Reminder Telephone Calls Research Articles

Effectiveness of a pelvic floor muscle exercise program on urinary incontinence following childbirth.

Objectives The primary objective of this review was to determine, from the available evidence, the effectiveness of an antenatal and/or a post-natal program of pelvic floor muscle exercises (PFME) compared with usual care on preventing, reducing or resolving the incidence and severity of stress incontinence, urge incontinence or mixed stress and urge urinary incontinence following childbirth. Secondary objectives were included to examine the effectiveness of a PFME program on pelvic floor muscle strength and on encouraging adherence to an exercising program. Inclusion criteria Types of studies Randomised controlled trials and non-randomised controlled trials were included in the review if, in relation to urinary incontinence, and/or adherence to a PFME program, and/or pelvic floor muscle strength, the following had been explored: • antenatal PFME compared with usual care; • post-natal PFME compared with usual care; • a PFME program compared with usual care. Usual care is commonly used to describe the care women normally receive from health professionals in the antenatal and/or post-natal period. In some cases usual care includes a standard information package given to all women attending the health service and in others it is advice about performing PFME. Types of participants Participants included women who experienced a spontaneous onset of labour and who subsequently delivered at more than 20 weeks gestation either vaginally, both spontaneous and assisted, or by non-elective caesarean section. Exclusions: • women who delivered by elective caesarean section; • women experiencing post-partum overflow urinary incontinence. Types of interventions 1 Pelvic floor muscle exercises. 2 PFME instruction and a PFME program's components, such as educational materials, feedback (including biofeedback, e.g. information about strength of pelvic floor muscle contractions by various means) and number of PFME. Exclusions: • electrical stimulation of pelvic floor muscles; • vaginal cones; or • other adjunct therapies. In studies that included a subgroup treated with one of these interventions, the results of the subgroup were excluded from the review's analysis. Types of outcome measures Outcomes that were of interest: • non-occurrence of urinary incontinence following childbirth; • a change in the frequency, duration or severity (as appropriate) of urinary incontinence up to 12 months following childbirth. • a change in the strength of pelvic floor muscle contractions; • period of time PFME continued after initial instruction; • frequency of PFME undertaken; • women's awareness of the importance of PFME; • satisfaction with PFME instruction. Search strategy All major electronic sources of information relevant to the topic (e.g. PubMed, CINAHL and the Cochrane Library) were searched to identify published and unpublished studies and previous work in the field. Printed journals were handsearched and reference lists checked for potentially useful research. The review included any studies undertaken between 1981 and 2003. The search did not attempt to locate unpublished research before 1991. Assessment of quality An independent Review Panel carried out quality assessment of studies. Two members of the panel, using quality assessment checklists developed for the review, reviewed each study. Disagreements between reviewers were resolved through discussion or a third reviewer examining a study. Data extraction and analysis A data extraction tool was developed to extract data relating to participant characteristics, study methods, interventions and outcomes. Two reviewers independently extracted the required data. Randomised controlled trials included in the review were pooled in several metaanalyses using RevMan software program. Heterogeneity between studies was determined to ensure that they were sufficiently similar to allow for the pooling of their results. Non-randomised controlled trials were discussed in narrative comparisons. TRUNCATED AT 600 WORDS

Somali refugee women speak out about their needs for care during pregnancy and delivery

More than half of all Somali refugees in the United States live in Minnesota. To obtain information to develop culturally sensitive health education materials, we conducted two focus groups with 14 Somali women who had each given birth to one child in Minnesota. Overall, women thought that their childbirth experience was positive. They also reported racial stereotyping, apprehension of cesarean births, and concern about the competence of medical interpreters. Women wanted more information about events in the delivery room, pain medications, prenatal visits, interpreters, and roles of hospital staff. The most desirable educational formats were a videotape, audiotapes, printed materials, and birth center tours. To increase their attendance at prenatal appointments, participants said they needed reminder telephone calls, transportation, and childcare.

Increasing the response rate to a mailed questionnaire by including more stamps on the return envelope: a cotwin control study.

Twins taking part in two unrelated studies were sent a questionnaire together with a self-addressed envelope that either carried one or multiple (up to 5) stamps to the same value. The unprompted proportion of questionnaires returned (before commencement of telephone reminder calls) was increased from 62% to 71% in one study, and from 43% to 52% in the other study (test for common odds ratio in studies, p = 0.04).

Development of a Prototype Time-Use Diary and Application in Baton Rouge, Louisiana

Over the last 10 years, household travel surveys have evolved from travel or trip diaries to activity diaries and then to time-use diaries. In all previous diaries, whether trip, activity, or time-use, successive trips or activities have been collected in sequence and were assigned a sequence number, beginning with 1. In current research, a time-use diary was developed that collects data on both in-home and out-of-home activities, treats travel as another activity, but gets away from sequential numbering of activities through the day. The new time-use diary is designed to have respondents record their activities by indicating start and end times in a 24-h diary format, similar to ones used in sociological time-use research. The development of the survey instrument through testing and a focus group is described, and a description of the final diary format is provided. Also described are the results of a pilot and main survey in which households were recruited by telephone and then sent diaries in the mail. Completed diaries were returned by mail, with a number of reminder telephone calls made to increase the response rate. The pilot and main survey data are analyzed to show the detail of the activities obtained and the completeness of information that this format of diary produces. The results of this small sample survey are compared with those of a conventional travel diary survey, carried out in Baton Rouge about 2 years earlier, by using telephone recruitment, diary mail out, and computer-aided telephone interview retrieval of diary data. Results, such as the number of trips and activities per household and per person, are compared, as are the sociodemographics of the two samples. It is concluded that the day-planner diary format is a promising format that may provide better reporting of travel and activities than other diary formats.

ECONOMIC CHALLENGES IN BREAST IMAGING: A Survivor's Guide to Success

Most breast imaging centers today operate under financial strain. Among strategies designed to improve their bottom line, more efficient use of the radiologist's time is the most fundamental strategy and the one most likely to succeed in all breast imaging centers. Tasks performed by the radiologist that are not directly related to interpretation and consultation should be shifted to other personnel. Other strategies that may help some breast imaging centers include accepting only self-paying patients, renegotiating the hospital contract, performing more interventional procedures, and extending the hours of operation. Measures that can improve the economic efficiency of screening mammography include batch interpretation of mammograms; paperwork reduction; brief automated reports; limiting requests for previous films from other facilities to only potentially necessary cases; dedicated screening mammography examination rooms; reduction in recall rates; and, in certain circumstances, extension of breast center hours. Measures that can improve the economic efficiency of diagnostic mammography performance and interpretation include dedicated diagnostic mammography examination rooms, automated film rotators, improved scheduling, and efficient work-flow patterns for examination performance. Measures that can improve the economic efficiency of both screening and diagnostic mammography include improved triage of screening and diagnostic patients, reminder telephone calls to confirm mammography appointments, greater use of medical assistants to help the radiologists and technologists, and streamlined film library procedures and operations. Measures that can improve the economic efficiency of breast interventional procedures include preprocedure work-up, establishment of scheduling protocols, and greater involvement of technologists and medical assistants in assisting the radiologist who performs the interventional procedures. All of these methods are intended to create a breast imaging center that is cost efficient while maintaining a patient-friendly atmosphere and diagnostic accuracy.

Erratum: Testing Reminder and Motivational Telephone Calls to Increase Screening Mammography: a Randomized Study

Erratum: Testing Reminder and Motivational Telephone Calls to Increase Screening Mammography: a Randomized Study

Erratum: Testing Reminder and Motivational Telephone Calls to Increase Screening Mammography: a Randomized Study

Erratum: Testing Reminder and Motivational Telephone Calls to Increase Screening Mammography: a Randomized Study

Improving compliance with tuberculin skin test interpretation in children

Abstract Objective To evaluate the effect of a quality improvement initiative which utilized educational interventions combined with a phone follow‐up program on the rate of return for tuberculin skin test (TST) interpretation. Design Before and after trial with analysis of practice records for all TSTs placed. Setting/Sample The study was conducted in a resident and attending primary care practice in an urban children's hospital. All children (n = 1315) who had TSTs placed during August and October of 1995 and August and October of 1996 were included in the study. Intervention Medical staff were re‐educated regarding TST screening. Patients families were given written information about tuberculosis. Physicians and nursing staff discussed TST screening with the patients' families prior to TST placement. All patients received a series of three reminder telephone calls on three consecutive days to remind them to return for TST interpretation followed by a letter if necessary. The following data were collected: date of birth, age, zip code, type of provider, transit time from the hospital, type of health insurance, number of telephone calls made, and return status for TST interpretation. Return rates were compared pre‐ and post‐intervention. Results A total of 1315 TSTs were placed during the pre‐ (n = 611) and post‐(n = 704) intervention periods. Return rates increased from 6.2 to 61.5%. Attendings' patients and those with private insurance were more likely to return. There was no relationship to season, age or distance from the practice. Conclusions Targeted screening programs utilizing more effective methods for TST interpretation should be considered.

The importance that community pharmacists in Malta place on the introduction of pharmaceutical care.

The results from a study to assess the importance Maltese pharmacists placed on various aspects of pharmaceutical care and their willingness to provide such care are reported. A modified version of the Behavioural Pharmaceutical Care Scale (BPCS) questionnaire (consisting of three dimensions and 14 domains) was mailed to the 198 privately owned community pharmacies in Malta. A total of 99 questionnaires were returned following two reminder telephone calls. Pharmacists were asked to score the importance of each pharmaceutical care activity contained in the modified BPCS on a 6 point Likert scale ranging from 0 to 5. The overall score for the questionnaire, which illustrated the importance pharmacists attributed to various aspects of pharmaceutical care, ranged from 90 to 170 with a mean score of 134.8. There was little difference recorded between the scores for the three dimensions. The Referral and Consultation domain recorded a slightly higher score than the other two domains. Younger pharmacists obtained significantly higher scores (p < 0.05; Kruskal-Wallis test) in the Verification of Patient Understanding domain. Approximately 72% of respondents indicated that they were willing to provide pharmaceutical care, but remarked that a number of issues e.g. reimbursement, qualified support staff, GP-pharmacist co-operation, had to be addressed. A series of strategic steps are needed to help pharmacists resolve these issues before pharmaceutical care programmes could be offered by Maltese community pharmacists.

Maximizing Response to Surveys in Health Program Evaluation At Minimum Cost Using Multiple Methods

This article shows how the use of multiple methods of follow-up can enhance the rate of response to mail questionnaires. The field design reported here consisted of an initial approach by mail, followed by reminder letters, telephone calls, and personal visits to nonrespondents. This procedure resulted in accurate identification of persons who, although included in the sampling frame, were not in the target population. This effectively removed from the sample about 12% of initially selected persons who were "out-of scope. " The follow-up activities also increased the response rate by persuading many initial nonrespondents to return questionnaires. The general elements of the design are suggested for consideration by evaluators seeking high response rates using data collection strategies that are realistic given the budgets available in small to medium size evaluations. The procedures are particularly useful in circumstances where the sampling frame is suspected of including cases outside the scope of the study.

COMPUTER-GENERATED PHONE CALLS INCREASE CLINIC VISITS.

Reminder telephone calls from computers can improve immunization rates (see Journal Watch accession number 941004007 and Arch Pediatr Adolesc Med 1994; 148:908). This randomized study from a Georgia public health clinic reports that computer calls can also increase clinic attendance. During a …

Office-based interventions to improve delivery of cancer prevention services by primary care physicians.

Physician forgetfulness, patient refusal, and practice logistical difficulties are among the major reasons that physicians perform cancer prevention activities less frequently than recommended by established guidelines. To improve delivery of prevention services, office system interventions of several types have been developed and tested. These include approaches aimed at patients during the medical encounter (in-reach) and outside the medical setting (outreach). In-reach interventions include medical record checklists and flow sheets, stickers and alerts, audit with feedback, nurse-initiated reminders, and computer-generated reminders, including ones generated by mainframe and microcomputer systems. In-reach interventions are directed at patients alone, at physicians alone, at patients and physicians simultaneously, or at office staff. Outreach reminder interventions include reminder postcards, letters, telephone calls, and questionnaires. Outreach reminders are directed at patients alone. The authors review the literature supporting the efficacy of such office systems. The analysis suggests that office systems are effective strategies in promoting cancer prevention activities.

An Appointment Reminder System’s Effect on Reducing the Number of Hypertension Patients Who Drop Out from Care

We evaluated the effects of an appointment reminder system on the appointment-keeping behavior and blood pressure control status of hypertensive patients receiving care in an urban medical clinic. The study population consisted of 973 adult hypertensive patients receiving medical care at a family practice clinic affiliated with the Wayne State University School of Medicine, Detroit, Michigan. Of the 973 patients enrolled in the study, 486 were randomly assigned to a group that received appointment reminder cards and telephone calls to reschedule missed appointments, and 487 were assigned to a nonintervention control group. Patients were followed-up with regard to their appointment-keeping behavior and blood pressure control status, five to eight months after being entered in the study. The study results indicate that patients in the appointment reminder group kept significantly more appointments and were less likely to drop out of treatment than patients in the control group. The dropout rate was 46 percent lower among patients in the appointment reminder group than in the control group. Patients in the appointment reminder group also demonstrated slightly better blood pressure control at the end of the study compared with patients in the control group, although none of the differences in blood pressure levels between groups were statistically significant at the 5 percent level.