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PubMed2006

Effect of telephone reminder/recall on adolescent immunization and preventive visits: results from a randomized clinical trial.

OBJECTIVE: To measure the effect of telephone-based reminder/recall on immunization and well-child care (WCC) visit rates among adolescents in urban practices. DESIGN: Randomized clinical trial of telephone-based reminder/recall over 18 months. SETTING: Four urban primary care practices. PARTICIPANTS: Adolescents aged 11 to 14 years.Intervention Adolescents within practices were randomized to study (n = 1496) or control groups (n = 1510). The study group was sent audiotaped telephone reminders about a scheduled or needed immunization or WCC visit. Households were called weekly if there was no response; telephone numbers were updated weekly. Controls received standard care. RESULTS: Baseline demographics and immunization and WCC visit rates were similar for study and control groups. The intervention was largely ineffective in improving immunization or WCC visit rates. Although at the end of the study, the study group had slightly higher hepatitis B coverage (3 vaccinations) (62% vs 57.8%; P = .02), WCC visits were the same (53% and 54%), and impact on other vaccinations was minimal. The effect of reminder/recall was equivalent across demographic subgroups (e.g., age, race/ethnicity, insurance). The major factor limiting intervention effectiveness was inaccurate telephone numbers. Seventy-one percent of study subjects with single telephone numbers throughout the study had a WCC visit vs 25% of study subjects with multiple/changed telephone numbers and 54% of controls (P<.001). CONCLUSIONS: An intensive telephone reminder and recall system was only minimally successful in improving immunization and WCC visit rates among urban adolescents. Lack of success was largely owing to changed or inaccurate telephone numbers.

Adolescent↗

PubMed2006

The telephone interview is an effective method of data collection in clinical nursing research: a discussion paper.

There are varying points of view regarding the advisability and utility of using the telephone to conduct research interviews. When undertaking the Women's Recovery from Sternotomy Study, we found the telephone was an effective mechanism for data collection. Our aim is to identify the advantages and challenges of using the telephone as a mechanism for data collection in clinical nursing research. The potential benefits associated with using telephone interviews as a mechanism of data collection include (a) using economic and human resources efficiently, (b) minimizing disadvantages associated with in-person interviewing, (c) developing positive relationships between researchers and participants, and (d) improving quality of data collection. The potential challenges to telephone interviewing include (a) maintaining participant involvement, (b) maintaining clear communication, (c) communicating with participants who offer extraneous information, (d) encountering participants with health concerns, and (e) communicating with a third party. Telephone interviewing can be an effective method of data collection when interviewers understand the potential benefits as well as challenges. We offer solutions to the identified challenges and make pragmatic recommendations to enhance researcher success based on the current literature and our research practice. Supportive training for interviewers, effective communication between interviewers and with research participants, and standardized telephone follow-up procedures are needed to ensure successful telephone data collection. We have found our 'Manual of Operations' to be an effective tool that assists research assistants to meet the requirements for successful telephone interviewing.

Canada↗

PubMedDate not supplied

Comparison between telephone and self-administration of Short Form Health Survey Questionnaire (SF-36).

OBJECTIVE: The characteristics of the 36 item Medical Outcome Short Form Health Study Survey (SF-36) questionnaire, designed as a generic indicator of health status for the general population, allow it to be self-administered or used in personal or telephone interviews. The main objective of the study was to compare the telephone and self-administered modes of SF-36 for a population from Girona (Spain). METHODS: A randomized crossover administration of the questionnaire design was used in a cardiovascular risk factor survey. Of 385 people invited to participate in the survey, 351 agreed to do so and were randomly assigned to two orders of administration (i.e., telephone-self and self-telephone); 261 completed both questionnaires. Scores were compared between administration modes using a paired t test. Internal consistency and agreement between modalities were analyzed by respectively applying Chronbach's alpha and intraclass correlation coefficients. The effect of the order of administration on the test-retest difference was analyzed by one-way ANOVA for repeated measurements. RESULTS: Physical function, physical role and social functioning received significantly lower scores when the self-administered questionnaire was used prior to the telephone survey. When the initial survey was conducted by telephone, all Chronbach's alpha coefficients (except social functioning) scored over 0.70 in the self-administered modality. The intraclass correlation coefficient ranged from 0.41 to 0.83 for the telephone-self order and from 0.32 to 0.73 for the self-telephone order. No clinically significant effect was observed for the order of application. CONCLUSIONS: The results of the present study suggest that the telephone-administration mode of SF-36 is equivalent to and as valid as the self-administered mode.

Adult↗

PubMed2004

Assessing mental health in primary care research using standardized scales: can it be carried out over the telephone?

BACKGROUND: Telephone interviewing has economic and logistical advantages but has not been widely used in the UK. Most studies comparing face-to-face and telephone psychiatric assessment have been carried out in the US, often restricted to a population with known psychiatric disorder and involving comparisons between two separate sample groups rather than repeat interviews with the same group. The aim of the present study was to compare face-to-face and telephone administration of the 12-item General Health Questionnaire and the Revised Clinical Interview Schedule in a UK general practice sample. METHOD: Ninety-eight consecutive attenders at two general practices were assessed twice within 48 h. The order of face-to-face and telephone interviews was alternated. RESULTS: There was no evidence that the mode of administration led to a bias in scores on the CIS-R. For the GHQ, those aged over 60 tended to score higher on the telephone. There was good agreement between face-to-face and telephone scores for both GHQ and CIS-R and good agreement for case definition. Participants had a strong preference for face-to-face interviews. CONCLUSIONS: Telephone assessment of mental health using the GHQ and CIS-R is a reasonable method to be used in primary care research in the UK with the limitation that telephone responses from older people might be different from face-to-face assessments for the GHQ. However, telephone interviewing appeared less acceptable and should probably be used in the context of established or ongoing personal contact between researcher and subject.

Adolescent↗

PubMed2004

An investigation of telephone use among cochlear implant recipients.

The purpose of this study was to examine telephone use among cochlear implant recipients. A questionnaire was constructed and mailed to 803 adults who received a Clarion cochlear implant system manufactured by Advanced Bionics Corporation. Questionnaire recipients were implanted at least 12 months prior to receiving the questionnaire (i.e., they were implanted in 1998 or 1999). Approximately 60% (n = 478) responded, of whom 70% (n = 336) were considered "telephone users" (i.e., they answered the telephone and/or initiated calls). Telephone users were significantly younger and had significantly more daily hours of cochlear implant use than nonusers. Not surprisingly, there were differences between groups with respect to method of communication (i.e., more users employed oral communication, while more nonusers employed both oral and manual communication) and ability to understand words without lipreading (i.e., more users were able to understand). Thirty-seven percent of the telephone users were male, and 63% were female. The average age was 51.8 years (SD = 15.5). Ninety-five percent of users initiated calls to family and friends, 65% made appointments by phone, and approximately 50% asked for information about a product or service and conducted business over the phone. Over 95% of users could identify a dial tone, a busy signal, and voices. The average telephone use per week was 5.4 hr. Approximately 85% indicated that they were able to interact with strangers on the telephone within 5 months of receiving the sound processor. Approximately 30% communicated via a cellular phone for personal use. The findings of this survey suggest an increase in cochlear implant users' telephone use relative to a decade earlier. Advances in cochlear implant and telephone technologies are 2 of several factors that may contribute to the changes observed.

Adult↗

PubMed1999

Hearing ability by telephone of patients with cochlear implants.

We investigated the telephone communication ability of patients with cochlear implants who could understand conversations in natural voice without difficulty. The hearing ability of those patients with telephone adapters, which usually are used to reduce noise level in the telephone and to record into a tape recorder, was also investigated. Vowel-confusion, consonant-confusion, and speech-tracking test results of patients listening to voices by telephone and by telephone adapter were compared with those of patients listening to natural, nontelephone voices. The average score of the speech-tracking test with natural voice was 111.5 phrases per 5 minutes. This score dropped to 62.4 by telephone. However, with a telephone adapter, the score of the speech-tracking test was 109.3 phrases per 5 minutes. This was almost the same score as that of the natural voice. So, generally speaking, the telephone communication ability of cochlear implant patients was not good enough. However, hearing ability with a telephone adapter came close to hearing ability during natural speech.

Cochlear Implants↗

PubMed2003

Report from the CDC. Telephone focus groups: an emerging method in public health research.

BACKGROUND: The focus group is a widely used qualitative method in public health research. Typically, focus groups involve face-to-face interaction, although focus groups have also been conducted via telephone conference calls. METHODS: The indexed medical and social sciences literature was reviewed to assess what is empirically known about the telephone focus group method and how this method has been used to explore health topics. RESULTS: Thirteen studies reported in 16 publications were found that used telephone focus groups. Of the 13 studies, 12 investigated health topics, and none explored any methodological issues. Some health studies used the telephone focus group method exclusively, whereas others used it in conjunction with additional methods. The studies involved a variety of lay and professional populations in six countries and explored a range of topics. Several of the studies included participants from a wide geographic area, such as across the entire United States. Two rationales for using the telephone focus group method were reported: assembling geographically disparate participants and increasing participant anonymity by eliminating visual contact. CONCLUSIONS: Health researchers appear to be the primary users of the telephone focus group method for academic research. The telephone focus group method may be especially useful in health studies involving populations that do not have adequate representation in any single region and studies investigating sensitive topics. Methods studies are needed to compare the group dynamics of telephone and in-person focus groups and determine the most appropriate size and duration for telephone focus groups.

Attitude to Health↗

PubMed2002

Telephone appointment visits for head and neck surgery follow-up care.

OBJECTIVES/HYPOTHESIS: To test the hypothesis that patients with a variety of otolaryngologic diagnoses using telephone appointment visits would be equally as satisfied as patients receiving physician office visits, the study compared telephone appointment visits with physician office visits for health maintenance organization patients who needed routine follow-up care in a head and neck surgery clinic. STUDY DESIGN: Randomized, nonblinded cross-sectional study. METHODS: After their initial visit to either of two head and neck surgery clinics, new otolaryngology patients were randomly assigned into treatment and control groups. Patients in the treatment group (n = 73) received follow-up care in the form of telephone appointment visits, and patients in the control group (n = 80) received physician office visits for follow-up care. Study data were collected using telephone interviews and physician tracking forms. RESULTS: Patients receiving telephone appointment visits were significantly less satisfied with their visits than patients receiving physician office visits (chi2 = 25.4, P < .005). Patients who had physician office visits were significantly more likely than were patients in the treatment group to agree "somewhat" or "strongly" that 1) the physician addressed their questions and concerns (chi2 = 24.0, P < .005); 2) the physician provided personal care and attention (chi2 = 29.9, P <. 005); and 3) the physician provided high-quality care (chi2 = 34.5, P < .005). CONCLUSIONS: Patients who received telephone appointment visits were statistically significantly less satisfied with all aspects of their follow-up appointment than were patients who had physician office visits. The study findings indicate that telephone appointment visits may not be an ideal type of follow-up visit for all patients. Despite these findings, one third of patients in the treatment group would consider receiving a telephone appointment visit for future routine follow-up care, and 21.9% had no preference, perhaps a factor indicating willingness to receive a telephone appointment for a follow-up visit.

Appointments and Schedules↗

PubMed1986

Telephone surveys in public health research.

The last 10 years have seen increasing use of telephone surveys in public health research. This paper reviews issues of sampling, data quality, questionnaire development, scheduling of interviewers, respondent burden, interviewer effects, and the use of the computer in telephone interviewing. Throughout, the authors focus on findings from recent research, with particular emphasis on those studies suggesting new advances or protocols for conducting telephone health surveys. The findings of this review suggest four conclusions. First, telephone interviews can be highly recommended for follow-up interviews in panel surveys that use an initial face-to-face interview. Second, telephone surveys can be recommended as a viable alternative to costly face-to-face surveys in cross-sectional studies of the general population. Third, when the focus of the survey is on subgroups of the population that have both low telephone coverage and higher rates of nonresponse (e.g., low income and low education respondents), telephone interviews should be used more cautiously. In these situations, a dual sampling frame approach (using a combination of face-to-face and telephone interviewing) may be considered. Finally, computer-assisted telephone interviewing (CATI) represents one of the most important and innovative technologic advances in health survey research in recent years. The advantages of CATI in improving survey management are noteworthy and ideally suited for moderate- to large-sample surveys. CATI also provides an attractive (and largely untapped) resource for testing and refining other methodologic protocols in survey research.

Computers↗

PubMed1997

Selection bias from sampling frames: telephone directory and electoral roll compared with door-to-door population census: results from the Blue Mountains Eye Study.

Many Australian public health research studies use the telephone directory or the electoral roll as a sampling frame from which to draw study subjects. The sociodemographic, disease-state and risk-factor characteristics of subjects who could be recruited using only the telephone directory or only the electoral roll sampling frames were compared with the characteristics of subjects who would have been missed using only these sampling frames, respectively. In the first phase of the Blue Mountains Eye Study we interviewed and examined 2557 people aged 49 and over living in a defined postcode area, recruited from a door-to-door census. This represented a participation rate of 80.9 per cent and a response rate of 87.9 per cent. The telephone directory was searched for each subject's telephone number and the electoral roll was searched for each subject. Subject characteristics for those who were present in each of these sampling frames were compared with the characteristics of those subjects not included in the sampling frames. The telephone directory listed 2102 (82.2 per cent) of the subjects, and 115 (4.5 per cent) had no telephone connected. The electoral roll contained 2156 (84.3 per cent) of the subjects, and 141 subjects (5.5 per cent) could not be found in either the electoral roll or the telephone directory. Younger subjects, subjects who did not own their own homes and subjects born outside of Australia were significantly less likely to be included in either of these sampling frames. The telephone directory was also more likely to exclude subjects with higher occupational prestige, while the electoral roll was more likely to exclude unmarried persons and males. Researchers using the telephone directory and electoral roll to select subjects for study should be aware of the potential selection bias these sampling frames incur and need to take care when generalising their findings to the wider community.

Aged↗

PubMedDate not supplied

Telephone counseling as an adjunct to antidepressant treatment in the primary care system. A pilot study.

CONTEXT: Many clinical and logistical barriers exist in the primary care model for treating adult depression. OBJECTIVE: To examine the feasibility and clinical effects of a telephone counseling and medication monitoring program for adults starting treatment for depression in primary care. DESIGN: Pilot study with a contemporaneous control group. SETTING: Group Health Cooperative, an HMO serving more than 450,000 persons in western Washington. PATIENTS: Twenty-eight adult primary care patients starting antidepressant treatment (telephone counseling group) were compared with 94 patients receiving usual care (control group). INTERVENTION: Telephone counseling participants received written educational materials addressing depression, followed by six weekly counseling and support sessions delivered over the telephone by a master's-level therapist. The intervention used the transtheoretical model of behavioral change and cognitive-behavioral strategies to enhance self-monitoring, self-management, and coping skills. DATA SOURCES: Telephone interviews and computerized pharmacy and visit records. OUTCOME MEASURES: Participation rate and retention, Hopkins symptom checklist depression scores, medication adherence and dose thresholds, and visits made for depression treatment. RESULTS: Ninety-three percent of telephone counseling participants contacted agreed to participate, and 92% completed the intervention. Telephone counseling patients showed significantly lower depressive symptoms than did control group patients at 3-month follow-up (0.89 vs. 1.13) and 6-month follow-up (0.79 vs. 0.95; P = 0.03). Telephone counseling patients were twice as likely to adhere to antidepressant medication with adequate dose thresholds (25% vs. 13%) and half as likely to meet criteria for major depression than were control group patients across time (8% vs. 16%), although these differences were not statistically significant. Total outpatient visits made for depression treatment between groups across time did not differ. Overall program cost per patient was estimated at about $150. CONCLUSIONS: A telephone counseling and medication monitoring intervention was well accepted by adult patients starting treatment for depression in primary care. The intervention seems to significantly improve depression outcomes without affecting the number of visits for treatment of depression.

Adult↗

PubMed2004

Telephone service interruption weighting adjustments for state health insurance surveys.

Many states rely on telephone surveys to produce estimates of uninsurance. To the extent that people in households without telephones differ from those living in households with telephones, estimates will be biased due to lack of coverage of those in households without telephones. We find the disparity in estimates of uninsurance in the Current Population Survey (all people vs. those living in households without telephones) shows a similar association to the disparity found in the state surveys (all people vs. those living in households with telephone service interruptions). We adjust the state survey weights of those people living in households that experienced telephone interruptions to account for people living in households without telephones and evaluate whether the weighting adjustment for telephone service interruptions is advisable.

Data Collection↗

PubMed2004

Racial and ethnic variation in response to mailed and telephone surveys among women in a managed care population.

PURPOSE: To describe the characteristics of participants who completed a mailed survey, compared to those initial non-responders who completed the same survey over the telephone. STUDY DESIGN AND PATIENT POPULATIONS: We conducted a mailed survey, in both Spanish and English, among women with abnormal Pap smears, who were members of a large managed care organization. Telephone follow up for non-responders was performed by a bilingual interviewer. A 20-minute long distance telephone card was offered as an incentive to individuals who completed the telephone survey. We used bivariate and multivariate analyses to describe the population characteristics of respondents who replied by mail, as compared to those who completed the survey by telephone. RESULTS: Of the 1049 potentially eligible participants, 733 women completed the survey, for an overall response rate of 70%. Fifty-six percent (N=411) of the surveys were received by mail, and 44% (N=322) were completed by telephone. Thirty-four percent of the telephone surveys were completed in Spanish, compared to 13% of the mailed surveys (P<.001). Telephone respondents were less satisfied with their health care than were those who responded by mail. CONCLUSIONS: Among this insured cohort of women, Latinas who completed the survey in Spanish were more likely to participate in a telephone survey that offered an incentive, than in a mailed survey. These findings should be considered when planning health surveys in this population.

Adult↗

PubMed1992

Telephone surveys as a method for obtaining dietary information: a review.

The use of telephone surveys has increased significantly in the past decade. One advantage of telephone surveys is the ability to reach a large number of individuals: 97% of the US population owns telephones. Another advantage is cost savings: telephone surveys cost as little as one quarter to one half the amount of face-to-face surveys. Computer-assisted telephone interviewing has improved data collection, coding, and analysis. Random-digit dialing and a number of statistical advances such as weighting and stratification have significantly enhanced sample selection and research design of telephone surveys. The increasing need to collect dietary information from populations in an affordable fashion has expanded the use of telephone dietary surveys. To date, telephone dietary surveys have been used for follow-up after initial face-to-face contact has been made. The most common dietary instruments used are the 24-hour recall and the food frequency questionnaire. This review indicates that well-designed and well-administered telephone surveys are as good as, and may be better than, other methods for obtaining dietary information.

Bias↗

PubMed1998

Telephone triage of acute illness by a practice nurse in general practice: outcomes of care.

BACKGROUND: Telephone working is an increasingly important way of managing general practice workload, particularly out of hours. The role of telephone triage, however, in managing acute consultations during the day has not been adequately researched. AIM: To determine the impact of telephone triage, conducted by a practice nurse, on the management of same day consultations in a general practice. METHOD: A general practice of 11,300 patients in South Tyneside collected prospective telephone and surgery consultation data over three months. Patient satisfaction, for those who had received only telephone advice, was measured using a postal questionnaire. Four outcomes were measured: changes in doctor and nurse workload; repeat consultations with the same problem; prescriptions issued; and patient satisfaction with the service. RESULTS: In three months, 1263 consultations were recorded. Doctor workload fell by 54%, from 1522 to 664 consultations, compared with the previous three months. A total of 325 (26%) telephone requests to see the doctor were managed by the nurse on the telephone without them visiting the surgery. Also, 273 (21%) patients saw the nurse in the surgery, 565 (45%) saw the doctor in the surgery, and 99 (8%) saw the doctor and the nurse in the surgery. The response rate to the postal questionnaire was 192/271 (71%); 154 (88%) were satisfied with nurse telephone advice. CONCLUSIONS: Telephone triage, by a practice nurse, of patients who wish to see the doctor on the same day, reduced doctor workload. This was a service that patients liked.

Family Practice↗

PubMed2003

Factors impeding dispatcher-assisted telephone cardiopulmonary resuscitation.

STUDY OBJECTIVE: Dispatcher-assisted telephone cardiopulmonary resuscitation (CPR) instruction can increase the proportion of sudden cardiac arrest victims who receive bystander CPR and has been associated with improved survival. Most sudden cardiac arrest victims, however, do not receive bystander CPR. The study objective was to examine factors that may impede implementation of telephone CPR. METHODS: We reviewed dispatcher audio recordings and emergency medical services reports for 404 cases of sudden cardiac arrest that occurred from July 1, 2000, to June 30, 2002, in the study county to assess the phase (1, instructions not offered; 2, instructions offered but declined; or 3, instructions offered and accepted but CPR not implemented) and specific factors within each phase that potentially impede telephone CPR. RESULTS: Twenty-five percent (99/404) of victims received bystander CPR without dispatch assistance, 34% (139/404) received telephone CPR, and 41% (166/404) did not receive bystander CPR. Each phase of telephone CPR process impeded the implementation of CPR: (1) instructions not offered in 48% (80/166); (2) instructions offered but declined in 31% (52/166); and (3) instructions offered and accepted but CPR not implemented in 21% (34/166). During the first phase, telephone CPR was potentially impeded most frequently because the victim was reported to have signs of life (51/80, 64%); during the second and third phases, telephone CPR was most often impeded because of bystander physical limitation (32/86, 37%). Emotional distress, disease transmission, disagreeable victim characteristics, or medicolegal concerns uncommonly impeded telephone CPR (10/86, 12%). CONCLUSION: Factors potentially impeding telephone CPR can be identified. Although many are logistically challenging, some may be addressable and hence provide opportunities to strengthen the chain of survival.

Aged↗

PubMed2006

Comparison of different mobile telephones in Combi40+ users.

CONCLUSION: Telephone usage is a difficult challenge for cochlear implanted patients. A significant number of cochlear implanted patients are able to carry on a land-line or mobile telephone conversation. The telephone model may be a critical factor for telephone performance. OBJECTIVES: The goals of this study were to evaluate speech discrimination through land-line and mobile telephones in Combi40+ users, and to compare different mobile telephone models to find out which could be more advisable for them. PATIENTS AND METHODS: Eighteen Combi40+ implantees were tested with CID sentences and bisyllabic words presented through land-line and mobile telephones, in both quiet and noisy environments. RESULTS: Mean scores for telephonic speech discrimination were over 85% for CID sentences and 28-59% for bisyllabic words. The Siemens M55 was superior to the other mobile telephones tested.

Adolescent↗

PubMed2004

Increasing access to smoking cessation treatment in a low-income, HIV-positive population: the feasibility of using cellular telephones.

This study examined the feasibility of using cellular telephones to improve access to smoking cessation counseling in a low-income, HIV-positive population. Two pilot studies were conducted: (a). A survey of interest and barriers in participating in a smoking cessation intervention (n=49) and (b). a cellular telephone smoking cessation intervention in which participants were provided with free cellular telephones and received six telephone counseling sessions over a 2-week period (n=20). A primary care clinic serving a multiethnic, medically indigent, HIV-positive population served as the setting. Demographics and smoking status were assessed by self-report and expired-air carbon monoxide testing. In study 1, participants reported multiple barriers to participating in a smoking cessation intervention, including transportation, transience, and telephone availability. However, they also reported a high level of interest in participating in a smoking cessation intervention, with the greatest interest in a cellular telephone intervention. In study 2, 19 of the 20 participants successfully completed 2 weeks of smoking cessation counseling with a 93% (106 of 114 calls) contact rate. A total of 19 participants made a quit attempt, and the 2-week end of treatment point-prevalence abstinence rate was 75%. The provision of cellular telephones allowed for the implementation of a proactive telephone smoking cessation intervention providing an underserved population with access to care. Cellular telephones also may provide unique benefits because of the intensity of counseling and support provided as well as the ability to provide counseling in real-world, real-time situations (in vivo counseling).

Adult↗