US relaxes rules for Rx shopping sprees to Canada.
Explore the source record for details and available documents.
SEARCH · PubMed Health
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
OBJECTIVE: The current study examined the efficacy of mailed personalized normative feedback (PNF) as a brief alcohol intervention for at-risk college drinkers, and investigated discrepancy as a possible mediator of the intervention effect. METHOD: Participants consisted of 100 at-risk college drinkers who completed an alcohol-use assessment at baseline, 6-week posttest and 6-month follow-up. Measures included number of drinks consumed per heaviest drinking week, frequency of heavy-drinking episodes, peak blood alcohol concentration and number of alcohol-related problems, all for the last month. Participants were randomly assigned to either a mailed brief intervention (MBI; n = 49) or attention-control (C; n = 51) group. The MBI group received mailed PNF that was based on baseline responses to the drinking measures; the C group received a psychoeducational brochure about alcohol. RESULTS: Mixed-model, repeated measures ANOVAs were used to examine the effects of time, group and gender on discrepancy and the drinking variables. Following the intervention, the MBI group reported significantly higher perceived discrepancy between self and others' drinking than the C group. The MBI group reported consuming significantly fewer drinks per heaviest drinking week and engaging in heavy episodic drinking less frequently than the C group at the 6-week posttest; however, these differences were no longer evident at the 6-month follow-up. Hierarchical regression analyses did not provide evidence for the hypothesized mediating effect of discrepancy. CONCLUSIONS: Mailed PNF may be a cost- and time-efficient means of developing discrepancy and temporarily reducing heavy alcohol consumption among at-risk college drinkers.
OBJECTIVE: The present study examined mode effects for collecting alcohol and other drug use data using a Web-based survey mode and a U.S. mail-based survey mode for comparison. METHOD: A survey regarding alcohol and other drugs was administered to a randomly selected sample of 7,000 undergraduate students attending a large midwestern research university in the spring of 2001. The sample was randomly assigned to either a Web-based survey mode (n = 3,500) or a U.S. mail-based mode (n = 3,500). RESULTS: The Web survey mode of administration resulted in a final sample that more closely matched the target sample in gender mix than did the U.S. mail survey mode. The response rate for the Web survey mode was significantly higher than for the U.S. mail survey mode. Chi-square results indicated there were significant differences in response propensity by several sample characteristics including sex, race, class year and academic credit hours. Multivariate logistic regression results revealed significant racial and gender differences in the response propensity between and withinmodes. After controlling for design discrepancies, there were no significant differences between modes in data quality or substantive responses to substance-use variables. CONCLUSIONS: The findings of the present study provide strong evidence that Web surveys can be used as an effective mode for collecting alcohol and other drug use data among certain populations who have access to the Internet and high rates of use. Web surveys provide promise for enhancing survey research methodology among undergraduate college students.
OBJECTIVE: Mail and Web surveys are two possible alternatives for reducing potential nonresponse bias in telephone-based studies of alcohol consumption. Mail surveys have been a staple of epidemiological research, but there is a dearth of similar research on Web surveys. Most studies using Web surveys have been conducted among college students or other specialized populations where Internet penetration is relatively high. The present study examines differences in self-reports of alcohol consumption among adult members of the general public surveyed by mail, Web and telephone. METHOD: Web and mail versions of the 2003 Behavioral Risk Factor Surveillance System (BRFSS) instrument, traditionally a telephone-only survey, were developed and administered to address-matched households drawn from the random-digit dialed sampling frame used for the BRFSS. Comparisons were made with results from the ongoing telephone-based surveillance. RESULTS: A total of 4,051 interviews (836 mail, 1,143 Web, and 2,072 telephone) were completed with adults ages 18 or older in four U.S. states. The findings indicate considerable variation in the estimates for heavy drinking (five or more drinks on an occasion during the past 30 days) obtained across these modes and population subgroups, particularly among the Web respondents. CONCLUSIONS: Mail surveys appear to be a viable alternative to more traditional telephone surveys, whereas use of Web surveys with the general public appears more problematic. Both approaches, however, may complement telephone studies when used in mixed-mode designs. Because alcohol consumption is associated with a number of diseases, caution is required when using different modes of data collection in epidemiological studies.
The usefulness of simplified techniques in sampling of individual mouse and rat sera and their shipping in wet state for serological checking of infections were described.
BACKGROUND: Immunization rates have improved in the United States, but are still far from the national 90% goal for the year 2000. There is scant evidence about the effectiveness and costs of automated telephone messages to improve immunization rates among privately insured children. OBJECTIVE: To evaluate the effectiveness and cost-effectiveness of sending letters, automated telephone messages, or both to families of underimmunized 20-month-olds in a health maintenance organization (HMO). METHODS: In this randomized trial, underimmunized 20-month-olds identified by the HMO's computerized immunization tracking system were assigned to one of four interventions: 1) an automated telephone message alone; 2) a letter alone; 3) an automated telephone message followed by a letter 1 week later; and 4) a letter followed by an automated telephone message 1 week later. The primary outcome was receipt of any needed immunization by 24 months of age. Decision analysis was used to evaluate the projected cost-effectiveness of the alternative strategies. RESULTS: A total of 648 children were randomized. A letter followed by a telephone message (58% immunized) was significantly better than either a letter alone (44% immunized) or a telephone message alone (44% immunized). A telephone message followed by a letter (53% immunized) also was more effective than either alone, although the differences were not statistically significant. Among a similar comparison group that received no systematic intervention, 36% were immunized. The estimated cost per child immunized was $7.00 using letters followed by automated telephone messages, $9.80 using automated telephone messages alone, and $10.50 using letters alone. Under alternative cost assumptions for automated telephone messages and mailed messages, the cost per child immunized ranged from $2.20 to $6.50. CONCLUSIONS: For underimmunized 20-month-olds in this HMO setting, letters followed by automated telephone messages were more effective and cost-effective than either message alone. The cost-effectiveness of automated telephone messages and letters may vary widely depending on the setting, and choices among strategies should be tailored to the populations being served.
OBJECTIVE: Government agencies and national organizations recommend that physicians counsel their child and adolescent patients about preventive health topics. Using data from a national survey, we describe the counseling patterns of pediatricians in regard to 9 recommended preventive health topics. METHODOLOGY: Between October 1998 and April 1999, information was collected from 907 of 1760 primary care pediatricians randomly selected from a nationally representative sample. Through either a telephone interview or a mail survey, pediatricians were asked how frequently in the past month they counseled about 9 preventive health topics during the well-care visits or routine check-ups of their patients. Pediatricians answered questions regarding their patients aged 2 to 5, 6 to 12, and 13 to 18 years. RESULTS: Over 80% of the pediatricians counseled about 1 or more recommended preventive health topics during the well-care visits or routine check-ups of their patients. As compared with pediatricians who did not counsel about any topic, pediatricians who counseled were significantly more likely to be female and spend longer amounts of time with their patients during these visits. The frequency with which specific preventive health topics were discussed varied with the topic and the age of the patient. CONCLUSION: Most pediatricians routinely counsel about some, but not all, recommended preventive health topics. An understanding of why pediatricians selectively counsel about specific topics is needed.
OBJECTIVES: To compare 3 communication modes (postal, fax, and e-mail) in a rotavirus vaccine physician survey. METHODS: We used 3 communication modes to distribute a survey to physicians listed in the membership directory of the Georgia Chapter of the American Academy of Pediatrics. The directory listed 1391 members; however, 404 were deemed ineligible on the basis of their listing as a specialist, retiree, resident in training, or government public health employee. Of the 987 members expected to administer vaccines, 150 were selected randomly to receive the postal survey (postal group). Of the remaining listings, 488 (58%) of 837 listed a fax number; 150 members were selected randomly and faxed a survey (fax group). Of the remaining members, 266 (39%) of 687 had e-mail addresses listed; 150 members were selected randomly for the e-mail survey (e-mail group). A follow-up survey was sent by the same mode at 2 weeks. A final survey was sent via another mode (mixed mode) at 1 month: by fax to e-mail and postal nonresponders and by post to fax nonresponders and those without fax. RESULTS: Eligible respondents in the 3 survey groups were similar in their practice setting and location. Although the e-mail group had fewer median years (8 years) since medical school graduation than the fax group (19 years) and postal group (17 years), a similar percentage of responders in all groups had computers (>85%) and Internet access (> or =70%) at work. However, only 39% of members listed an e-mail address in the directory. In the 2 weeks after the first mailing, 39 surveys were completed via postal mail, 50 via fax, and 16 via e-mail. In the 2 weeks after the second contact (sent at 2 weeks), 20 surveys were completed via postal mail, 15 via fax, and 17 via e-mail. The response rate after the first 2 mailings was 41% (59 of 143) for postal, 47% (65 of 137) for fax, and 26% (33 of 125) for e-mail surveys. The third and final survey (sent 1 month after the first mailing) was sent by a different (ie, mixed) mode and elicited an additional 73 responses: 19 responses (15 postal, 4 fax) from the postal group, 19 responses (18 postal, 1 fax) from the fax group, and 35 responses (15 postal, 13 fax, 7 e-mail) from the e-mail group. Twenty-three percent (9 of 40) of the e-mail and 18% (15 of 83) of the fax surveys completed were returned on the same or subsequent day they were sent, compared with none of the postal surveys. There were significant differences among the 3 groups for invalid addresses/numbers (4% postal, 8% fax, and 16% e-mail) listed in the directory. Using mixed modes as the third contact, the overall response rate increased from 39% before mixed mode to a final of 53%. On the basis of the 3 initial groups, responses to 1 of 12 rotavirus questions differed significantly. CONCLUSIONS: Future use of e-mail surveys in selected circumstances is promising, because the majority of providers have Internet access and acknowledged interest in participating in e-mail surveys. E-mail surveys could be especially useful if rapid response time is necessary. There were fewer incomplete questions by participants who completed the e-mail survey compared with postal or fax participants. Updating membership e-mail addresses and routinely using e-mail as a communication tool should improve the ability to use e-mail surveys. There may need to be ongoing evaluations that critically evaluate providers' responses to e-mail surveys compared with other survey modes before e-mail surveys can become a standard survey tool. In the meantime, mixed-mode surveys may be an option.
OBJECTIVES: We compared the effectiveness of a telephone outreach approach versus a direct mail approach in improving rates of colorectal cancer (CRC) screening in a predominantly Black population. METHODS: A randomized trial was conducted between 2000 and 2003 that followed 456 participants in the New York metropolitan area who had not had recent CRC screening. The intervention group received tailored telephone outreach, and the control group received mailed printed materials. The primary outcome was medically documented CRC screening 6 months or less after randomization. RESULTS: CRC screening was documented in 61 of 226 (27.0%) intervention participants and in 14 of 230 (6.1%) controls (prevalence rate difference=20.9%; 95% CI = 14.34, 27.46). Compared with the control group, the intervention group was 4.4 times more likely to receive CRC screening within 6 months of randomization. CONCLUSIONS: Tailored telephone outreach can increase CRC screening in an urban minority population.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The method of data collection in household health surveys can be a major determinant of cost and data quality. A survey strategy can comprise mail, telephone, or home interview methods, individually or in combination to follow up non-respondents. The purpose of this study in Montreal was to compare cost and data quality of various strategies. Strategies which began with mail or telephone contact, followed by the two other methods, provided response rates as high as a home interview strategy (all between 80 and 90 per cent), for one-half the cost of home interviews when used as the sole method. The telephone response rate was higher than the mail response rate. Comparing different follow-up approaches to strategies beginning with mail or telephone, it proved less costly, and equally effective, to use home interviewing as a last resort for persistent non-respondents. Validity of response (comparing individual responses with records of a government health insurance data bank) and willingness to answer sensitive questions were greatest in mail strategy.
The Ohio Department of Health initiated a program of mailing an immunization reminder to the mothers of six-month-old children predicted to be at high risk of failure to receive vaccinations based on birth certificate information. The evaluation results indicated a 50% gain in immunizations amongst children whose parents received the letter when compared with those not receiving the letter.
A probability sample of American general practitioner dentists, 40 years of age or older, in solo private practice, was the target of two direct mail interventions offered at two different times, to test whether knowledge regarding prophylaxis of patients at risk for infective endocarditis could be improved. Tests of knowledge were responses in a mail questionnaire to clinical vignettes, designed to elicit the content of antibiotic regimens used for patients at risk. The research design enabled detection of (1) the effect of the interventions; (2) the differences in their effect; (3) the attenuation of their effect; and (4) the effect of time. Where baseline knowledge was low, it was improved and did not rapidly disappear. Both mail interventions were equally effective, in most instances, and there was no attenuation of the interventions' effect and no effect of time on the control groups' knowledge over a 4 1/2 month period. The results suggest that it is possible to improve clinicians' knowledge of expert recommendations through direct mail intervention.
BACKGROUND: Studies have indicated that cigarette smokers have more occupational accidents and injuries and use more sick time and health benefits than nonsmokers, thereby producing sizeable costs for employers. However, they usually have not controlled for other possible sources of these costs. We analyzed occupational costs associated with smoking while adjusting for a number of potential confounders. METHODS: We conducted a prospective, controlled study of the association between smoking and employment outcomes in 2537 postal employees, adjusting for age, gender, race, drug use, job category, and exercise habits. RESULTS: For smokers, the relative risk for turnover was 1.01 (95% confidence interval [CI], 0.83-1.21); for accidents 1.29 (CI, 1.07-1.55); for injuries 1.40 (CI, 1.11-1.77); for discipline 1.55 (CI, 1.19-2.02). Their mean absence rate was 5.43% compared with 4.06% for nonsmokers. CONCLUSIONS: Our study shows that cigarette smoking is associated with adverse employment outcomes after controlling for a number of possible confounders. This finding has implications for companies formulating smoking policies and considering the establishment of smoking cessation programs.
OBJECTIVES: In a health maintenance organization that mails letters to women recommending that they schedule mammograms, we conducted a randomized trial to evaluate simple methods of increasing the use of screening mammography. METHODS: Using a 2 x 2 factorial design, we tested the effects of (1) mailing the recommendation letter from each woman's primary care physician rather than from the program director and (2) sending a subsequent reminder postcard. RESULTS: Sending a reminder postcard nearly doubled the odds that women would get mammograms within 1 year (participate). The letter from the woman's personal physician had no effect. Attending a clinic more than 45 minutes from the screening center, being a current smoker, or being in fair or poor health were negatively associated with subsequently obtaining a mammogram. The odds of participation doubled if women had had previous mammograms. CONCLUSIONS: When preceded by written recommendations to schedule mammograms, reminder postcards effectively increased participation. Future randomized trials to promote use of screening mammography should compare interventions with a reminder condition.