTS AND METHODS: Observational survey. Trained interviewers studied 4,067 front-seat occupants, at ten intersections of Madrid, according to "National Highway Traffic Safety Administration" guidelines. TELEPHONE SURVEY: We selected 433 front seat occupants from the Madrid city residential telephone directory. The questionnaire was completed by trained interviewers. RESULTS: Prevalence by the observational survey was 58.5%, and was significantly higher at interurban intersections (OR = 2.1) than city intersections. In the telephone survey, the overall prevalence was 94% at interurban area and 64% at city area and it was associated with no history of lines and positive opinion of effectiveness of safety belts. CONCLUSIONS: The safety belt prevalence observed is low, especially in the urban area. The telephone survey overestimates the safety belt use, but contributes with useful information for planning strategies.

Adult↗