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Background: Many studies that collect maternal and neonatal outcomes rely on patient self-report phone calls. It is unclear how reliable or accurate these phone call reports are. Objective: To evaluate the reliability of telephone calls in information collection in IVF. Study design: The women were interviewed seven days after delivery by a nurse via telephone. The maternal and neonatal outcomes were recorded based on a self-report from one of the spouses. Meanwhile, the standardized electronic hospitalized discharge records were extracted from the hospital medical database. For each case, maternal and neonatal information obtained from telephone interviews and extracted from medical files were compared. Results: Agreement was classified as "almost perfect, K = 0.81–1.00" for preterm birth, cesarean delivery, low birth weight baby, and macrosomia. The strength of agreement was classified as "moderate, K = 0.41–0.60" for some antepartum complications: gestational diabetes (K = 0.569); pregnancy-induced hypertension (K = 0.588); intrahepatic cholestasis of pregnancy (K = 0.597) and oligohydramnios (K = 0.432). The strength of agreement between telephone interviews and hospitalized discharge records can be classified as "slight (K = 0–0.20)" for some complications: thyroid diseases (K = 0.137), anemia (K = 0.047), postpartum hemorrhage (K = 0.016), and Fetal distress (K = 0.106). Conclusion: Some variables (preterm birth, cesarean delivery, birth weight) information collected by telephone follow-up were reliable. However, other complications (thyroid diseases, anemia, postpartum hemorrhage, and fetal distress) collected via self-report was non-reliable. Compared with complications during labor, antepartum complications have higher agreement between different follow-up methods. IVF records and hospitalized discharge records should be matched and collected simultaneously when discussing maternal and neonatal outcomes of IVF. [ABSTRACT FROM AUTHOR]

To examine the effectiveness of self-directed, off-the-shelf information and communications technology (ICT)-based interventions in improving the quality of life, physical and psychosocial outcomes of community-dwelling stroke survivors and their support persons (SP). Medline, EMBASE, CINAHL and Cochrane databases were searched (2006–19th June 2020) for randomized controlled trials, controlled trials, controlled before and after studies, or interrupted time series studies that met the eligibility criteria. The quality of included studies was assessed. Interventions effectiveness was narratively synthesized, as was participant adherence and acceptability. Seventeen studies were eligible. Three studies were rated as low risk of bias across all methodological review criteria. Nine studies reported on interventions delivered using self-directed computer programs, two studies utilized internet or web-based support programs and six studies used mobile phone interventions. Few studies reported on intervention acceptability or adherence. Those that did generally reported good acceptability, although adherence was variable. Fifteen studies reported significant positive effects for at least one outcome examined including stroke-specific outcomes, physical outcomes, behavioural outcomes and health service use. No studies found an effect for psychosocial wellbeing. ICT-based interventions are likely to provide benefit to stroke survivors and their SPs. However, there is a need for further robustly designed intervention studies that include larger sample sizes, longer follow-up, and outcomes for SPs. ICT-based interventions with minimal clinician supervision are likely to provide some benefits to stroke survivors and their SPs. There is insufficient evidence to allow recommendations to rehabilitation professionals regarding the type, length and intensity of ICT-based interventions for specific targeted outcomes. Rehabilitation professionals should use professional judgement prior to recommending ICT-based interventions to stroke survivors and their SPs. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the effects of telenursing on patients' activities of daily living and instrumental activities of daily living (ADLs and IADLs) following a myocardial infarction (MI). Methods: This randomized, parallel‐group, controlled trial was conducted on 95 patients post‐MI from 2018 to 2019. Patients were randomly assigned to the intervention (telenursing) and control groups using permuted block randomization. Through telephone calls, telenursing was performed twice a week during the first six consecutive weeks, then once a week until week 12. ADL and IADL questionnaires were completed by both groups before intervention and 12 weeks later. The CONSORT 2010 checklist was used to report the study protocol. Results: The mean age of patients was 56.8 ± 11.07 and 54.2 ± 9.8 years in the telenursing and control group, respectively. The mean ADL and IADL scores in the telenursing group were substantially greater than in the control group [4.57 (3.18, 5.97); P < 0.001 and 4.40 (3.06, 5.75); P < 0.001, respectively]. The odds of a higher degree of independence (no disabilities vs. mild disabilities and disability as well as no disabilities and mild disabilities vs. disability) regarding ADLs and IADLs were significantly greater in the telenursing group as compared with the control group (P < 0.001 and P < 0.001, respectively). Conclusions: Our findings suggest that the use of telenursing intervention may increase patients' ADLs and IADLs after an MI and may enhance their independence. Geriatr Gerontol Int 2022; 22: 616–622. [ABSTRACT FROM AUTHOR]

Background: Evidence supports loneliness and social isolation as a strong risk factor for poor mental and physical health outcomes for older adults. The COVID-19 pandemic necessitated older adults isolate themselves for a prolonged duration. The Faculty of Medicine at the University of Toronto established the Student-Senior Isolation Prevention Partnership (SSIPP), a volunteer program involving telephone calls between medical students and older adults.Methods: A mixed methods pre-post study design included collecting quantitative data from older adults using the UCLA Loneliness Scale and the Warwick-Edinburgh Mental Well-being Scale. The study included 29 medical students and 47 older adults. The medical students filled out a questionnaire on self-perceived knowledge of social isolation, perception of seniors, attitudes towards seniors, and likelihood to engage in specialties focusing on older adults. Interviews were conducted with both the older adults and the medical students to understand each groups' experiences and perspectives with taking part in the SSIPP program.Results: Participation in the program resulted in significant changes for medical students in areas such as increasing their likelihood to engage in care for older adults (p < .001), improving their knowledge of social isolation for seniors (p < .001), and the value of addressing social isolation in older adults (p < .001). The interviews conducted with the medical students support these findings and provide insight into contributing factors. Loneliness and mental well-being scales did not show significant changes for older adults however, our interviews revealed they considered the program to be valuable.Conclusions: Our results showed that after the communication outreach program, medical students' perceptions were positively influenced towards older adults and they were more likely to pursue a career concentrated on older adults. The qualitative analysis revealed older adults valued the program. Timing and consistency of calls were factors identified by this group as having practical importance. [ABSTRACT FROM AUTHOR]

Abstract: We conducted a complier average causal effect (CACE) analyses for 2 pragmatic randomised controlled trials. We aimed to assess the effectiveness of telephone-based lifestyle weight loss interventions compared with usual care among compliers. Participants from 2 trials with low back pain (n = 160) and knee osteoarthritis (n = 120) with a body mass index ≥27 kg/m2 were included. We defined adherence to the telephone-based lifestyle weight loss program as completing 60% (6 from 10) of telephone health coaching calls. The primary outcomes for CACE analyses were pain intensity (0-10 Numerical Rating Scale) and disability (Roland Morris Disability Questionnaire for low back pain and Western Ontario and McMaster Universities Osteoarthritis Index for knee osteoarthritis). Secondary outcomes were weight, physical activity, and diet. We used an instrumental variable approach to estimate CACE in compliers. From the intervention groups of the trials, 29% of those with low back pain (n = 23/80) and 34% of those with knee osteoarthritis (n = 20/60) complied. Complier average causal effect estimates showed potentially clinically meaningful effects, but with low certainty because of wide confidence intervals, for pain intensity (-1.4; 95% confidence interval, -3.1, 0.4) and small but also uncertain effects for disability (-2.1; 95% confidence interval, -8.6, 4.5) among compliers in the low back pain trial intervention compared with control but not in the knee osteoarthritis trial. Our findings showed that compliers of a telephone-based weight loss intervention in the low back pain trial generally had improved outcomes; however, there were inconsistent effects in compliers from the knee osteoarthritis trial. Complier average causal effect estimates were larger than intention-to-treat results but must be considered with caution. [ABSTRACT FROM AUTHOR]

To investigate and compare perceptions about the efficacy and acceptability of allied health care delivered via telephone and video call for adults with disabilities during the COVID-19 pandemic. Cross-sectional national survey. Participants who accessed occupational therapy, physiotherapy, psychology, or speech pathology care via telephone or via video call from June to September 2020. Five hundred eighty-one adults with permanent or significant disabilities, or their carers, partners, or family members, who were funded by the Australian National Disability Insurance Scheme. Not applicable. Experiences (eg, safety, efficacy, ease of use) with telephone and video-delivered care. Data were analyzed by calculating response proportions and chi-square tests to evaluate differences in experiences between allied health professions and between telephone and video modalities. Responses were obtained for 581 adults with disabilities. There was no evidence of differences between experiences with telephone or video-delivered services or across allied health professions. Overall, 47%-56% of respondents found telehealth technology easy to use (vs 17%-26% who found it difficult), 51%-55% felt comfortable communicating (vs 24%-27% who felt uncomfortable), 51%-67% were happy with the privacy and/or security (vs 6%-9% who were unhappy), 74% were happy with the safety (vs 5%-7% who were unhappy), and 56%-64% believed the care they received was effective (vs 17% who believed it was ineffective). Despite this, 48%-51% were unlikely to choose to use telephone or video consultations in the future (vs 32%-36% who were likely). Adults with disabilities in Australia had generally positive experiences receiving allied health care via telehealth during the COVID-19 pandemic, although some experienced difficulties using and communicating via the technology. Findings indicated no differences between satisfaction with telephone or video modalities, or between physiotherapy, speech pathology, occupational therapy, or psychology services. [ABSTRACT FROM AUTHOR]

Background: There are limited data regarding the management of guideline-directed medical therapy (GDMT) for heart failure with reduced ejection fraction (HFrEF) with virtual visits in comparison with in-office visits. We sought to compare the changes in GDMT (angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, angiotensin receptor neprilysin inhibitors, mineralocorticoid receptor antagonists, and sodium glucose cotransporter-2 inhibitors) and loop diuretics across visit types.Methods and Results: This study included 13,481 outpatient visits performed for 5439 unique patients with HFrEF between March 16, 2020, and March 15, 2021. The rates of initiation and discontinuation of GDMT were documented, and multivariable logistic regression was performed to test associations with outcomes between modes of visit. The rates of medication initiation were higher in office (11.7%) compared with video (9.6%) or telephone (7.2%) visits. In multivariable adjusted analysis, the initiation of at least 1 GDMT class was similar between in-office visits and video visits (adjusted odds ratio [OR] 0.97, 95% confidence interval [CI] 0.82-1.14, P = .703). Telephone visits were associated with less frequent initiation of at least 1 class of GDMT in comparison with in-office visits (adjusted OR 0.64, 95% CI 0.55-0.75; P < .001) and video visits (adjusted OR 0.67, 95% CI 0.55-0.81, P < .001). Despite similar rates of baseline loop diuretic use, patients seen with both video visits (adjusted OR 0.70, 95% CI 0.52-0.94, P = .018) and telephone visits (adjusted OR 0.64, 95% CI 0.49-0.83, P < .001) were less likely to have a loop diuretic initiated when compared with in-office visits.Conclusions: The initiation of GDMT for HFrEF was similar between in-office and video visits and lower with telephone visits, whereas the initiation of a loop diuretic was less frequent in both types of virtual visits. These data suggest that video streaming capabilities should be encouraged for virtual visits. [ABSTRACT FROM AUTHOR]

Objective: To test the effects of text messages for promoting physical activities in people with prediabetes. Methods: This randomized controlled trial was performed in participants with prediabetes. Participants were recruited from a primary care unit. Allocation to the study groups used a stratified block randomization. All participants received physical activity education at baseline. The intervention group additionally received supportive text messages by using mobile phone text messages. Participants were assessed at baseline at 8 and 12 weeks. The primary outcome measure was physical activity energy. Secondary outcomes included weight, body mass index, waist circumstance, and blood pressure. Results: All participants were included in the analyses (n = 324; control: n = 162; intervention: n = 162). Mean physical activity energy was significantly increased in those who received text messages at 8 weeks, increasing 1,590.73 Metabolic Equivalent of Tasks (METs)/min/week (95% confidence interval [CI]: 837.72, 2343.75) in the intervention group and 407.39 METs/min/weeks (95% CI: −267.59, 1082.36) in the control group with an adjusted mean difference of −1,183 METs/min/weeks (95% CI: −2190.11, −176.58, p = 0.02). Over the 12 weeks follow-up period, mean physical activity energy did not differ statistically by group. Mixed-model repeated-measures analysis of the total physical energy revealed no significant differences, with an adjusted mean difference 273.3 METs/min/week (95% CI: −530.64, 1077.21, p = 0.513). However, moderate physical energy was significantly increased to 256.40 METs/min/week (95% CI: 17.20, 495.63, p = 0.040). Conclusion: Text messaging significant in physical activity at the 8-week. But, text messaging no significant in physical activity at 12-week. Further research is needed to identify optimal times to send messages to people with prediabetes. Thai Clinical Trials Registry (TCTR), number: TCTR20200624008. [ABSTRACT FROM AUTHOR]

Background: Patient‐centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends. However, when supportive care referrals are offered in hospital settings, distressed patients and carers do not consistently act on those referrals, which can prolong patient suffering. The degree to which sub‐optimal referral uptake also occurs in Australian telephone support services is unknown. Aims: To report, among a sample of distressed patients and caregivers who called a cancer information and support service: 1) the types of services used; 2) proportion who received and actioned a referral (uptake); 3) associations between referral to a service and callers' characteristics); and, 4) associations between uptake of a referred service and callers' characteristics. Methods: This study used cross‐sectional data collected at 3‐month post‐baseline from control participants (usual care group) enrolled in the Structured Triage and Referral by Telephone (START) trial. The START trial recruited distressed adult cancer patients and caregivers from the Cancer Council Information and Support Service (CIS). A research assistant conducted a 30–45 min telephone interview with participants, which included recall of referrals provided by CIS staff and reported uptake of referral(s) to the offered service types. Results: Most patients (98%) and caregivers (97%) reported receiving a referral to a service. For patients and caregivers respectively, information materials (71%, 77%), CIS call‐back (51%, 43%), practical services (52%, 45%), and group peer support (49%, 51%) were the services most frequently offered. For callers receiving a referral, uptake was highest for information materials (91%) and CIS call‐backs (89%) and lowest for specialist psychological services (30%). Significant association was found between older age and reduced uptake of services (p = 0.03). Conclusion: The high uptake rate of CIS call‐backs suggests it is a potentially more acceptable form of support compared to specialist psychological services. Efforts to reduce the barriers to telephone‐based psychological services are required. Specifically, older age peoples' and caregivers' preferences for support and priorities who may benefit from a referral coordinator. [ABSTRACT FROM AUTHOR]

Abstract Background A spontaneous subarachnoid haemorrhage (SAH) is one of the most critical neurological emergencies a dispatcher can face in an emergency telephone call. No study has yet investigated which symptoms are presented in emergency telephone calls for these patients. We aimed to identify symptoms indicative of SAH and to determine the sensitivity of these and their association (odds ratio, OR) with SAH. Methods This was a nested case–control study based on all telephone calls to the medical dispatch center of Copenhagen Emergency Medical Services in a 4-year time period. Patients with SAH were identified in the Danish National Patient Register; diagnoses were verified by medical record review and their emergency telephone call audio files were extracted. Audio files were replayed, and symptoms extracted in a standardized manner. Audio files of a control group were replayed and assessed as well. Results We included 224 SAH patients and 609 controls. Cardiac arrest and persisting unconsciousness were reported in 5.8% and 14.7% of SAH patients, respectively. The highest sensitivity was found for headache (58.9%), nausea/vomiting (46.9%) and neck pain (32.6%). Among conscious SAH patients these symptoms were found to have the strongest association with SAH (OR 27.0, 8.41 and 34.0, respectively). Inability to stand up, speech difficulty, or sweating were reported in 24.6%, 24.2%, and 22.8%. The most frequent combination of symptoms was headache and nausea/vomiting, which was reported in 41.6% of SAH patients. More than 90% of headaches were severe, but headache was not reported in 29.7% of conscious SAH patients. In these, syncope was described by 49.1% and nausea/vomiting by 37.7%. Conclusion Headache, nausea/vomiting, and neck pain had the highest sensitivity and strongest association with SAH in emergency telephone calls. Unspecific symptoms such as inability to stand up, speech difficulty or sweating were reported in 1 out of 5 calls. Interestingly, 1 in 3 conscious SAH patients did not report headache. Trial registration NCT03980613 ( www.clinicaltrials.gov ).

The issue of the formation of one of the central communication management bodies of the Russian Empire — the Telegraph Department is considered. The relevance of the study is due to the need to study the features of the evolution of departments to improve the mechanism of public administration at the present stage. The author provides an overview of the views of historians on the establishment and liquidation of the Ministry of Posts and Telegraphs. Particular attention is paid to the activities of the Ministers of Posts and Telegraphs I.M. Tolstoy, L.S. Makov and Director of the Telegraph Department K.K. Luders. The novelty of the research is seen in the fact that the author reveals and clarifies previously unknown aspects of the functioning of the Telegraph Department. New data from archival sources are introduced into scientific circulation. The results of a comparative analysis of the number and financial position of officials of the Telegraph and Post Departments are presented. It has been proved that the maintenance of the personnel of the communication structures was developing towards equalization, expressed in a decrease in salaries in the Postal Department and an increase in the Telegraph departments. The author dwells on the consideration of the privileges of officials of the Telegraph Department and the position of women employees.

Abstract Background Diabetic ketoacidosis causes a significant number of hospitalisations worldwide, with rates tending to increase with remoteness and socioeconomic disadvantage. Our study aimed to explore healthcare professionals’ perceptions of factors affecting presentation of people with type 1 diabetes in a low socioeconomic area of Queensland, Australia. Methods This was a qualitative study. Individual semi-structured face-to-face or telephone interviews were completed with patients with type 1 diabetes who had presented in diabetic ketoacidosis, and healthcare professionals who have experience in related care. Data were analysed using Gibbs’s framework of thematic analysis. Results Four patients with type 1 diabetes and 18 healthcare professionals were interviewed. Restricted access was identified as a factor contributing to diabetic ketoacidosis and delayed presentation, with ketone testing supplies, continuous glucose monitoring technology and transport considered barriers. Many of these factors were arguably preventable. Opportunities to improve the care available to patients with type 1 diabetes were detailed, with particularly strong support for dedicated out of hours telephone help lines for adults with type 1 diabetes. Conclusions Gaps in support for patient self-care to avoid diabetic ketoacidosis presentations and prevent late presentation of diabetic ketoacidosis revealed by this study require service reconfiguration to support care delivery. Until change is made, people with type 1 diabetes will continue to make both avoidable and delayed, acutely unwell, presentations to Emergency Departments.

Background & Aim: Epilepsy is the most common chronic neurological disease after headache. About half of the patients with epilepsy do not properly adhere to medication regimens, which leads to a lack of control over seizures, increased treatment costs, and even increased mortality rate in these patients. The aim of this study was to determine the effect of telephone education on medication adherence in patients with epilepsy. Methods & Materials: In this quasi-experimental study, 60 patients referred to neurology clinic of Valiasr Hospital in Zanjan in 2019 were selected by the convenience sampling method, and were randomly divided into either control or experimental groups. The Morisky drug adherence Questionnaire was used for data collection. At the beginning of the study and after completing the questionnaires, a face-to-face training session was held for the study participants. Then, telephone education was performed for the experimental group for two months and no intervention for the control group. Two months after the intervention, all the patients completed the questionnaire again. Finally, the collected data were analyzed through the SPSS software version 25 using descriptive (mean and standard deviation) and inferential statistics (Chi-square, Fisherchr('39')s exact test, independent t-test and paired t-test). Results: Before the intervention, there was no statistically significant difference between the two groups in terms of individual characteristics and medication adherence scores (P

BackgroundQUIT is the only primary care-based brief intervention that has previously shown efficacy for reducing risky drug use in the United States (Gelberg et al., 2015). This pilot study replicated the QUIT protocol in one of the five original QUIT clinics primarily serving Latinos.DesignSingle-blind, two-arm, randomized controlled trial of patients enrolled from March-October 2013 with 3-month follow-up.SettingPrimary care waiting room of a federally qualified health center (FQHC) in East Los Angeles.ParticipantsAdult patients with risky drug use (4-26 on the computerized WHO ASSIST): 65 patients (32 intervention, 33 control); 51 (78%) completed follow-up; mean age 30.8 years; 59% male; 94% Latino.Interventions and measuresIntervention patients received: 1) brief (typically 3-4 minutes) clinician advice to quit/reduce their risky drug use, 2) video doctor message reinforcing the clinician's advice, 3) health education booklet, and 4) up to two 20-30 minute follow-up telephone drug use reduction coaching sessions. Control patients received usual care and cancer screening information. Primary outcome was reduction in number of days of drug use in past 30days of the highest scoring drug (HSD) on the baseline ASSIST, from baseline to 3-month follow-up.ResultsControls reported unchanged HSD use between baseline and 3-month follow-up whereas Intervention patients reported reducing their use by 40% (p

Emergency 9-1-1 callers use a wide range of terms to describe abnormal breathing in persons with out-of-hospital cardiac arrest (OHCA). These breathing descriptors can obstruct the telephone cardiopulmonary resuscitation (CPR) process. We conducted an observational study of emergency call audio recordings linked to confirmed OHCAs in a statewide Utstein-style database. Breathing descriptors fell into 1 of 8 groups (eg, gasping, snoring). We divided the study population into groups with and without descriptors for abnormal breathing to investigate the impact of these descriptors on patient outcomes and telephone CPR process. Callers used descriptors in 459 of 2411 cases (19.0%) between October 1, 2010, and December 31, 2014. Survival outcome was better when the caller used a breathing descriptor (19.6% versus 8.8%, P

PurposeMany Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective in real-world clinical populations.DesignRetrospective cohort study comparing wellness coaching participants with two groups of controls.SettingKaiser Permanente Northern California, a large integrated health care delivery system.SubjectsTwo hundred forty-one patients who participated in telephonic tobacco cessation coaching from January 1, 2011, to March 31, 2012, and two control groups: propensity-score-matched controls, and controls who participated in a tobacco cessation class during the same period. Wellness coaching participants received an average of two motivational interviewing-based coaching sessions that engaged the patient, evoked their reason to consider quitting, and helped them establish a quit plan.MeasuresSelf-reported quitting of tobacco and fills of tobacco cessation medications within 12 months of follow-up.AnalysisLogistic regressions adjusting for age, gender, race/ethnicity, and primary language.ResultsAfter adjusting for confounders, tobacco quit rates were higher among coaching participants vs. matched controls (31% vs. 23%, p < .001) and comparable to those of class attendees (31% vs. 29%, p = .28). Coaching participants and class attendees filled tobacco-cessation prescriptions at a higher rate (47% for both) than matched controls (6%, p < .001).ConclusionTelephonic wellness coaching was as effective as in-person classes and was associated with higher rates of quitting compared to no treatment. The telephonic modality may increase convenience and scalability for health care systems looking to reduce tobacco use and improve health.

BackgroundTwenty-five million people in the United States have limited English proficiency (LEP); this growing and aging population experiences worse outcomes when hospitalized. Federal requirements that hospitals provide language access services are very challenging to implement in the fast-paced, 24-hour hospital environment.ObjectiveTo determine if increasing access to professional interpreters improves hospital outcomes for older patients with LEP.DesignNatural experiment on a medicine floor of an academic hospital.ParticipantsPatients age 50 years or above discharged between January 15, 2007 and January 15, 2010.ExposureDual-handset interpreter telephone at every bedside July 15, 2008 to Mar 14, 2009.Outcome measuresThirty-day readmission, length of stay, estimated hospital expenditures.ResultsOf 8077 discharges, 1963 were for LEP, and 6114 for English proficient patients. There was a significant decrease in observed 30-day readmission rates for the LEP group during the 8-month intervention period compared with 18 months preintervention (17.8% vs. 13.4%); at the same time English proficient readmission rates increased (16.7% vs. 19.7%); results remained significant in adjusted analyses. This improved readmission outcome for the LEP group was not maintained during the subsequent postintervention period when the telephones became less accessible. There was no significant intervention impact on length of stay in either unadjusted or adjusted analyses. After accounting for interpreter services costs, the estimated 119 readmissions averted during the intervention period were associated with estimated monthly hospital expenditure savings of $161,404.ConclusionsComprehensive language access represents an important, high value service that all medical centers should provide to achieve equitable, quality healthcare for vulnerable LEP populations.

ObjectiveTo evaluate the impact of a population-based telephonic wellness coaching program on weight loss.MethodsIndividual-level segmented regression analysis of interrupted time series data comparing the BMI trajectories in the 12 months before versus the 12 months after initiating coaching among a cohort of Kaiser Permanente Northern California members (n = 954) participating in The Permanente Medical Group Wellness Coaching program in 2011. The control group was a 20:1 propensity-score matched control group (n = 19,080) matched with coaching participants based on baseline demographic and clinical characteristics.ResultsWellness coaching participants had a significant upward trend in BMI in the 12 months before their first wellness coaching session and a significant downward trend in BMI in the 12 months after their first session equivalent to a clinically significant reduction of greater than one unit of baseline BMI (P < 0.01 for both). The control group did not have statistically significant decreases in BMI during the post-period.ConclusionsWellness coaching has a positive impact on BMI reduction that is both statistically and clinically significant. Future research and quality improvement efforts should focus on disseminating wellness coaching for weight loss in patients with diabetes and those at risk for developing the disease.

BackgroundBrain magnetic resonance imaging (MRI) allows researchers to observe structural pathology that may predict cognitive decline. Some populations are less accessible through traditional in-person visits, and may be under-represented in the literature.MethodsWe examined white matter hyperintensity volume (WMHV) and cerebral parenchymal fraction (CPF) as predictors of cognitive decline measured by a modified Telephone Interview for Cognitive Status (TICS-m) in the Northern Manhattan Stroke Study, a racially and ethnically diverse cohort study. Participants were stroke-free, above 50 years old, and had no contraindications to MRI. A total of 1143 participants had MRI and TICS-m data available [mean age 70 (SD=9), 61% women, 66% Hispanic, 17% Black, 15% white].ResultsThose in the third and fourth quartiles of WMHV had significantly greater decline in TICS-m over time as compared with those in the first quartile (Q3: -0.17 points/year, Q4: -0.30 points/year). Those in the bottom 2 quartiles of CPF had significantly greater decline in TICS-m than those in the top quartile (Q1: -0.3 points/year, Q2: -0.2 points/year). Apolipoprotein E (APOE) e4 allele carriers had greater cognitive decline per unit of CPF. Those with greater CPF preserve TICS-m performance better despite greater WMHV.ConclusionsTelephone cognitive assessments can detect decline due to white matter lesions and smaller brain volumes.

This study reports on the initial validation of the Autism Symptom Interview (ASI), School-Age, a brief (15-20 min) phone interview derived from questions from the Autism Diagnostic Interview-Revised (ADI-R). The ASI, School-Age was administered by interviewers with minimal training to parents of children ages 5 to 12 who had all been previously identified with (or referred for assessment of) ASD or another neurodevelopmental disorder. Children then underwent a comprehensive assessment to determine a best-estimate clinical diagnosis of ASD (n = 159) or non-ASD (e.g. language disorder, intellectual disability, ADHD; n = 130). Clinicians who conducted the assessments were blind to ASI results. ROC analyses compared ASI scores to clinical diagnosis. Due to the small number of participants with non-ASD diagnoses who were classified as nonverbal (i.e. not yet using phrases on a daily basis), it was not possible to assess sensitivity and specificity of the nonverbal algorithm in this sample. The verbal algorithm yielded a sensitivity of 0.87 (95% CI = 0.81-0.92) and a specificity of 0.62 (95% CI = 0.53-0.70). When used in conjunction with the Autism Diagnostic Observation Schedule (ADOS), sensitivity and specificity were 0.82 (95% CI = 0.74-0.88) and 0.92 (95% CI = 0.86-0.96), respectively. Internal consistency and test-retest reliability were both excellent. Particularly for verbal school age children, the ASI may serve as a useful tool to more quickly ascertain or classify children with ASD for research or clinical triaging purposes. Additional data collection is underway to determine the utility of the ASI in children who are younger and/or nonverbal. Autism Res 2017, 10: 78-88. © 2016 International Society for Autism Research, Wiley Periodicals, Inc.

Introduction: Remote contact between general practitioners and patients is a key component of accessibility to primary care. Objective: This study aims to determine the frequency of (and attitudes towards) the use of telephone and e-mail between general practitioners working in Matosinhos and their patients. Methods: A census of general practitioners working in Matosinhos was invited to participate in a cross-sectional survey-based study. An anonymous, paper, self-administered questionnaire was applied, and descriptive data analysis was used. Results: Eighty-one completed questionnaires were obtained (90.0% response rate). All general practitioners reported communicating with patients by telephone but one-third never/rarely exchanged e-mails with them. Most considered that the use of the telephone and e-mail is an overload for which they do not have enough time but acknowledged that both tools facilitate the management of patient lists and appointments. Participants stated that they would use both tools more often if interactions could be recorded in real-time and that they would use the telephone more often if it was accounted for in their performance evaluation. General practitioners with larger lists more often reported telephone calls with their patients. General practitioners working in ‘Model B’ practices more often used e-mail with their patients. General practitioners that use e-mail less often considered that it represents an overload and has a negative risk/benefit ratio, they less often agree that it facilitates the management of patient lists and appointments and wouldn't increase the frequency of use even if it was accounted for in their performance evaluation. Conclusion: All general practitioners have telephone calls with patients but express several negative attitudes towards this type of remote contact. General practitioners who are frequent e-mail users more often express positive attitudes, compared to the ones who are not regular e-mail adopters. Organizational policies should consider general practitioners’ attitudes.

We’ll present the Catalan experience of follow up by phone contats of suicide attempters, and the results up to 10 years. We develop a Suicide Prevention Program that started with the EAAD project in 2008 in a 0,5 M people catchment area, later generalized to 7,5 M people through the Catalonia Suicide Risk Code (SRC-Cat). The SRC-cat is a real-time registry of suicide attempts (65% women) that allows immediate attention and telephone follow-up and ensures continuity of care for 12 months. To evaluate the effectiveness of our telephone management plan, we conducted two types of analysis; a) 12-month short-term analysis: non-randomised controlled analysis of suicide reattempts comparing two cities (2007-2008); b) 8-year long-term analysis with the evolution of suicide rates (men and women) between our area, and two other cities (territorial differences and over time from 2010 to 2017). Results: a) the SRC-Cat in our catchment area reduced significantly the proportion of people who re-attempt suicide by 57% over 12 months (from 14% to 6 %); b) we found lower standardized suicide death rate among women in our catchment area (both territorially and over time). Conclusions: a) Short-term telephone management (12-month), ensuring chain of care after hospital discharge, reduces more than 50% the proportion of patients who re-attempt; b) Long-term telephone management (8-year) of suicide attempt survivors over 12 months, significantly reduces suicide deaths in women only (64% of patients in telephone follow-up are women).

Abstract Background Using frameworks such as the Behaviour Change Wheel to develop behaviour change interventions can be challenging because judgement is needed at various points in the process and it is not always clear how uncertainties can be resolved. We propose a transparent and systematic three-phase process to transition from a research evidence base to a behaviour change intervention. The three phases entail evidence synthesis, stakeholder involvement and decision-making. We present the systematic development of an intervention to enhance the quality of psychological treatment delivered by telephone, as a worked example of this process. Method In phase 1 (evidence synthesis), we propose that the capabilities (C), opportunities (O) and motivations (M) model of behaviour change (COM-B) can be used to support the synthesis of a varied corpus of empirical evidence and to identify domains to be included in a proposed behaviour change intervention. In phase 2 (stakeholder involvement), we propose that formal consensus procedures (e.g. the RAND Health/University of California-Los Angeles Appropriateness Methodology) can be used to facilitate discussions of proposed domains with stakeholder groups. In phase 3 (decision-making), we propose that behavioural scientists identify (with public/patient input) intervention functions and behaviour change techniques using the acceptability, practicability, effectiveness/cost-effectiveness, affordability, safety/side-effects and equity (APEASE) criteria. Results The COM-B model was a useful tool that allowed a multidisciplinary research team, many of whom had no prior knowledge of behavioural science, to synthesise effectively a varied corpus of evidence (phase 1: evidence synthesis). The RAND Health/University of California-Los Angeles Appropriateness Methodology provided a transparent means of involving stakeholders (patients, practitioners and key informants in the present example), a structured way in which they could identify which of 93 domains identified in phase 1 were essential for inclusion in the intervention (phase 2: stakeholder involvement). Phase 3 (decision-making) was able to draw on existing Behaviour Change Wheel resources to revisit phases 1 and 2 and facilitate agreement among behavioural scientists on the final intervention modules. Behaviour changes were required at service, practitioner, patient and community levels. Conclusion Frameworks offer a foundation for intervention development but require additional elucidation at each stage of the process. The decisions adopted in this study are designed to provide an example on how to resolve challenges while designing a behaviour change intervention. We propose a three-phase process, which represents a transparent and systematic framework for developing behaviour change interventions in any setting.

Resumen: Antecedentes y objetivo: Durante la pandemia COVID-19, la actividad de los servicios quirúrgicos se ha visto obligada a adaptarse y transformarse. La telemedicina se está implantando como nunca antes en esta nueva situación, en la que los pacientes están confinados y los profesionales sanitarios presentan riesgo de infectarse.El objetivo es mostrar que una reestructuración combinada telemática y presencial de las visitas, permite asegurar la asistencia médica, garantizando la protección del personal sanitario y de los pacientes. Material y método: Estudio descriptivo observacional sobre el seguimiento de pacientes durante la pandemia por COVID-19, combinando la consulta telefónica con la presencial. Resultados: Se realizaron un total de 5.031 llamadas telefónicas, diferenciando entre derivaciones, visitas de atención primaria especializada y consulta externa hospitalaria.Se registraron como: efectivas, tributarias de visita presencial y no se logra contacto telefónico. Y las dividimos en dos grupos: resueltas y no resueltas.Del total de visitas no presenciales telefónicas fueron efectivas un 53%. Conclusiones: La medicina telemática es una opción factible en un servicio de traumatología, y de manera adecuada será una opción interesante de mantener tras la pandemia.Futuras líneas de investigación deberían ser abiertas para mejorar la capacidad de resolución de este sistema, analizar su relación coste-efectividad y subsanar los conflictos legales que pudieran existir. Abstract: Background and aim: The current COVID-19 pandemic scenario has driven surgical departments to a transformation.The worldwide spread of the disease has led to a public health quarantine where health care professionals are at high risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. This study aims to demonstrate that a combined framework based on telematics and in-person clinical encounter not only ensures medical care but the safety of healthcare professionals and patients. Material and method: Descriptive observational study on the follow-up of patients during the COVID19 Pandemic, combining telephone and traditional. Results: A total of 5031 telephone calls were made, differentiating between medical referrals, specialized primary care visits, and outpatient consultation.They were classified as successful, required an in-person visit, or no successful telephone contact. Furthermore, we divided them into 2 groups: resolved and unresolved.53% of all telematic visits were successful. Conclusions: Telematic medical systems are a feasible option in a orthopedics department and an interesting resource to preserve once the pandemic is resolved. Future lines of research should be opened to improve system success, analyze its cost-effectiveness ratio, and correct any legal conflicts that may exist.

Road users other than online public transportation must also be given legal protection and together enjoy the convenience of traffic facilities. Drivers are required to concentrate while driving a vehicle. This is regulated in Law Number 22 of 2009 concerning Road Transportation Traffic, Article 106 that everyone driving a motorized vehicle on the road is obliged to drive his vehicle fairly and with full concentration. The observations made were that attaching a communication device to online public transportation proved that the telephone was used while driving a vehicle. Communicating by telephone while driving a vehicle will cause an accident that will harm other road users. This study discusses the regulations for using the telephone while driving against online motorcycle taxis and law enforcement analysis the regulations for using the telephone while driving against online motorcycle taxis in Bandar Lampung. The results showed the telephone regulations while driving to online motorcycle taxis in Bandar Lampung were Permenhub No. 12 of 2019 Article 4, Article 6, Article 17, Article 18, and Article 19. The results of the analysis of law enforcement on the use of telephones while driving in the form of online motorcycle taxis to contact consumers on their way to the location 3 (three) times, namely 32% (thirty-two per cent) and the intensity of online motorcycle taxis to contact consumers more than 3 (three) times, namely 27% (twenty-seven percent). The analysis data has proven that the intensity of contacting passengers is very much done while driving. Online motorcycle taxi drivers do not obey the rules because they communicate more by telephone while driving.

Background and Aims: Management of alcohol use disorder (AUD) could be enhanced by effective remote treatments. This study tested whether supplementing intensive outpatient programs (IOPs) with continuing care delivered via (1) telephone, (2) smartphone or (3) their combination improves outcomes relative to (4) IOP only. Continuing care conditions were also compared. Design Randomized controlled trial of four groups with 3‐, 6‐, 9‐, 12‐ and 18‐month follow‐ups. Setting: University research center in Philadelphia, PA, USA. Participants: Participants (n = 262) met DSM‐V criteria for AUD, were largely male (71%) and African American (82%). Interventions and Comparator: Telephone monitoring and counseling (TMC; n = 59), addiction comprehensive health enhancement support system (ACHESS; n = 68) and TMC + ACHESS (n = 70) provided for 12 months. The control condition received IOP only (TAU; n = 65). Measurement The primary outcome was percentage of days heavy drinking (PDHD) in months 1–12. Secondary outcomes were any drinking, any drug use, drinking consequences and quality of life. Findings Mean PDHD in months 1–12 was 10.29 in TAU, 5.41 in TMC, 6.80 in ACHESS and 5.99 in TMC + ACHESS. PDHD was lower in TMC [Cohen's d = 0.35, P = 0.018, 95% confidence interval (CI) = (−1.42, −0.20)], ACHESS [d = 0.31, P = 0.031, 95% CI = (−1.27, −0.06)] and TMC + ACHESS [d = 0.36, P = 0.009, 95% CI = (−1.40, −0.20)] than in TAU. Differences between TMC + ACHESS, TMC and ACHESS were small (d ≤ 0.06) and non‐significant. Findings were inconclusive as to whether or not the treatment conditions differed on PDHD at 18 months. A significant effect was obtained on any drinking, which was higher in months 1–12 in TAU than in TMC [odds ratio (OR) = 3.02, standard error (SE) = 0.43, 95% CI = (1.30, 6.99), P = 0.01] and TMC + ACHESS [OR = 2.43, SE = 0.39, 95% CI = (1.12, 5.27), P = 0.025). No other significant effects were obtained on other secondary outcomes during or after treatment. Conclusions: A telephone‐delivered intervention and a smartphone‐delivered intervention, alone and in combination, provided effective remote continuing care for alcohol use disorder. The combination of both interventions was not superior to either alone and effects did not persist post‐treatment. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has seen a move away from face‐to‐face interactions and core psychiatry training has not been immune to this. The Royal College of Psychiatrists introduced online examinations (https://www.rcpsych.ac.uk/training/exams), Health Education England utilized virtual annual reviews of competencies (https://www.hee.nhs.uk/coronavirus-information-trainees), and locally, trusts adopted virtual academic and clinical work. This article seeks to highlight the impact of the pandemic on acquiring psychotherapy experience in the context of core psychiatry training. Trainees delivering psychodynamic psychotherapy via telephone in Surrey and Borders NHS Foundation Trust were included in the study and data were gathered using a phenomenological approach via reports provided by two core trainees in addition to a questionnaire distributed to all core trainees delivering telephone therapy. The results indicated that whilst telephone therapy may not be a full replacement for face‐to‐face contact, it has been an adequate substitute during the COVID‐19 period, enabling trainees to achieve the required competencies, receive supervision and provide care where it may otherwise have been impossible. [ABSTRACT FROM AUTHOR]

Objective: Compare a telephone version and full version of the Montreal Cognitive Assessment (MoCA). Methods: Cross-sectional analysis of a prospective study. A 20-point telephone version of MoCA (Tele-MoCA) was compared to the Full-MoCA and Mini Mental State Examination. Results: Total of 140 participants enrolled. Mean scores for language were significantly lower with Tele-MoCA than with Full-MoCA (P =.003). Mean Tele-MoCA scores were significantly higher for participants with over 12 years of education (P <.001). Cutoff score of 17 for the Tele-MoCA yielded good specificity (82.2%) and negative predictive value (84.4%), while sensitivity was low (18.2%). Conclusions: Remote screening of cognition with a 20-point Tele-MoCA is as specific for defining normal cognition as the Full-MoCA. This study shows that telephone evaluation is adequate for virtual cognitive screening. Our sample did not allow accurate assessment of sensitivity for Tele-MoCA in detecting MCI or dementia. Further studies with representative populations are needed to establish sensitivity. [ABSTRACT FROM AUTHOR]

What are the core capabilities that physiotherapists need in order to deliver quality telephone-based care? Three-round modified e-Delphi survey. An international Delphi panel comprising experts in the field, including consumers, physiotherapy researchers, physiotherapy clinicians and representatives of physiotherapy organisations. A modified e-Delphi survey was conducted. A draft framework was adapted from a previously developed core capability framework for physiotherapists delivering care via videoconferencing. The panel considered the draft framework of 39 individual capabilities across six domains. Over three rounds, panellists rated their agreement (via Likert or 0-to-10 numerical rating scales) on whether each capability was essential (core) for physiotherapists to deliver telephone-based care. Capabilities achieving consensus, defined as 75% of the panel rating the item at least 7 out of 10 in Round 3, were retained. Seventy-one panellists from 17 countries participated in Round 1, with retention of 89% in Round 2 and 82% in Round 3. The final framework comprised 44 capabilities across six domains: compliance (n = 7 capabilities); patient privacy and confidentiality (n = 4); patient safety (n = 7); telehealth delivery (n = 9); assessment and diagnosis (n = 7); and care planning and management (n = 10). This framework outlines the core capabilities that physiotherapists need to provide telephone-based care. It can help inform content of physiotherapy curricula and professional development initiatives in telehealth delivery and provide guidance for physiotherapists providing care over the telephone. [ABSTRACT FROM AUTHOR]

Copyright of BMS: Bulletin de Methodologie Sociologique (Sage Publications Ltd.) is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Turkiye Klinikleri Journal of Nursing Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: There has been increasing amounts of work on the use of telephone follow-up (TFU) in trauma and orthopaedics, but little direct work on its use in the follow-up of elective day case hand surgery. The aim of this study is to compare patient satisfaction with face-to-face follow-up (FFU) and TFU after elective day case hand surgery. Methods: Sixty-four patients from an FFU and 61 patients from a TFU cohort were contacted by telephone at least 6 months after their last follow-up. A customized questionnaire with answers recorded on a Likert scale (0–10) was used to evaluate their satisfaction with the follow-up they received. Results: Data from 48 patients from the FFU and 52 patients from the TFU cohorts were available for the analysis. There were no statistically significant differences in patient demographics between the two cohorts. Patient satisfaction was significantly greater in all domains of the questionnaire in the TFU cohort. Most patients from both cohorts (71% face-to-face, 86% telephone) said they would prefer TFU if they were to have the same procedure again. Conclusions: Patients were more satisfied with TFU compared to FFU following elective day case hand surgery. Level of Evidence: Level III (Therapeutic) [ABSTRACT FROM AUTHOR]

Objective: To explore trends and patterns of laypeople's activity for seeking telephone number of emergency medical services (EMS) based on analysis of online search traffic, including changes of the search activity with onset of the coronavirus disease 2019 (COVID-19) outbreak, in five countries - the United States of America (USA), India, Brazil, the United Kingdom (UK) and Russia.Methods: Google Trends (GT) country-level data on weekly relative search volumes (RSV) for top queries to seek EMS number were examined for January 2018-October 2021, including a comparison of RSVs between pre-COVID-19 period (January 2018-October 2019) and COVID-19 period (January 2020-October 2021), and evaluation of temporal associations of RSVs with weekly numbers of new COVID-19 cases.Results: The countries demonstrated diverse patterns of the search activity with significantly different mean RSVs (the USA 1.76, India 10.20, Brazil 2.51, the UK 6.42, Russia 56.79; p < 0.001). For all countries excepting the USA mean RSVs of the COVID-19 period were significantly higher compared with the pre-COVID-19 ones (India +74%, Brazil +148%, the UK +22%, Russia +9%; p ≤ 0.034), and exhibited positive correlations with numbers of new COVID-19 cases, more pronounced for 2021 (India rS = 0.538, Brazil 0.307, the UK 0.434, Russia 0.639; p ≤ 0.045).Conclusion: Laypeople's activity for seeking EMS telephone number greatly varies between countries. It clearly responds to the spread of COVID-19 and could be reflective of public need for obtaining emergency help. Further studies are required to establish the role of GT for conducting real-time surveillance of population demand for EMS. [ABSTRACT FROM AUTHOR]

Christensen's theory of disruptive innovation is a conceptually elegant theory of innovation and competitive response. The basic tenets of the theory have been broadly validated over a wide range of situations, primarily in the context of the developed world, leaving a gap in our understanding of how the theory explains similar situations in a developing world context. We studied the application of Christensen's theory in the Indian context over nine cases in six industrial segments. Closely following Christensen's definition, four key concepts of the theory were identified and analyzed in each case. A novel four-stage disruption matrix was evolved to map the antecedents and temporal evolution of the process of disruption. Although the theory finds broad support for some of the key concepts, it has limitations in its present form in explaining situations from a developing economy with a complex socioeconomic and regulatory background. We suggest possible reasons for these anomalous observations and propose a more generalized definition of what constitutes a Christensen disruption. [ABSTRACT FROM AUTHOR]

Abstract Background Older patients discharged from the emergency department (ED) are at increased risk for adverse outcomes. Transitional care programs offer close surveillance after discharge, but are costly. Telephone follow-up (TFU) may be a low-cost and feasible alternative for transitional care programs, but its effects on health-related outcomes are not clear. Aim We systematically reviewed the literature to evaluate the effects of TFU by health care professionals after ED discharge to an unassisted living environment on health-related outcomes in older patients compared to controls. Methods We conducted a multiple electronic database search up until December 2019 for controlled studies examining the effects of TFU by health care professionals for patients aged ≥65 years, discharged to an unassisted living environment from a hospital ED. Two reviewers independently assessed eligibility and risk of bias. Results Of the 748 citations, two randomized controlled trials (including a total of 2120 patients) met review selection criteria. In both studies, intervention group patients received a scripted telephone intervention from a trained nurse and control patients received a patient satisfaction survey telephone call or usual care. No demonstrable benefits of TFU were found on ED return visits, hospitalization, acquisition of prescribed medication, and compliance with follow-up appointments. However, many eligible patients were not included, because they were not reached or refused to participate. Conclusions No benefits of a scripted TFU call from a nurse were found on health services utilization and discharge plan adherence by older patients after ED discharge. As the number of high-quality studies was limited, more research is needed to determine the effect and feasibility of TFU in different older populations. PROSPERO registration number CRD42019141403.

Abstract Background Providing care for someone with a disease or chronic condition can have a negative psychological, physical, social, and economic impact upon informal caregivers. Despite the socio-economic relevance and more than three decades of caregiver intervention research only very few translational efforts of successful interventions are reported. Still less of these interventions have been implemented into routine services. The aim of the ReDiCare study (German acronym BerTA) is to evaluate the effectiveness of a stepped counselling approach for burdened caregivers delivered by care counsellors of two long-term care insurances and registered psychotherapists. Methods/ design A pragmatic randomised controlled trial with 572 caregivers of older adults (≥ 60 years) receiving benefits of one of the two participating long-term care insurances. Participants are assigned (t0) to either the ReDiCare intervention or a control group receiving routine care and counselling. Data are collected at baseline (-t1), 3-month (t1), 9-month (t2) and 15-month (t3). The 9-month post-intervention assessment (t2) is the primary endpoint to evaluate the results on the primary and secondary outcomes, measured by self-reported questionnaires. Depressive symptoms measured with the CES-D are the primary outcome. The main secondary outcomes are physical complaints, utilization of psychosocial resources, caregiver self-efficacy and burden, positive aspects of caregiving and perceived care quality. A process evaluation, including audio tapes, self-report questionnaires and documentation will be conducted to examine internal and external validity of the intervention. Data on direct and indirect costs are collected for the (health) economic evaluation, using a health care perspective and a societal perspective. Discussion While comparable previous caregiver interventions have been developed and evaluated for specific caregiver groups (e.g. dementia caregivers, stroke caregivers), the ReDiCare study will indicate whether a stepped approach will be effective also in a broader group of caregivers. The intervention is one of the very few translational studies in caregiver intervention research and will provide valuable insights into relevant factors for training, intervention protocol adherence, effectiveness, and costs for future implementation steps. Trial registration Deutsches Register Klinischer Studien (German Clinical Trials Register), DRKS00014593 ( www.drks.de, registered 14 May 2018) and International Clinical Trials Registry Platform, DRKS00014593 ( https://apps.who.int/trialsearch/ ).

Abstract Background Increasingly, public health interventions are delivered via telephone and/or text messages. Recent systematic reviews of early childhood obesity prevention interventions have not adequately reported on the way interventions are delivered and the experiences/perceptions of stakeholders. We aimed to summarise the literature in early childhood obesity prevention interventions delivered via telephone or text messages for evidence of application of process evaluation primarily to evaluate stakeholders’ acceptability of interventions. Methods A systematic search of major electronic databases was carried out using the Population, Intervention, Comparison, Outcomes framework. Studies were included if interventions were delivered via telephone/text messages; aimed at changing caregivers’ behaviours to prevent early childhood obesity; with one or more outcomes related to early obesity risk factors such as breastfeeding, solid feeding, tummy time, sleep and settling, physical activity and screen time; published from inception to May 2020. All eligible studies were independently assessed by two reviewers using the Cochrane Collaboration tool for assessing risk of bias. Qualitative studies were assessed using the Consolidated Criteria for Reporting Qualitative Research and Standards for Reporting Qualitative Research tools. Results Twenty-four studies were eligible, and the overall risk of bias was low. Eight studies (33%) had evidence of process evaluation that examined participants’ perceptions of interventions. Participants appreciated the convenience of receiving interventions via telephone or text messages. 63% of all studies in this review showed improvement in one or more behaviours related to childhood obesity prevention. Participants were likely to modify behaviours if they received information from a credible source such as from health professionals. Conclusion There is limited reporting of stakeholders’ experiences in early obesity prevention studies delivered by telephone or text messages. Only one-third of studies examined participants’ acceptability and the potential for delivery of childhood obesity prevention interventions conveniently using this mode of delivery. Interventions delivered remotely via telephone or text messages have the potential to reach equal or a greater number of participants than those delivered via face-to-face methods. Future research should build in process evaluation alongside effectiveness measurements to provide important insight into intervention reach, acceptability and to inform scale up. Trial registration PROSPERO registration: CRD42019108658

Aim: The aim of the study was to explore the impact of the coronavirus disease 19 (COVID-19) lockdown on the clinical outcome of patients with Type 2 diabetes mellitus (DM) attending a primary care Diabetes Clinic in Lagos State, Nigeria, in terms of their compliance with medication intake, blood pressure (BP), and glycemic control and ability to modify medication through telephone consultation. Methodology: A retrospective review of the clinical characteristics of patients was carried out. Telephone calls were made to patients with Type 2 DM who attended the chronic medical disorder clinic of the Family Medicine Department, Lagos State University Teaching Hospital, Lagos, Nigeria. The information obtained included questions on demographic data, type of medications used, and medication compliance, use of self-monitoring devices for BP, and blood glucose levels. Data analysis was performed using SPSS program version 26. Results: A total of 178 patients were eligible. Most (87%) reported using their medication as prescribed, 74% of patients had self-monitoring of blood glucose (SMBG) during lockdown, though only 29% checked glucose level regularly and 54% practiced home monitoring of BP (HMBP). Medication was modified in 34% of patients by the doctor who called in. Biguanides and Sulfonylureas were the most prescribed oral antidiabetic medications, while Renin Angiotensin Aldosterone System (RAAS) blockers were the most prescribed antihypertensive class. The HMBP was associated with lower systolic BP (t-test 3.49, P = 0.0008). Conclusions: Type 2 diabetic patients managed through telephone during the COVID-19 lockdown reported good level of drug compliance, while improved practice of SMBG, and HMBP resulted in better level of control. The findings of this review suggest that the use of e-consultation can play a role in patient management of Type 2 diabetes even beyond the COVID-19 era including reaching patients in distant locations who are unable to come to the hospital. There is a need for further studies on e-medicine role on various aspects of medical care.

Objective: Given the high prevalence of maternal morbidity and mortality, it is imperative that maternal health interventions are comprehensively evaluated, so they can be scaled with fidelity. Community-based care management models focused on perinatal health care are a priority for health care systems and payers. Alternative care management delivery modalities, such as video visits, are needed to expand program reach amidst growing system-level challenges. This evaluation explores the feasibility, acceptability, and impact of video versus telephonic care in perinatal care management., Methods: Using a mixed methods approach, we implemented a quality improvement project to learn about the integration and impact of video-enabled care into the UPMC Health Plan "Pregnancy Clinical Support" (PCS) care management delivery model. Focus groups were conducted with PCS care managers (CMs) to explore their perspectives on video-visit integration. Video-only members were propensity scores matched to telephonic-only members; statistical comparisons were conducted to assess between-group differences in engagement., Results: PCS CMs discussed ways to structure effective video-visit onboarding, strengths, and drawbacks of video-enabled care, workflow integration challenges, and best practices for introducing video visits to members. Video-only members had significantly (P < 0.0001) more clinical sessions (2.56 ± 1.57 vs 2.05 ± 1.52) and longer case duration measured in calendar days (209 ± 80 vs 169 ± 94) during the 17-month project period than telephonic-only members., Conclusion: Evidence generated provides direct guidance on successfully integrating video visits into workflows of community-based CMs while improving engagement in care across diverse member populations., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Background: Stroke remains the second leading cause of death worldwide, with a 20 % risk of recurrence within 5 years. Preventing secondary stroke events is crucial for patient management. Kraft et al. highlighted the potential of telemedicine in secondary prevention, but noted the need for further research. Our study incorporates recent trials to provide an updated analysis of telemedical strategies in stroke prevention., Methods: We reviewed and analyzed RCTs and observational studies from PubMed, Cochrane, Google Scholar, and Clinicaltrials.gov (May 19, 2016 - March 20, 2024) comparing telephone-based follow-up to standard care in stroke patients. The meta-analysis focused on SBP changes within 12 months. We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) and observational studies, sourced from PubMed, Cochrane, Google Scholar, and ClinicalTrials.gov (May 19, 2016 - March 20, 2024). We compared telephone-based follow-up to standard care in stroke patients, and the primary outcome was systolic blood pressure (SBP) changes within 12 months., Results: Our systematic review included data from 21,904 patients. The meta-analysis focused on studies with comparable systolic blood pressure (SBP) data. It involved 3,501 individuals in the control group and 3,485 in the experimental group. The analysis revealed a significant reduction in SBP with telemedicine strategies for secondary stroke prevention, with a p-value of 0.003. Additionally, a systemic review of the included studies demonstrated that these strategies improved medication adherence, lifestyle habits, and physical performance, positively correlating with better health outcomes and reduced mortality risk., Conclusion: With the inclusion of recent clinical trials, our updated systematic review and meta-analysis concludes that telemedicine supports secondary prevention in cerebrovascular diseases, particularly blood pressure control. While telemedicine may have a role in reducing recurrent stroke risk, we believe further studies with longer follow-up periods are needed to validate the role of telemedical strategies in reducing recurrence rates., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest and no financial interests related to the material of this manuscript. Funding No financial support was received for this study., (Copyright © 2024 Elsevier Inc. All rights reserved.)

When and how to survey potential respondents is often determined by budgetary and external constraints, but choice of survey modality may have enormous implications for data quality. Different survey modalities may be differentially susceptible to measurement error attributable to interviewer assignment, known as interviewer effects. In this paper, we leverage highly similar surveys, one conducted face-to-face (FTF) and the other via phone, to examine variation in interviewer effects across survey modality and question type. We find that while there are no cross-modality differences for simple questions, interviewer effects are markedly higher for sensitive questions asked over the phone. These findings are likely explained by the enhanced ability of in-person interviewers to foster rapport and engagement with respondents. We conclude with a thought experiment that illustrates the potential implications for power calculations, namely, that using FTF data to inform phone surveys may substantially underestimate the necessary sample size for sensitive questions., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aim: To gain a better understanding of consumer experiences with and preferences for telephone and videoconference consultations (telehealth), and how these compare to traditional in-person consultations., Methods: A national cross-sectional survey was administered to a representative sample of Australian adults who have received a telehealth service within the last year. Consumers were recruited by Qualtrics® through their online sampling service. The sample was representative of the broader Australian population according to gender, age, location (state/territory), and place of residence (urban or remote). Information on demographics (e.g., age, gender, employment status), recent telehealth experience, and preferences for consultation modality was collected. To measure preferences consumers were asked to indicate which modality they would prefer (in-person, telephone, or videoconference) for different scenarios. These included consultations of various time lengths, and for the top ten conditions for which individuals sought a general practitioner., Results: A total of 1069 consumers completed the survey. When consumers were asked to describe their most recent telehealth appointment, most were for follow-up appointments (67%) and completed by telephone (77%) rather than by videoconference, and with a general practitioner (75%). In-person consultations at a clinic were the top preference in all clinical scenarios presented, except when needing a prescription or to receive test results. In these cases, a telephone consultation was the preferred modality. Inexperience with videoconference and duration of consultation influenced preference for consultation mode. Consumers preferred to have short consultations of around five minutes done by telehealth (telephone or videoconference), while they preferred in-person for longer consultations (up to 60 minutes)., Conclusions: Many Australians have used telehealth in the past year to access healthcare, with telephone being the most common form of communication. Given the option and the experience to date, consumers prefer telephone when consultations related to either prescriptions or test results. Experience with videoconference for consultations increased consumer preferences for using it for future consultations.

Objective: Understanding the causal mechanisms through which telephone and mobile health continuing care approaches reduce alcohol use can help develop more efficient interventions that effectively target these mechanisms. Self-efficacy for successfully coping with high-risk alcohol relapse situations is a theoretically and empirically supported mediator of alcohol treatment. This secondary analysis aims to examine self-efficacy as a mechanism through which remote-delivered continuing care interventions reduce alcohol use., Method: The study included 262 adults ( M age = 7.4) who had completed 3 weeks of an intensive outpatient alcohol treatment program. The sample was predominantly male (71%), African American (82%), and completed a high school education (71%). The four-arm randomized clinical trial compared three active continuing care interventions (telephone monitoring and counseling [TMC], addiction comprehensive health enhancement support system [ACHESS], and combined delivery of TMC and ACHESS) to usual care and assessed longitudinal measures of alcohol use and self-efficacy. Analyses employed the potential outcomes framework and sensitivity analyses to address threats to causal inference resulting from an observed mediator variable.SD = 7.4) who had completed 3 weeks of an intensive outpatient alcohol treatment program. The sample was predominantly male (71%), African American (82%), and completed a high school education (71%). The four-arm randomized clinical trial compared three active continuing care interventions (telephone monitoring and counseling [TMC], addiction comprehensive health enhancement support system [ACHESS], and combined delivery of TMC and ACHESS) to usual care and assessed longitudinal measures of alcohol use and self-efficacy. Analyses employed the potential outcomes framework and sensitivity analyses to address threats to causal inference resulting from an observed mediator variable., Results: Relative to usual care, the two intervention conditions that included TMC reduced alcohol use through improvements to self-efficacy. There was no evidence that self-efficacy mediated the effect of ACHESS on alcohol use., Conclusions: Based on our findings, self-efficacy is an important mechanism through which telephone continuing care interventions affect alcohol use. Future research to identify which components of TMC influence self-efficacy and factors that mediate ACHESS effects could enhance the effectiveness of remote delivery of continuing care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Nearly 75% of persons living with dementia (PLWD) in the US live at home and are cared for by informal family members who have limited access to supportive and accessible services, indicating an increased need for these types of services (Alzheimer's Association, 2023). The Alzheimer's Association call centers offer free telephone care consultations, but it currently remains unclear which types of brief telephone support benefit caregivers. This study compares outcomes of participants who received traditional care consultation calls via the Alzheimer's Association National Helpline with care consultation calls from Helpline staff trained in Solution-Focused Brief Strategies (SFBS), a client-centered evidence- and resource-based approach., Method: Sequential callers were randomly assigned to the "traditional" or "SFBS" care consultation groups and were assessed at the time of call (baseline) and post-call (T1). The outcomes of interest were general self-efficacy (GSE), self-efficacy in managing emotions (PROMIS), caregiver mastery, therapeutic alliance, and goal setting., Results: Of over 500 callers, callers receiving the SFBS scored higher on therapeutic alliance and goal-setting metrics, such as greater sense of collaboration on goals (effect size = 0.280, p  = 0.0005, significant with Bonferroni correction), mutual agreement with care consultant on goals (effect size = 0.418, p  < 0.0001, significant with Bonferroni correction), and believing the way the problem was resolved was correct (effect size = 0.286, p  = 0.0007, significant with Bonferroni correction) than those receiving the traditional care consultation. Both groups reported improvements in the PROMIS measure, but there were no differences between groups. There were no significant differences in GSE or caregiver mastery scores between groups., Conclusion: This study provides evidence for the effectiveness of the integration of SFBS in dementia care consultation calls as part of telephone-based supportive services for dementia caregivers.