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PubMedDate not supplied

Comparison of three inducement techniques to improve compliance in a health survey conducted by telephone.

The use of telephone interviews for epidemiologic and public health studies has increased in recent years. Since telephone surveys are susceptible to lower response rates than personal interviews, several attempts have been reported to increase respondents' compliance using various precontact procedures. This investigation evaluates the comparative effectiveness of three techniques to enhance compliance with a relatively long telephone interview on epidemiologic topics. The theoretical and practical applications in the domain of telephone surveys of two techniques, the foot-in-the-door and the low ball, commonly considered nonpressure techniques, are discussed. A newly suggested, combined compliance procedure is also introduced and tested. Results show that compliance was greater for the new method when compared with each of the other two methods. Moreover, each of the three methods outperformed a control condition. The theoretical models developed to devise and explain the new techniques received empirical support in a public health survey employing 335 adult residents of Tel Aviv, Israel, in May 1988.

Adult↗
PubMed1990

Dietary assessment in children using electronic methods: telephones and tape recorders.

Selection of dietary assessment methodology is important in dietary intervention studies. Few studies have reported the relative merits of various assessment methods or the feasibility of electronic methods in pediatric populations. Parent-child dyads performed telephone recalls (no. = 32) and tape recorded dietary records (no. = 33). Traditional recalls were first conducted to familiarize parents and children with the telephone recall procedure, to introduce two-dimensional food models, and to instruct on the use of the tape recorder. Parents monitored and documented as unobtrusively as possible the child's intake on the day before the telephone recall and also on the day of the taped record. Children were called at random to reduce bias. Simple correlation coefficients (r) were calculated for nine nutrients and calories for both methods. For telephone recalls, values ranged from a low of r = .64 for saturated and polyunsaturated fat to r = .85 for cholesterol and r = .93 for iron. Tape-recorded data yielded r = .80 or above, except calories with r = .68 (p less than .001 for all values, 1-tail tests). Mean nutrient values were within expected ranges, e.g., 1,800 kcal +/- 500, with saturated fat about 14% of calories per day. Comparisons between parents and childrens reports of food frequencies and portion sizes revealed the best correlations for beverages, bread-cereals-crackers, meat-fish-poultry, and mixed dishes. We conclude that preadolescent children are able to provide dietary intake data using electronic methods in a manner that compares favorably with their parents' written records.

Child↗
PubMed1990

Use of telephone interviewing in health care research.

Increasingly, telephone interviewing has become the data collection procedure of choice in large-scale health services research surveys. Previous analyses indicate that excluding nontelephone households does not seriously affect most national parameter estimates, such as yearly estimates of number of ambulatory visits, mainly because the proportion of households without telephones is small. Moreover, if the exclusion of nontelephone households simply underestimates the proportions in the population with certain characteristics, such as age and ethnicity, and the "true" proportions are known, it is possible to appropriately weight the study group in order to mitigate the telephone-exclusion bias. However, regression analyses undertaken on three years of national Health Interview Surveys indicate, at least on some key measures such as having health insurance, that persons living in households with and without telephones represent different populations, and parameter estimates are distorted by excluding nontelephone households. Under these circumstances, it is not possible to adjust parameter estimates to take into account nontelephone households.

Ambulatory Care↗
PubMed1990

[Telephone consultations with the pediatrician on-call].

Prospective registration of telephone consultations with the paediatrician-on-call during a period of four months was undertaken. Telephone records were made for this purpose and 256 consultations were registered. In 39% of these consultations, the contact was with a doctor who desired advice about a definite patient. In 36%, the persons making the contact were parents of children attending the paediatric outpatient clinic. 20% of the contacts were from parents of acutely ill children and were without connection with the paediatric department. In 37% of the consultations therapeutic advice was given. The paediatrician-on-call appears to have a function as an emergency telephonic consultant for the primary and secondary health sectors and as the doctor-on-call. Establishing of telephone records in paediatric departments is recommended.

Child↗
PubMed1989

Telephone management curriculum for pediatric interns: a controlled trial.

The purpose of this study was to evaluate the effect of a role-play telephone management curriculum on history taking and management skills. The study was a nonrandomized controlled trial carried out in the outpatient department of a primary care pediatric residency training program. Six PL-I residents (treatment group) participated in a role play curriculum during their first month of rotation through the outpatient department; seven PL-I residents (control group) received no formal instruction in telephone management. Baseline performance was measured on entry into the study using telephone calls made by a "simulated" mother using standardized scripts. Follow-up calls were made approximately 3 months later. Transcripts of these calls were rated by examiners who were unaware of group assignment using a standardized instrument that measured three aspects of performance: general history taking, specific history taking, and general management. Results were as follows: Mean posttest scores for the combined groups were: 59.4% (general history taking), 75.9% (specific history taking), and 77.7% (general management). By analysis of covariance, treatment group residents had significantly higher posttest scores in general history taking than control group residents (67.1% v 53.6%, P = .004). This difference occurred without a significant increase in the time spent answering the call. These data indicate that a role play curriculum results in improved performance in at least one aspect of telephone management.

Analysis of Variance↗
PubMedDate not supplied

Nursing care by telephone: describing practice in an ambulatory oncology center.

Ambulatory oncology nursing care focuses on providing patients and families with the knowledge and resources needed to manage the symptoms of disease and the side effects of treatment. Nurses practicing in ambulatory care settings have limited face-to-face interaction with patients and families. As a result, telephone contact is used to give information, provide encouragement, and assess the patient's condition. To develop and test methods of delivering care to oncology patients by telephone, current practices must be documented. This study describes the use of the telephone in ambulatory oncology nursing in one patient care setting. Over a six-month period, nurses reported on 1,844 patient calls. Data collected on these telephone calls included: duration, initiator, purpose, nurse's assessment of urgency level, impact on the nursing care plan, and changes made in the use of healthcare services. The Outcome Standards for Cancer Nursing Practice of The American Nurses' Association and the Oncology Nursing Society most frequently addressed during the calls were information, comfort, and coping. Nurses in this setting functioned independently, handling 91% of the calls they received and using consultation for 52% of the calls.

Adaptation, Psychological↗
PubMedDate not supplied

Very low birth-weight infants: parental visiting and telephoning during initial infant hospitalization.

The purposes of this study were to examine visiting and telephoning patterns of families of very low birth-weight (VLBW) infants during their initial hospitalization and to identify factors related to visiting and telephoning. The sample of 65 VLBW infants (less than or equal to 1,500 gm) and their families was followed for 6 weeks in the special care nurseries. Mothers were the primary visitors, with the typical mother visiting the nursery twice per week. Fathers and other family members made most of their visits in the first few weeks with minimal involvement thereafter. During a typical week the number of telephone calls to the nursery from mothers ranged from one to three. Fathers and other family members made minimal calls. Significantly fewer visits were made by families in which the mother was unmarried, the mother was younger, Medicaid was the type of insurance, annual income was less than $10,000, and private transportation was unavailable. There were no significant relationships between total number of telephone calls made and maternal demographic variables.

Adolescent↗
PubMed1988

Vaccination of high-risk patients for influenza. A comparison of telephone and mail reminder methods.

During the 1984-1985 influenza season two study groups were used to compare telephone and letter reminder methods with a control group that received no reminder to determine which was the most effective strategy to increase influenza vaccination rates among the high-risk patient population of a university-based family practice. Seven hundred eighty-seven high-risk patients were randomly assigned to one of the three study groups: a mailed-reminder group, a telephone-reminder group, and a control group. Vaccination rates for both reminder methods were significantly higher than for the control group (P less than .02), and if successfully contacted, the telephone-reminder group had a significantly better vaccination rate than the mailed-reminder group (P less than .05). If successful telephone contact can be made, this reminder method is more effective than a letter reminder to increase influenza vaccination rates among high-risk patients.

Canada↗
PubMed1987

The telephone management of gastroenteritis by family medicine residents.

In order to describe the telephone management of gastroenteritis by family practice residents, audiotapes and transcripts of telephone calls by 31 family practice residents were analysed with respect to clinical content, temporal patterns, and physicians' utterance form. The study hypothesis were that year 3 residents would have shorter calls, take more complete histories, and score better on other performance measures than year 1 residents, but no significant differences were demonstrated in the study. The mean duration of telephone calls was 4.6 minutes. Residents talked three times longer than the caller. History taking completeness was highly correlated with telephone call duration and particularly with time spent talking by the caller. Significant questions, such as asking about hydration status, were frequently omitted. Most questions were closed (84 percent). Time spent talking by the caller was longer, and more listener feedback was given, with year 1 than with year 3 residents.

Child, Preschool↗
PubMedDate not supplied

Cancer counseling by telephone help-line: the UCLA Psychosocial Cancer Counseling Line.

This paper describes the Psychosocial Cancer Counseling Line (PCCL) of the University of California at Los Angeles, a National Cancer Institute-supported communications project in which the feasibility of providing psychological support to cancer patients and their significant others by telephone has been explored. Staffed by a combination of professional and paraprofessional volunteer counselors, the PCCL provides (a) direct telephone counseling to cancer patients, their families, and their friends; (b) referrals, when necessary, to community resources relevant to the psychosocial needs of callers; and (c) telephone consultation and information to health professionals. Call-record data reveal that the service is used mainly by family and friends of patients (45 percent of callers) and by patients themselves (23 percent), who represent a wide range of cancer diagnoses. Demographically, the modal caller is a well-educated, white, non-Hispanic woman in her thirties. Among the many different psychosocial concerns presented by callers, the most frequently discussed issues are requests for referral to a support group, anxiety associated with the disease or its treatment, family problems engendered or exacerbated by illness, and difficulties in doctor-patient communications. On the basis of the PCCL experience, the author argues that a telephone counseling service can perform important functions within the broad spectrum of psychosocial services needed by cancer patients and their families. These functions include provision of information, needs assessment, linkage to health professionals, psychological interventions during intervals between in-person contacts, provision of continuing emotional support not available elsewhere, and outreach to psychologically underserved populations.

Adult↗
PubMed1985

Telephone surveying for drug abuse: methodological issues and an application.

In light of New York State's experience, it is probable that future household drug use surveys will use telephone administration. Drug use questions are not as sensitive as had been thought, and are easily administered by telephone. In addition, the lower costs, the computer-assisted capabilities, and the saving in time are some of the advantages in comparison to face-to-face surveying. In order to address the nontelephone segments of the household population--despite their declining proportion--and to improve response rates, mixed-mode interviewing may have to be considered. Given a better understanding of telephone-associated behavior and the increasing popularity of technological advances, such as the portability and mobility of phones, telephone surveying may become even more attractive in the future.

Cross-Sectional Studies↗
PubMed1986

Inductive coupling of hearing aids and telephone receivers.

The present investigation sought to determine the effects of hearing loss, signal level, telephone receiver type, and telecoil location on the aided word-discrimination abilities of hearing impaired subjects using electromagnetic coupling of their hearing aids to the telephone. As expected, significant deterioration in discrimination scores was observed with increasing hearing loss. In addition, significant improvement in discrimination scores was observed, for all subject groups, as the signal level increased from 80 dB SPL to 105 dB SPL. Of the four receiver conditions, the U1 and BARC receivers resulted in the best discrimination scores. Also, the results suggest that the U1 and BARC receivers are indeed equivalent in terms of word discrimination scores. Finally, the telecoil location in individual hearing aids appeared to have little influence on the speech discrimination capabilities of the subjects in this study. However caution must be used in interpreting that result, since subjects were allowed to adjust the telephone handset position to maximize the signal level in any given condition. This occasionally resulted in inappropriate handset locations for conventional telephone use.

Activities of Daily Living↗
PubMed1979

Controlled clinical trial of pediatric telephone protocols.

A randomized clinical trial of pediatric protocols administered by health assistants demonstrated an alternate method of handling telephone complaints in a large emergency room. The new system advised a higher medical examination rate than the current system in the emergency room probably bacause the current system has deficits with respect to collecting necessary information and making explicit decisions. This higher rate of recommended visits demonstrated in the emergency room was not confirmed in the two pediatric primary-care settings in which the protocol system was also tested. In addition to this use, the telephone protocols may also be useful in training medical and nursing students, in handling telephone complaints similar to a poison control center, in triaging problems in a rural or emergency medical service, and in providing a record of the telephone call.

Age Factors↗
PubMed1984

Telephone communication system for handicapped individuals.

Simple low-cost telephone systems for independent use by individuals with limited upper extremity function are described. The systems can be easily assembled from readily available telephone components. Communication is accomplished through a telephone amplifier and uses operator-assisted dialing. Use requires the manipulation of only two switches. One switch connects the amplifier to the phone line; the other dials the operator. "Dial (0)" telephone systems, costing less than $100, are readily affordable for many handicapped individuals.

Communication Devices for People with Disabilities↗
PubMed1980

Sexually transmitted diseases: health education by telephone.

In Rotterdam an experiment was recently conducted using an automatic telephone answering service to provide information about sexually transmitted diseases (STD) and treatment. The answering service was started in September 1976 and was advertised in the "Clubs" column of two daily newspapers, three times a week, for 15 weeks. Readers of advertisements of sex clubs were the target group and the objectives were (1) to bring to their notice a special telephone number for information on STD, and (2) to urge them to report to an STD outpatient clinic if they thought they needed treatment. During the 15-week intervention there were 72,536 calls, i.e. about 700 calls per day and three and a half years after termination of the advertisements there are still about 500 calls per week. In addition, during the intervention about 100 subjects called a special telephone number (manned by a trained nurse) for additional information. New visitors reporting to the STD clinic during the September-December intervention increased by at least 11% and furthermore there was a considerable increase (about 50%) in the number of cultures for gonococci sent to the laboratory. However, the percentage of negative examination results was nearly the same during that period and similar periods of time during preceding years--which proves that the campaign did not provoke a rush of predominantly worried people to the STD clinic and/or to general practitioners and specialists. Based on these results it is suggested that the automatic telephone answering service, which apparently meets a need, be incorporated with the other forms of education on sexually transmitted diseases.

Adolescent↗
PubMed1982

Comparative evaluation of clinical pharmacists and physicians in the management of medication-related telephone calls in family practice offices.

A comparative evaluation of clinical pharmacists and physicians in the management of medication-related telephone calls in family practice offices is described. A peer review panel, composed of two family practice physicians and two clinical pharmacists not involved in the study, evaluated the appropriateness of management in 102 medication-related telephone calls. The effects of the following variables on the management ratings were determined by analysis of variance: (1) provider group (staff physicians, family practice residents, clinical pharmacists); (2) caller (patient, community pharmacist, third party, e.g., family member or friend); (3) type of medication-related telephone call (refill, new medication, drug information, or other); (4) consultation with another provider; and (5) recommendation for follow-up. Among the provider groups, a larger proportion of the calls to clinical pharmacists (72.6%) received the highest management rating of "appropriate, best alternative available" compared with staff physicians (39.7%) and residents (34.6%). Analysis of variance indicated that the management by clinical pharmacists was rated significantly more favorably than management by staff physicians or residents (p less than 0.05).] Statistical analyses also indicated that the differences in the management ratings among the provider groups were not explained by differences in the callers, type of medication-related call, consultation with another provider, or recommendation for a follow-up. These data suggest that clinical pharmacists may contribute substantially to improved patient-care through the management of medication-related telephone calls.

Community Pharmacy Services↗
PubMed1980

A study of telephone prescriptions in family practice.

Telephone prescriptions are a unique aspect of North American medicine which has received relatively little attention. This paper examines certain behaviors of the physician and the patient with respect to prescriptions in the office and over the telephone. The results indicate that patients receiving prescriptions over the telephone are demographically distinct, tend to receive large amounts of psychotropic drugs, and are more likely to be seen by their physicians as "problem patients." Suggestions are made to help identify the habitual telephone prescription patient to allow the physician to review the need for the medication and the status of the physician-patient relationship.

Adult↗
PubMed1995

Follow up of patients after valvular surgery: mail vs. telephone.

A study was undertaken to compare the results of patient follow up done by mail and by telephone. Using valve follow up questionnaires recently received by mail, 100 patients were randomly selected from this group for further follow up by telephone. Interviews were conducted while blinded to the mail response. Patients were questioned as to their functional status (NYHA), improvement as a result of surgery (IMP), incidence of reoperation (REOP) or bacterial endocarditis (SBE) and thromboembolic complications (TE). They were also asked whether they would prefer future follow up by mail or telephone. Analysis using the kappa coefficient and McNemar's test revealed a difference (p < 0.001) in NYHA when comparing mail and telephone responses but no difference in either IMP or TE. There was no incidence of REOP or SBE. Sixty-six percent of patients had no preference in type of future follow up and of the remaining 33%, two-thirds preferred to be contacted by phone. It appears that NYHA is significantly overestimated by the patient whereas the two methods of follow up are comparable when assessing IMP and TE. It should be noted, however, that patients seem to have difficulty in identifying the occurrence of TE and in differentiating between stroke and TIA.

Activities of Daily Living↗