Personal Telephone Calls Research Articles

African Americans in Standard Behavioral Treatment for Obesity, 2001-2015: What Have We Learned?

African Americans (AAs) bear a disproportionate burden of the obesity epidemic, yet have historically been underrepresented in weight loss research. We conducted a narrative review of large ( N > 75) randomized prospective clinical trials of standard behavioral treatment for weight loss that reported results in the past 15 years (2001-2015) to (a) determine the rates of inclusion and reported results for AAs and (b) further identify strategies that may result in improved outcomes. Of the 23 trials reviewed, 69.6% of the studies met or exceeded population estimates for AAs in the United States. However, only 10 reported outcomes and/or considered race in the analytic approach. At 6 months, AA participants consistently lost less weight than White participants. The use of culturally tailored intervention materials and monthly personal telephone calls were reported as factors that may have enhanced treatment response. Future behavioral weight loss trials should also increase reporting of outcomes by race.

The forgotten risk? A systematic review of the effect of reminder systems for postpartum screening for type 2 diabetes in women with previous gestational diabetes.

BackgroundScreening for type 2 diabetes is recommended for women with previous gestational diabetes (GDM). However, the screening rates remain low. We aimed to evaluate the reminders and reminder systems for women with previous GDM and the health professionals in primary and secondary health care with screening rate among postpartum women as primary outcome.MethodsObservational and intervention studies were included and the PRISMA guidelines were followed for the literature extraction.ResultsSix studies were included: two long-term follow up studies and four early terms. Five studies focused on secondary care settings and one on primary care. Three studies focused on reminders to postpartum women only, two studies to both the women and health care professional, and one study on the health care provider only. Types of reminders varied from letters, emails, and personal telephone calls to the women to register-based reminders or letters to the health care professionals. Reminders were efficient but efficiency varied between studies. Two studies found that direct telephone calls strengthened the reminding of the women. The effect of reminding both the women and the health professional screening rates decreased compared to reminding either health professionals or reminding the women separately.ConclusionsReminders have a potential for early detection and prevention of type 2 diabetes in this high risk group of women; however, the kind of reminder and the frequency of reminders should be carefully considered accordingly to the target group.

Protocol for a randomised blocked design study using telephone and text-messaging to support cardiac patients with diabetes: a cross cultural international collaborative project

BackgroundThe prevalence of type 2 diabetes is rising internationally. Patients with diabetes have a higher risk of cardiovascular events accounting for substantial premature morbidity and mortality, and health care expenditure. Given healthcare workforce limitations, there is a need to improve interventions that promote positive self-management behaviours that enable patients to manage their chronic conditions effectively, across different cultural contexts. Previous studies have evaluated the feasibility of including telephone and Short Message Service (SMS) follow up in chronic disease self-management programs, but only for single diseases or in one specific population. Therefore, the aim of this study is to evaluate the feasibility and short-term efficacy of incorporating telephone and text messaging to support the care of patients with diabetes and cardiac disease, in Australia and in Taiwan.Methods/designA randomised controlled trial design will be used to evaluate a self-management program for people with diabetes and cardiac disease that incorporates the use of simple remote-access communication technologies. A sample size of 180 participants from Australia and Taiwan will be recruited and randomised in a one-to-one ratio to receive either the intervention in addition to usual care (intervention) or usual care alone (control). The intervention will consist of in-hospital education as well as follow up utilising personal telephone calls and SMS reminders. Primary short term outcomes of interest include self-care behaviours and self-efficacy assessed at baseline and four weeks.DiscussionIf the results of this investigation substantiate the feasibility and efficacy of the telephone and SMS intervention for promoting self management among patients with diabetes and cardiac disease in Australia and Taiwan, it will support the external validity of the intervention. It is anticipated that empirical data from this investigation will provide valuable information to inform future international collaborations, while providing a platform for further enhancements of the program, which has potential to benefit patients internationally.Trial registrationACTRN 12611001196932.

Effekte der Kernspinresonanztherapie auf Krankenstand bei Patienten mit Nervenwurzelirritation infolge eines lumbalen Bandscheibenvorfalls

The prevalence of spinal symptoms in Western industrialised countries ranges up to 80 %. Back pain ranks second among the most common reasons to seek medical advice. The resulting financial burden on the health-care system is proportional to the subjectively experienced pain. The aim of the present study was to determine whether the use of magnetic resonance therapy alters the duration of sickness absence in patients with discogenic radiculopathy. In a double-blind prospective randomised study, the use of magnetic resonance therapy for back pain in patients with discogenic radiculopathy was evaluated in the context of health economics. Patients aged 20 to 55 years with lumboischialgia and no indication for surgery were included in the study. The primary variable was the number of days of sickness absence in a study group before and after magnetic field therapy, and in a control group. The number of days of sickness absence was determined on the basis of a pain diary and by telephone inquiry. Patients who were treated with an activated magnetic resonance therapy device had significantly fewer days of sickness absence (p = 0.009) when evaluated by personal telephone calls. The duration of sickness absence before therapy was 14.7 days and that after therapy 5.8 days. In contrast, the days of sickness absence in the control group were 7.6 days before therapy and 13.8 days after therapy. The duration of symptoms was negatively correlated with the days of sickness absence. Patients who reported a burden at work had more days of sickness absence (8.3 days) than those with no burden at work (3.2 days). This correlation does not apply to familial burden. The cost-effectiveness analysis showed different degrees of compensation of the cost of magnetic resonance therapy, depending on the occupational group. Direct and indirect costs of magnetic resonance therapy were compensated by 16.9 fewer days of sickness absence among workers, 11.4 fewer days of sickness absence among employees, and 9.1 fewer days of sickness absence among civil servants. Based on the number of days of sickness absence, the study confirmed that a relatively economical alternative technique is able to provide pain relief as well as benefit the health economy. Unemployed patients or patients who have submitted an application for a pension may be problematic because they may not wish to be pronounced healthy by their doctors.

Cost-Effectiveness of Insuring the Uninsured: The Case of Korean American Children

More than one-quarter of Korean American children are uninsured, and many are eligible for children's health insurance programs. The objective of this study is to evaluate the effectiveness and cost-effectiveness of different school-based health insurance strategies to provide coverage to uninsured Korean American children. The authors used a quasi-experimental nonequivalent control group design, conducted from July to December 2005 in Los Angeles, California. The subjects were in 3 groups/schools (n = 1181). Parents received a variation of outreach methods (i.e., information sheets, school site presentations, automated telephone messages, personal telephone calls) and application assistance (i.e., telephone helpline, on-site assistance). The authors used bivariate and multivariable analysis to assess effectiveness. Cost-effectiveness was performed using a 3-stage model and Monte Carlo simulation. Of the uninsured in the intensive intervention group, 41% applied for insurance compared with 13% of the control group (P = 0:002). This success was due to personal telephone calls. Of the uninsured in the intensive intervention group, 23% enrolled in insurance compared with 10% of the control group (P = 0:048). The most common reason reported by parents for nonenrollment despite assistance was failure to mail in the application. Despite the small increase in insurance enrollment from the intensive intervention strategy compared with the control group, it is cost-effective. Personal telephone calls are effective in increasing outreach for children's health insurance application. However, more research is needed to investigate why parents fail to mail in the application. Ultimately, insuring more children will result in cost-effective improvements in quality-adjusted life years.

Endoscopy teaching in Canada: A survey of obstetrics and gynecology program directors and graduating residents

Objective To examine the current state of basic and advanced gynecologic endoscopy teaching in Canadian Obstetrics and Gynecology (Ob/Gyn) residency programs. Methods On Institutional Research Board approval, 2 pretested anonymous questionnaires were developed: one distributed to all Canadian Ob/Gyn program directors and a second to graduating residents (Canadian Task Force classification III). Two mailings were sent to maximize response, and some department chairs received personal telephone calls by the senior author to encourage participation. Residents on maternity leave were excluded from the study. Results Fifteen of 16 (94%) program directors, and 47 of 62 (76%) residents participated. Directors expect all residents to be knowledgeable and competent performing basic endoscopic procedures on graduation. However, considerable variation exists among programs that teach advanced endoscopy. Some of the more important factors limiting integration of advanced endoscopic teaching include paucity of trained faculty, lack of attending interest, scarcity of operating time, and financial constraints. Most graduating residents consider undertaking additional gynecologic endoscopy fellowships. Conclusion Most Ob/Gyn program directors and graduating residents consider endoscopic surgery essential to contemporary practice. There is consensus to improve resident teaching in gynecologic endoscopy and commitment to better prepare future practitioners to ensure patient safety. Paucity of trained faculty and fiscal constraints appear to be important limiting factors.

Collective contributions of women to cardiothoracic surgery: a perspective review

Background. Of 5,812 persons boarded by the American Board of Thoracic Surgery (ABTS), 99 (< 2%) are women. This study was designed to collect and report the contributions made by these women in the specialty of cardiothoracic surgery. Methods. Identification of ABTS board-certified women was obtained from the ABTS. Compilation of data was accomplished through membership databases, medical licensing boards, thoracic surgery residency programs, and residency program attending surgeons. Data were substantiated through hospital medical staff offices, local practitioners, and personal telephone calls. Curricula vitae were requested; practice types (adult, pediatric, cardiac, general thoracic, or transplantation) were established. Data were collated, extrapolated, and tallied. Trends over time were analyzed by logistic regression analyses. Results. Currently, 84 women are actively practicing: 44 have academic appointments and 40 are in private practice. Of the remaining 15 women, 4 are deceased; 4 are retired; 5 are in other professional fields; and 2 are in an unknown practice setting. Accumulated data confirmed that women surgeons are practicing in every type and subgroup of cardiothoracic surgery (adult, pediatric, cardiac, general thoracic, transplantation, and combinations of these). Collectively, they have published 2,292 articles and book chapters. Manuscripts directly related to cardiac topics number 1,220. Women in cardiothoracic surgical research have been awarded $31.9 million in grant funds. Two trends over time were identified. First, the distribution of practice setting (academic or private) was stable compared with year of board certification. Secondly, a statistically significant rise in the annual percentage of board-certified persons who are women ( p < 0.0001) has been established. Conclusions. The percent of ABTS board-certified women surgeons has increased; more than 50% have academic appointments; and a stable trend for women to choose academic cardiothoracic surgery exists.

Obtaining Cooperation in a Survey of Business Executives

Surveys of elite groups often require special efforts to obtain cooperation. A survey is described in which the crucial first step was to obtain from chief executives of business firms the names of certain of their subordinates and approval to survey them. Among several techniques used to obtain a high rate of cooperation were two involving personalization of the first approach to the chief executives: addressing initial letters to them by name, and use of personal telephone calls after the letters to obtain the desired information and approval. Comparison of response rates and other results with those obtained from a control group surveyed only by mail indicates that the personalization procedures had an effect opposite that desired.