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At least 19 recordsLinked to original sources

PubMed2001

Validity of a telephone-administered 24-hour dietary recall in telephone and non-telephone households in the rural Lower Mississippi Delta region.

OBJECTIVE: To determine if 24-hour dietary recall data are influenced by whether data are collected by telephone or face-to-face interviews in telephone and non-telephone households. DESIGN: Dual sampling frame of telephone and non-telephone households. In telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or telephone interview. In non-telephone households, participants completed a 24-hour dietary recall either by face-to-face interview or by using a cellular telephone provided by a field interviewer. SUBJECTS/SETTING: Four hundred nine participants from the rural Delta region of Arkansas, Louisiana, and Mississippi. MAIN OUTCOME MEASURES: Mean energy and protein intakes. STATISTICAL ANALYSES PERFORMED: Comparison of telephone and non-telephone households, controlling for type of interview, and comparison of telephone and face-to-face interviews in each household type using unpaired t tests and linear regression, adjusting for gender, age, and body mass index. RESULTS: Mean differences between telephone and face-to-face interviews for telephone households were -171 kcal (P = 0.1) and -6.9 g protein (P = 0.2), and for non-telephone households -143 kcal (P = 0.6) and 0.4 g protein (P = 1.0). Mean differences between telephone and non-telephone households for telephone interviews were 0 kcal (P = 1.0) and -0.9 g protein (P = 0.9), and for face-to-face interviews 28 kcal (P = 0.9) and 6.4 g protein (P = 0.5). Findings persisted when adjusted for gender, age, and body mass index. No statistically significant differences were detected for mean energy or protein intake between telephone and face-to-face interviews or between telephone and non-telephone households. APPLICATIONS/CONCLUSIONS: These data provide support that telephone surveys adequately describe energy and protein intakes for a rural, low-income population.

Adolescent↗

PubMed2001

Telephone counselling for smoking cessation.

BACKGROUND: Telephone services can provide information and support for smokers. Counselling may be provided proactively or offered reactively to callers to smoking cessation helplines. OBJECTIVES: To evaluate the effect of proactive and reactive telephone support to help smokers quit. SEARCH STRATEGY: We searched the Cochrane Tobacco Addiction Group trials register for studies using free text term 'telephone*' or the keywords 'telephone counselling' or 'Hotlines' or 'Telephone'. Date of the most recent search: August 2000. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials in which proactive or reactive telephone counselling to assist smoking cessation was offered to smokers or recent quitters. DATA COLLECTION AND ANALYSIS: Trials were identified and data extracted by one person and checked by a second. The main outcome measure was abstinence from smoking after at least six months follow-up. We used the most rigorous definition of abstinence in each trial, and biochemically validated rates where available. Participants lost to follow-up were considered to be continuing smokers. Where interventions were similar, we performed meta-analysis using a fixed effects model to give an odds ratio. MAIN RESULTS: Twenty three trials met inclusion criteria. Ten trials compared proactive counselling to a minimal intervention control. There was statistical heterogeneity, with three trials showing a significant benefit, and seven showing non significant differences. Four trials adding telephone support to a face to face intervention control failed to detect a significant effect on long term quit rates. Four trials failed to detect an additional effect of telephone support in users of nicotine replacement therapy. Providing access to a hotline showed a significant benefit in one trial and no significant difference in two. Varying the type of counselling provided has not been shown to affect outcome. REVIEWER'S CONCLUSIONS: Proactive telephone counselling can be effective compared to an intervention without personal contact. There was heterogeneity between trials so the size of effect is uncertain. The available evidence neither confirms nor rules out a benefit of telephone counselling as an adjunct to face to face counselling or pharmacotherapy. Further trials randomising access to helplines are unlikely to be done but indirect evidence suggests they can be a useful part of a smoking cessation service.

Counseling↗

PubMed2004

Telephone psychotherapy and telephone care management for primary care patients starting antidepressant treatment: a randomized controlled trial.

CONTEXT: Both antidepressant medication and structured psychotherapy have been proven efficacious, but less than one third of people with depressive disorders receive effective levels of either treatment. OBJECTIVE: To compare usual primary care for depression with 2 intervention programs: telephone care management and telephone care management plus telephone psychotherapy. DESIGN: Three-group randomized controlled trial with allocation concealment and blinded outcome assessment conducted between November 2000 and May 2002. SETTING AND PARTICIPANTS: A total of 600 patients beginning antidepressant treatment for depression were systematically sampled from 7 group-model primary care clinics; patients already receiving psychotherapy were excluded. INTERVENTIONS: Usual primary care; usual care plus a telephone care management program including at least 3 outreach calls, feedback to the treating physician, and care coordination; usual care plus care management integrated with a structured 8-session cognitive-behavioral psychotherapy program delivered by telephone. MAIN OUTCOME MEASURES: Blinded telephone interviews at 6 weeks, 3 months, and 6 months assessed depression severity (Hopkins Symptom Checklist Depression Scale and the Patient Health Questionnaire), patient-rated improvement, and satisfaction with treatment. Computerized administrative data examined use of antidepressant medication and outpatient visits. RESULTS: Treatment participation rates were 97% for telephone care management and 93% for telephone care management plus psychotherapy. Compared with usual care, the telephone psychotherapy intervention led to lower mean Hopkins Symptom Checklist Depression Scale depression scores (P =.02), a higher proportion of patients reporting that depression was "much improved" (80% vs 55%, P<.001), and a higher proportion of patients "very satisfied" with depression treatment (59% vs 29%, P<.001). The telephone care management program had smaller effects on patient-rated improvement (66% vs 55%, P =.04) and satisfaction (47% vs 29%, P =.001); effects on mean depression scores were not statistically significant. CONCLUSIONS: For primary care patients beginning antidepressant treatment, a telephone program integrating care management and structured cognitive-behavioral psychotherapy can significantly improve satisfaction and clinical outcomes. These findings suggest a new public health model of psychotherapy for depression including active outreach and vigorous efforts to improve access to and motivation for treatment.

Adult↗

PubMed2005

Reducing bias in telephone survey estimates of the prevalence of drug use: a randomized trial of telephone audio-CASI.

AIM: To assess the impact of telephone audio computer-assisted self-interviewing (T-ACASI) on reporting of alcohol use, alcohol problems and illicit drug use in telephone surveys of the general population. Prior research suggests that illicit drug use is underreported in traditional, interviewer-administered, telephone surveys. DESIGN: Randomized experiment embedded in telephone survey of probability samples of populations of USA and Baltimore, MD. Survey respondents were randomly assigned to be interviewed either by human telephone interviewers or by T-ACASI after household screening, recruitment, and informed consent procedures were completed. SETTING: Respondents were interviewed by telephone in their homes. PARTICIPANTS: Probability samples of 1543 English-speaking adults ages 18-45 residing in telephone-accessible households in USA and 744 similarly defined adults residing in Baltimore, MD, USA. MEASUREMENTS: Nine questions on alcohol, marijuana, cocaine, and injection drug use adapted from 1994 NHSDA and four CAGE questions on alcohol problems. Crude odds ratios and odds ratios controlling for demographic factors calculated to test for differences between responses obtained by T-ACASI and human interviewers. FINDINGS: T-ACASI had mixed effects on reporting of alcohol use, but it did increase reporting of one of four CAGE alcohol problems: feeling guilty about drinking (23.0% in T-ACASI vs. 17.6% in T-IAQ, OR = 1.4, P < 0.01). T-ACASI also obtained significantly more frequent reporting of marijuana, cocaine, and injection drug use. The impact of T-ACASI was most pronounced for reporting of recent use of 'harder' drugs. Thus T-ACASI respondents were more likely to report marijuana use in the past month (10.0% vs. 5.7%, crude OR = 1.9, P < 0.001), cocaine use in the past month (2.1% vs. 0.7%, crude 3.2, P < 0.001) and injection drug use in the past five years (1.6% vs. 0.3%, crude OR = 4.8, P < 0.01). CONCLUSIONS: Telephone survey respondents were more likely to report illicit drug use and one alcohol problem when interviewed by T-ACASI rather than by human telephone interviews.

Adolescent↗

PubMed1993

Does excluding patients without telephones affect the results of telephone reminder studies?

Studies of the effectiveness of telephone reminders to improve the rate of appointments kept have shown conflicting results. Few have accounted for patients without telephones. We conducted a controlled clinical trial to study the effect of excluding patients without telephones in a study of telephone reminders in an urban pediatric clinic. Telephone reminders were attempted the evening before scheduled visits for 238 subjects; 259 controls received no reminders. The overall rate of kept appointments was the same (54%) for both the intervention group and the control group. In neither group was there a substantial difference in the "show" rate between patients with and without telephones (intervention group 52% versus 57%, control group 55% versus 54%). In the intervention group, the show rate was higher for those with telephones who were contacted (66%) than for those who were not (37%) (P < .001). Telephone reminders did not improve the overall rate of kept appointments but appeared to result in a significant improvement in the show rate of those who could be reached. Excluding patients who could not be reached by telephone may affect the usefulness of previous studies.

Appointments and Schedules↗

PubMed1996

Utility of telephone company records for epidemiologic studies of cellular telephones.

We conducted a survey of over 5,000 telephone users who were customers of one large cellular telephone company covering four major geographical areas. Our primary goal was to assess the utility of ascertaining information on telephone use and type from telephone company records. We compared information from 3,949 respondents with corresponding data from company billing records. We found that 48% of the account holders were sole users, and 69% were the primary user, meaning that they accounted for at least 75% of the use. Respondent reports of amount of telephone use were highly correlated with data on the billing record (r = 0.74). Respondent reports of telephone type were similarly correlated with data from the manufacturer (r = 0.92). We also inquired about telephone holding patterns, since these have implications for exposure. Most users reported favoring one side of the head when using the telephone, but the side of the head used was not strongly associated with handedness.

Adult↗

PubMed2000

Pediatric residents' telephone triage experience: do parents really follow telephone advice?

BACKGROUND: A previous study showed that calls received by our continuity clinic residents were similar to those in private practice. However, that study did not address the compliance of the parents to the advice given. OBJECTIVE: To determine parents' compliance to after-hours telephone advice given by pediatric residents in a continuity clinic. DESIGN: Advice given during initial telephone contact of 493 after-hours telephone calls was categorized into 3 groups: only telephone advice, appointment the next day, or immediate visit to the emergency department (ED). Follow-up telephone calls were made to all families 3 to 7 days after initial contact to determine compliance with the advice given. SETTING: Pediatric resident continuity clinic of a tertiary hospital in Augusta, Georgia. PATIENTS: Children registered in the pediatric resident continuity clinic. RESULTS: Overall, 412 (83.6%) of 493 caregivers followed the telephone advice that residents gave them. Of the 270 callers only given telephone advice, 244 (90.4%) followed the advice, 15 (5.6%) went to the ED, and 11 (4.1%) made an appointment for the next day. Of the 112 patients instructed to make an appointment, 82 (73.2%) reported at the scheduled time, 18 (16.1%) improved and did not come to the appointment, and 1 (.9%) reported worsened symptoms and went to the ED. When a visit to the ED was recommended, 86 (93.5%) of 92 complied, 2 (2.2%) improved and did not come, 1 (1.1%) had transportation problems, and 3 (3.3%) did not think an ED visit was warranted. CONCLUSION: If an after-hours line is used by caregivers, they are more likely to follow the recommendations given by pediatric residents in a tertiary center.

Adult↗

PubMed1993

After-hours telephone coverage: the application of an area-wide telephone triage and advice system for pediatric practices.

BACKGROUND: After-hours telephone calls are a stressful and frustrating aspect of pediatric practice. At the request of private practice pediatricians in Denver, a metropolitan area-wide system was created to manage after-hours pediatric telephone calls and after-hours patient care. This system, the After-Hours Program (AHP), uses specially trained pediatric nurses with standardized protocols to provide after-hours telephone triage and advice for the patients of 92 Denver pediatricians, representing 56 practices. OBJECTIVES: This report describes the AHP, presents data from 4 years' experience with the program, and describes results of our evaluation of the following aspects of the program: subscribing physician satisfaction, parent satisfaction, the accuracy and appropriateness of telephone triage, and program costs. METHODS: After-Hours Program records (including quality assurance data) for all 4 years of operation were retrospectively reviewed, tabulated, and analyzed. The results of two subscribing physician surveys and one parent caller satisfaction survey are presented. A retrospective review of after-hours patient care encounter forms assessed the necessity for after-hours visits triaged by the AHP. An analysis of the total cost of this program to 10 randomly selected subscribing physicians was conducted using current AHP data and a survey of the 10 physicians. RESULTS: In 4 years, 107,938 calls have been successfully managed without an adverse clinical outcome. Minor errors in using protocols occurred in one call out of 1450 after-hours calls. After-hours phoen calls necessitated an after-hours patient visit 20% of the time and generated one after-hours hospital admission out of every 88 calls. Just over half of the patients were managed with home care advice only, and 28% were given home care advice after-hours and seen the next day in the primary physician's office. Of all patients directed by the telephone triage nurses to be seen after hours, 78% were determined to have a condition necessitating after-hours care. Data are presented regarding call volumes by time of day, day of week, patient age, and patient's initial complaint. The 6 most common complaints accounted for more than one half of the calls, and 38 complaints accounted for more than 95% of all after-hours calls. Utilization by subscribing physicians is described. Satisfaction among subscribing pediatricians was 100%, and among parents was 96% to 99% on a variety of issues. The total cost to participating Denver pediatricians (which includes revenues "given up" as a result of not seeing patients after hours) ranged from 1% to 12% of their annual net income, depending on a variety of factors. CONCLUSIONS: Large-scale after-hours telephone coverage systems can be effective and well-received by patients, parents, and primary physicians. Data presented in this report can assist in planning the training of personnel who provide after-hours telephone advice and triage. Controversies associated with this type of program are discussed. Suggestions are made regarding the direction of future programs and research.

Ambulatory Care↗

PubMed1998

[Differences between listed and unlisted telephone subscribers among telephone survey respondents].

The number of telephone surveys conducted has increased in Japan, with the telephone directory often used for sampling respondents in telephone surveys. As some subscribers request that their numbers not be listed, they are excluded. The Random Digit Dialing (RDD) survey method, however, not only makes possible smooth data collection, but also random sampling of all subscribers in telephone surveys. The authors conducted a telephone survey in Tokyo using the RDD method to investigate any differences in behavior and demographic or social attributes between listed and unlisted subscribers. These attributes included gender, age, family size, job, and residential area. The findings were as follows: 1) The listing rate in telephone directories was 65.8% among respondents. 2) Old age, large family size and certain residential areas correlated with higher listing rates. 3) Nevertheless, the relationship between listing in the telephone directory and residential area remains somewhat unclear due to the confounding attributes of age and family size. 4) Using Hayashi's second method of quantification, age, family size and occupation correlated with listing frequency. 5) There were also significant differences between listed and unlisted subscribers on questions of health maintenance and lifestyle.

Adult↗

PubMed1991

Organisation of telephone services and patients' access to doctors by telephone in general practice.

OBJECTIVES: To assess how accessible general practitioners are to patients by telephone and to examine the relations between organisation, number of lines, and number of patient-doctor calls. DESIGN: Postal survey of a random sample of general practitioners stratified by rural and urban practice areas, with differential sampling fractions. SETTING: General practices in England and Wales. SUBJECTS: 2000 general practitioners, of whom 1459 (74%) responded. MAIN OUTCOME MEASURES: Number of calls received by general practitioner a day, time reserved for patients' calls, and communication of availability of telephone contact. RESULTS: 1421 general practitioners said that they accepted non-emergency calls from patients during the day and 285 reported reserving specific times of the day for this purpose. 848 estimated that they received four or fewer patient calls a day. The number of calls was significantly related to reserving time for calls (p less than 0.001), informing patients that the doctor was accessible by telephone (p less than 0.00001), and the number of periods when calls were accepted (p less than 0.00001). On average there were 3659 patients per incoming line; the number of patients per incoming line rose significantly as practice size increased (p less than 0.00001). CONCLUSIONS: The apparent willingness of general practitioners to accept calls was not reflected in the number of calls received. Reserving time, increasing periods of availability, and publicising telephone access increased the number of doctor-patient telephone contacts. Line congestion may be a problem, and impartial advice and guidance on telephone organisation and line requirements would be helpful.

England↗

PubMedDate not supplied

[Twenty-five years of telephonic emergency service in Poland: the aim and role of the Telephone Helpline in the prevention of social pathology].

In 1992 Polish Telephonic Emergency Service celebrated its 25th anniversary. The first two posts of "Telefon Zaufania" (Confidence Telephone) started simultaneously but independently in Wrocław and Gdańsk in 1967. Both sought to serve people in psychological crisis. The Gdańsk post became known as "Anonymous Friend" and it was run on a voluntary basis. In Wrocław "Telefon Zaufania" was strictly professional, it was organized in the Psychiatric Clinical of the Medical Academy and manned only by psychiatrists. Today in Poland there are such telephone posts almost in all cities and larger towns. Since 1973 the Polish telephone posts belong to IFOTES (International Federation of Telephonic Emergency Service) and they follow the norms of IFOTES: anonymity, unselfishness, confidence and befriending callers. In 1990 their was organized the Polish Association of Telephone Service in order first of all to improve the quality and efficiency of their service, to coordinate their work and to co-operate with Polish and international centers. The major problems of callers in crisis are the same in all types of post: family conflicts, marital troubles, peer group problems, the lack of the sense life, suicidal thoughts, drink and/or drug addiction. In the prevention of social pathology "Telefon Zaufania" proves the first, often the only rescue line to people in psychological crisis.

Anniversaries and Special Events↗

PubMed1994

Can you hold please? How internal medicine residents deal with patient telephone calls. Telephone Encounters Learning Initiative Group.

Little is known about the mechanisms used in internal medicine residency programs to handle patient telephone calls. To address this, a survey of internal medicine residents was conducted at 10 different internal medicine residency programs. The response rate was 76% (N = 388). Approximately 90% of the residents handled patient telephone calls. The residents saw a mean of 7 patients per week in clinic (standard deviation +/- 2) and received an average of 2 patient calls daily (standard deviation +/- 2). The mean number of patient calls received each night on-call was 3 (standard deviation +/- 6) and on weekend call days, an average of 4 patient calls were received (standard deviation +/- 8). Internal medicine residents reported spending an average of 7 minutes per call talking to the patient (standard deviation +/- 5) and 8 minutes in follow-up activities (standard deviation +/- 6). Residents reported documenting calls less than 35% of the time. Residents disagreed with the statements "I am very satisfied with my patient telephone call system" and "My patients are very satisfied with my telephone call system." Most internal medicine residents handle a significant amount of patient telephone calls, and the systems for handling these calls are less than satisfactory. The procedures used to manage patient calls and the training for this component of practice should be improved.

Attitude of Health Personnel↗

PubMed1999

Telephone ownership and deaf people: implications for telephone surveys.

OBJECTIVES: This study was done to determine the prevalence of telephone ownership in different deaf populations and to explore its implications for telephone-based surveys. METHODS: Multivariate analyses, with adjustments for sociodemographics and health status, were done of National Health Interview Survey (NHIS) data from 1990 and 1991, the years in which the NHIS Hearing Supplement was administered. RESULTS: Prelingually deafened adults were less likely than members of the general population to own a telephone (adjusted odds ratio [AOR] = 0.35; 95% confidence interval [CI] = 0.15, 0.82), whereas postlingually deafened adults were as likely as members of the general population to own one (AOR = 1.00; 95% CI = 0.78, 1.28). CONCLUSIONS: Telephone surveys risk marginalizing prelingually deafened adults because of low telephone ownership and language barriers between the deaf and hearing communities.

Adult↗

PubMed2004

[Feasibility of telephone screening interview in a validity and reliability study of telephone interview to assess dietary intake in Beijing, Shanghai and Hong Kong].

OBJECTIVE: To understand the feasibility of telephone interviews to achieve recruitment of subjects to assess the validity and reliability of the telephone interview in eliciting dietary intake. METHODS: A multi-phase study was conducted in Beijing, Shanghai and Hong Kong in 2002. RESULTS: Three hundred eligible women aged from 20 to 49 years old were recruited in those cities. In the screening interview, 2462 random telephone numbers were dialed with 95% of dials completed within 5 times of attempts. The average number of dial for the completion was two calls, the rates of completion and refusal conversion were not improved remarkably by the increase of calls although some calling attempts reached 20 times. Regarding the processing of the sampling pools in those three cities, Beijing had a lower efficiency rate but a satisfactory completion rate, Shanghai was good in both indicators, and Hong Kong had a good efficiency rate but lower completion rate. The overall telephone screening interview completion rate was 42%, with Hong Kong having the lowest rate (32%) compared with Beijing and Shanghai (47% and 50%, respectively, P < 0.001). CONCLUSION: The telephone interview method could successfully reach the target of urban Chinese women and earn their cooperation with a satisfactory completion rate.

Adult↗

PubMed2003

Telephone nurses' experience of problems with telephone advice in Sweden.

By telephoning a healthcare call centre, individuals in Sweden can consult a nurse to discuss medical problems and health care accessibility, and to receive professional information on how to find their way about the health care system. The aim of the study was to identify problems, difficulties and disadvantages that telephone nurses with varying degrees of experience had met during their professional careers. The Delphi technique was used with three sets of questionnaires. Twenty-five nurses with varying experience of working with telephone advice from six 24-hours call centres participated in the study. The response rate was 100%. An open-ended question generated 154 statements. Comments were categorized into 24 different problem categories. Ten problem categories were mainly related to the nurse perspective, i.e. the problems experienced were associated with the qualities of the nurse, eight principally to the patient perspective, i.e. problems associated with caller characteristics and six mostly to the organizational perspective, i.e. problems linked to the organization of the national health service. 'Lack of health care resources' was rated as the biggest problem, 'second-hand consultations' as the second and 'always making a decision' as the third biggest problem. Decision-making seems to be the core of telephone advice nursing and problems related to the nurses, patients and organization seem to influence the telephone nurses' working situation. Training should focus on active listening and handling social conflicts.

Adult↗

PubMed1977

[Psychiatric first aid by telephone--"the telephone of trust"].

From the experiences of the telephone system for psychiatric advice "Telephone of Trust" installed in CSSR in 1964, and a closer observation of the telephone point which has been operating in Brno since 1965 (with over 48 calls to its name already) recommendations are being made regarding the eventual installation and operation of these telephone points, the usefulness of which, in the sense of advice in cases of "problems in life", has already been demonstrated, for primary and secondary prevention of psychic disorders, crisis intervention and psycho-hygiene.

Crisis Intervention↗

PubMed1991

Telephone T.A.L.K.: a telephone communication program.

Twenty-four percent of all medical care contacts are made on the telephone. Practicing pediatricians and emergency physicians often manage children's illnesses by telephone. Studies have shown that there is a need for improved communication between physicians and patients, and it is believed that quality of, and satisfaction with, health care services will improve with increased emphasis on interpersonal communication skills in medical training. The Department of Pediatrics at Harbor-UCLA Medical Center includes interpersonal telephone communication as part of residency training. This article describes the telephone program, which differs from other programs in medical settings in that it focuses on communication process skills only. A conceptual framework around the acronym T.A.L.K. is outlined. Topic sessions in the pediatric emergency department and individual resident review sessions are discussed. The guidelines designed to follow the conceptual framework are presented.

Clinical Protocols↗

PubMed1979

Development and field testing of protocols for the management of pediatric telephone calls: protocols for pediatric telephone calls.

Although telephone calls comprise almost one fourth of all childhood patient-physician contacts, the content of telephone care is not emphasized in most educational and service programs. In response to the need to improve management of telephone calls to our pediatric emergency room, we developed 28 protocols to deal with the 25 most common complaints presented by phone. This paper describes the content of these protocols, the training of the health assistants who administered them, and the measures we took to assure their safety and general utility in pediatric practice settings. The study demonstrates the feasibility of an organized system for telephone care based on protocols which include: (1) basic data to be collected for each chief complaint category; (2) a range of appropriate dispositions; and (3) advice for home management when the patient does not require an immediate medical visit. Potential uses of these protocols for medical and nursing education and for clinical service needs are discussed.

Age Factors↗