Telephone-based Service Research Articles

What’s wrong with IVR system service? A spatial theorisation of customer confusion and frustration

Purpose – The purpose of this paper is to re-examine the important question of what is wrong with interactive voice response (IVR) system service by expanding a spatially informed conceptualisation of virtual navigation which recognises the experience of movement within and through space. Design/methodology/approach – First, previous research on IVR systems is reviewed to highlight key themes to a service audience. Second, the metaphorical aspects of language used by the popular and trade press to describe IVR systems is examined. Usability and design issues are identified from previous research as a basis from reinterpreting them from a spatial perspective of navigation. Findings – Both figurative and conceptual spatial metaphors are used to describe the IVR system as an enclosed physical space, within which customers enter, feel stuck, get lost, or try to escape from. The usability issues of human memory, linearity, and feedback, can be reinterpreted from a spatial perspective as a basis for explaining confusion and frustration with IVR systems. Research limitations/implications – Since the paper is conceptual, further research is needed to empirically investigate different types and features of IVR systems. The possible influence of age and culture upon the spatial nature of experience is especially interesting topics for future study. Practical implications – The paper identifies the absence of space as an inherent limitation of IVR systems. It subsequently recommends that firms should provide spatial resources to support customer use of IVR systems, which is supported by the recent emergence of visual IVR. Originality/value – The paper introduces the broader literature on IVR systems to the service field as a basis for raising awareness about this ubiquitous technological component of telephone-based service delivery. It applies and develops a highly abstract conceptual perspective to examine and interpret the representation and experience of IVR systems, as a basis for explaining the confusion, frustration, and dislike of them.

Exploring end user adoption and maintenance of a telephone-based physical activity counseling service for individuals with physical disabilities using the Theoretical Domains Framework

Purpose: In Canada, two counseling services are offered to facilitate physical activity participation among persons with physical disabilities, yet both have encountered concerns related to the recruitment and retainment of clients. The purpose of this paper is to explore factors related to service adoption among nonusers, and the barriers and facilitators to maintaining service participation among adopters.Methods: Individuals who had never enrolled in the services (nonusers, n = 13) as well as current/previous service clients (adopters, n = 26) participated in interviews based on the Theoretical Domains Framework. Transcripts were subjected to deductive thematic analysis according to participant group.Results: Fifteen themes relating to service adoption within 10 of the 12 theoretical domains were identified for nonusers, while 23 themes relating to maintenence of service participation were identified across all 12 theoretical domains for adopters.Conclusions: The findings provide strategies to improve recruitment, adoption, and retention of clients in counseling services and to enhance the experiences of targeted service users.Implications for RehabiliationPeer support and education for equipment use should be built into physical activity programs to encourage participation among persons with physical disabilities.Programs that encourage physical activity among individuals with disabilities should be designed by practitioners to be responsive to a variety of needs, which are addressed in the program’s advertisements and offerings.The Theoretical Domains Framework is a useful framework for providing valuable insight about clients’ experiences of adoption and maintenance of a behavior change service, suggesting merit in other rehabilitation settings.

Peer support: more than tea and sympathy

Peer support: more than tea and sympathy

Application of satellite navigation system for emergency warning and alerting

One of the key responsibilities of any government is to communicate and disseminate safety information and warnings to the general public in case of an emergency. Traditionally, warnings are issued by the government through a broadcast approach using communication channels such as TV and radio. However this monopolistic approach is now challenged by new technologies and media capable of providing individualised warnings to personal mobile devices. Location-based emergency services and mobile alerts are becoming increasingly prevalent in the provision of emergency warnings. These new modes of emergency services have been adopted by several countries worldwide including Australia. One example is the Australian National Emergency Alert (EA) which is a telephone-based service enhanced with location-based capabilities. This paper introduces the concept of applying global satellite navigation systems such as the Japanese satellite system in the domain of emergency warning and alerting. The Japanese satellite warning system can be tailored to transmit real-time location-based emergency warnings to people's mobile devices while not being constrained by the limitations of ground-based communication technologies. A key advantage of satellite based communication is its high resilience to communication network overload and failure of ground systems and network infrastructure during a disaster. This enables people to obtain necessary information anywhere (outdoor) and anytime during times of disaster. A satellite-based warning system could also be integrated with existing warning services and be used as a complementary technology. This paper examines opportunities and challenges for using satellite navigation systems to deliver warnings and safety messages during emergencies and disasters.

One Health e-Surveillance for Early Detection of Gastrointestinal Disease Outbreaks

In human and animal health, conventional approaches to preventing and controlling gastrointestinal disease (GI) have not reduced the overall disease burden. In order to understand and mitigate shared GI aetiologies between humans and animals it is necessary to develop One Health Surveillance approaches that integrate data-sources contributed to by human and veterinary healthcare. Here we describe how a real-time surveillance system for early detection of GI outbreaks in small animal and human health is being developed by collecting electronic health records from veterinary practitioners and a telephone-based 24-hour medical triage service in the UK.

Smoking quit rates among patients receiving pharmacist-provided pharmacotherapy and telephonic smoking cessation counseling

ObjectivesTobacco use is the nation's leading cause of preventable illness and death, causing a significant burden on the health care system. Many cessation pharmacotherapy treatment options are available to help smokers quit, including nicotine replacement therapies (NRTs) and prescription medications. Research indicates that pharmacists are able to provide a positive benefit to smokers who want to quit through pharmacologic and nonpharmacologic interventions. The aim of the present work was to examine the quit rates among participants who received smoking cessation pharmacotherapy and pharmacist-provided telephone-based quit counseling services. DesignRetrospective database review of enrolled participants. SettingTelephone-based pharmacotherapy and medication counseling services offered from a medication management center. ParticipantsState employees who voluntarily contacted a medication management center for smoking cessation services after receiving promotional flyers. Main outcome measuresLong-term quit rates at 7 and 13 months were determined by means of patient self-report in response to questioning. Smoking cessation was considered to be a success if the patient reported not smoking for the past 30 days. ResultsA total of 238 participants were included in the review. Thirty-nine participants completed the program after the first treatment, 12 participants after the second treatment, and 4 participants after the third treatment. Two patients completed the program more than once. Eighty-five participants (36%) reported results at 7-month follow-up; of these, 43 (51%) were smoking free. A total of 44 participants (18%) reported results at 13-month follow-up; of these, 24 participants (55%) reported being smoking free. There were no significant differences in the percentages of smoking-free participants at 7 or 13 months, regardless of their first treatment (P = 0.06 and 0.345, respectively). ConclusionSuccessful quit rates were higher than previously demonstrated with other telephone-based smoking cessation programs. Therefore, pharmacist-provided telephone-based counseling may be beneficial in helping patients to quit smoking. Future research is warranted to examine the benefits of these types of programs.

Perceptions of crisis care in populations who self-referred to a telephone-based mental health triage service.

Although psychiatric crises are very common in people with mental illness, little is known about consumer perceptions of mental health crisis care. Given the current emphasis on recovery-oriented approaches, shared decision-making, and partnering with consumers in planning and delivering care, this knowledge gap is significant. Since the late 1990s, access to Australian mental health services has been facilitated by 24/7 telephone-based mental health triage systems, which provide initial psychiatric assessment, referral, support, and advice. A significant proportion of consumers access telephone-based mental health triage services in a state of crisis, but to date, there has been no published studies that specifically report on consumer perceptions on the quality and effectiveness of the care provided by these services. This article reports on a study that investigated consumer perceptions of accessing telephone-based mental health triage services. Seventy-five mental health consumers participated in a telephone interview about their triage service use experience. An eight-item survey designed to measure the responsiveness of mental health services was used for data collection. The findings reported here focus on the qualitative data produced in the study. Consumer participants shared a range of perspectives on telephone-based mental health triage that provide invaluable insights into the needs, expectations, and service use experiences of consumers seeking assistance with a mental health problem. Consumer perceptions of crisis care have important implications for practice. Approaches and interventions identified as important to quality care can be used to inform educational and practice initiatives that promote person-centred, collaborative crisis care.

Investigating the validity and usability of an interactive computer programme for assessing competence in telephone-based mental health triage.

Telephone-based mental health triage services are frontline health-care providers that operate 24/7 to facilitate access to psychiatric assessment and intervention for people requiring assistance with a mental health problem. The mental health triage clinical role is complex, and the populations triage serves are typically high risk; yet to date, no evidence-based methods have been available to assess clinician competence to practice telephone-based mental health triage. The present study reports the findings of a study that investigated the validity and usability of the Mental Health Triage Competency Assessment Tool, an evidence-based, interactive computer programme designed to assist clinicians in developing and assessing competence to practice telephone-based mental health triage.

Feasibility, effectiveness and cost-effectiveness of a telephone-based weight loss program delivered via a hospital outpatient setting.

Engaging patients in a group-based weight loss program is a challenge for the acute-care hospital outpatient setting. To evaluate the feasibility, effectiveness and cost-effectiveness of a telephone-based weight loss service and an existing face-to-face, group-based service a non-randomised, two-arm feasibility trial was used. Patients who declined a two-month existing outpatient group-based program were offered a six-month research-based telephone program. Outcomes were assessed at baseline, twomonths (both groups) and sixmonths (telephone program only) using paired t tests and linear regression models. Cost per healthy life year gained was calculated for both programs. The telephone program achieved significant weight loss (-4.1 ± 5.0%; p = 0.001) for completers (n = 35; 57% of enrolees) at sixmonths. Compared to the group-based program (n = 33 completers; 66%), the telephone program was associated with greater weight loss (mean difference [95%CI] -2.0% [-3.4, -0.6]; p = 0.007) at twomonths. The cost per healthy life year gained was $33,000 and $85,000, for the telephone and group program, respectively. Telephone-delivered weight management services may be effective and cost-effective within an acute-care hospital setting, likely more so than usual (group-based) care.

Tobacco Cessation May Improve Lung Cancer Patient Survival

This study characterizes tobacco cessation patterns and the association of cessation with survival among lung cancer patients at Roswell Park Cancer Institute: an NCI Designated Comprehensive Cancer Center. Lung cancer patients presenting at this institution were screened with a standardized tobacco assessment, and those who had used tobacco within the past 30 days were automatically referred to a telephone-based cessation service. Demographic, clinical information, and self-reported tobacco use at last contact were obtained via electronic medical records and the Roswell Park Cancer Institute tumor registry for all lung cancer patients referred to the service between October 2010 and October 2012. Descriptive statistics and Cox proportional hazards models were used to assess whether tobacco cessation and other factors were associated with lung cancer survival through May 2014. Calls were attempted to 313 of 388 lung cancer patients referred to the cessation service. Eighty percent of patients (250 of 313) were successfully contacted and participated in at least one telephone-based cessation call; 40.8% (102 of 250) of persons contacted reported having quit at the last contact. After controlling for age, pack year history, sex, Eastern Cooperative Oncology Group performance status, time between diagnosis and last contact, tumor histology, and clinical stage, a statistically significant increase in survival was associated with quitting compared with continued tobacco use at last contact (HR = 1.79; 95% confidence interval: 1.14-2.82) with a median 9 month improvement in overall survival. Tobacco cessation among lung cancer patients after diagnosis may increase overall survival.

The EASY (Early Access to Support for You) sickness absence service: a four-year evaluation of the impact on absenteeism.

In May 2008, the National Health Service (NHS) Lanarkshire (NHSL) implemented a unique telephone-based sickness absence management service entitled "EASY" (Early Access to Support for You). The EASY service supplements existing absence policies and enables telephone communication between the absentee, their line manager, and the EASY service from the first day of absence and referral to occupational health services at day ten. The aim of this study was to determine if the EASY service was effective between May 2008 and May 2012 in reducing sickness absence in NHSL compared to normal occupational healthcare in NHS Scotland and is, as such, a cost-saving intervention. This study included time-series analysis of health board sickness absence data and analyses of the EASY service database (survival analyses and Cox's proportional hazards model). The EASY service was effective in reducing sickness absence by 21% in NHSL, whereas the nonspecific tightening of the sickness absence policies across the rest of Scottish NHS health boards reduced sickness absence by approximately 9%. The richness of the EASY database gave detailed information on absentees by cause, duration, job family, and reporting compliance. The mean duration of musculoskeletal absences was significantly shorter in years 2, 3, and 4 compared to year 1. Those absentees contacted by phone on the first day of absence were more likely to return to work than those contacted on subsequent days. The EASY service improves economic efficiency; the value of the hours saved from the reduced sickness absence exceeds the cost of operating the service. The study highlights the importance of an early telephone-based intervention for sickness absence management.

FARMERS’ USE OF MOBILE PHONE-BASED SERVICES FOR ACCESSING AGRICULTURE AND RURAL DEVELOPMENT INFORMATION IN NORTHERN ZONE OF EDO STATE, NIGERIA

Telephone-based services are becoming widespread and could be useful in agriculture and rural development (ARD). This study assessed the use of mobile phone based services (MPBSs) among farmers in the northern zone of Edo State. A multistage sampling procedure was used to draw a sample of 150 respondents. Data on the objectives were obtained with structured questionnaire and analysed using frequency counts, percentages, mean, Likert scale and Spearman rho correlation. Results show that majority of respondents were males (72.7%), within the age group of between 51-60 years (53.3%), married (80.0%), had family size of 5-8 persons (62.0%) and had telephones (94.7%). The frequently accessed and regularly used MPBS were phone calls (x=2.57; 3.39) and SMS (x=2.28; 3.29).The ARD information frequently accessed using MPBSs included farmers’ meetings (x=2.26), planting/breeding materials (x=2.17), community meetings (x=2.56), warnings and alarms (x=2.47) and community projects (x=2.52). Constraints to usage of MPBSs included shortage of capital to recharge, dearth of knowledge on application of MPBSs and poor electricity supply There was significant correlation between respondents’ age (r=-0.401), education (r=0.413) as well as farming experience (r=-0.229) and frequency of usage of MPBSs to access ARD information. It was concluded that access and usage of mobile phone based services was low due to several constraints. ARD information should be disseminated using MPBS and farmers’ sensitization and capacity building on MPBSs is necessary to improve extension delivery. Keywords: Telephone services, Agricultural development information, Mobile phone based services

Telephone based Lactation Counseling: A Qualitative Study on the Lactation Counselor’s Experience

Background: This qualitative study was undertaken as a follow-up of the results of a randomized controlled trial (RCT) conducted in Kuala Lumpur in 2010. Objective: The main objective of this study was to explore the Lactation Counselors’ perspectives regarding counselor-initiated telephone-based lactation counseling service to mothers in Kuala Lumpur. Methods: In-depthinterviews were held with the lactation counselors. The analytical framework was conceptualized using the Grounded Theory method. Results: The greatest determinant which affected telephone-based lactation counseling was the intention of counselors, followed by external factors such as time constraints, mothers’ behaviors and their control in decision making, family influence and cultural differences. Strong motivation is required for the counselors to perform telephone lactation counseling. Conclusion: The Lactation Counselors in general have appreciated the experiences and benefits gained from the service. However, external factors pose major impact towards the conduct and effectiveness of counseling.

Help at the end of the line: Trialling a telephone-based health-coaching service for achieving healthy weight gain during pregnancy

Alliance of North America (MANA), National Association of Certified Professional Midwives (NACPM), and North American Registry of Midwives (NARM) have formed an alliance to translate these standards for midwifery across the United States, resulting in a cohesive and stronger midwifery voice across the country. Conclusion: The combined evidence establishes a mandate for changing health care. How do we use it to forge the future of midwifery and to achieve the triple aim of (a) improving the health of populations; (b) improving the care experience (including quality and satisfaction); and (c) reducing the per capita cost of health care? It is both an opportunity and challenge, but represents one of the most critical moments in the history of midwifery!

Barriers and facilitators to using NHS Direct: a qualitative study of 'users' and 'non-users'.

BackgroundNHS Direct, introduced in 1998, has provided 24/7 telephone-based healthcare advice and information to the public in England and Wales. National studies have suggested variation in the uptake of this service amongst the UK’s diverse population. This study provides the first exploration of the barriers and facilitators that impact upon the uptake of this service from the perspectives of both ‘users’ and ‘non- users’.MethodsFocus groups were held with NHS Direct ‘users’ (N = 2) from Bedfordshire alongside ‘non-users’ from Manchester (N = 3) and Mendip, Somerset (N = 4). Each focus group had between five to eight participants. A total of eighty one people aged between 21 and 94 years old (M: 58.90, SD: 22.70) took part in this research. Each focus group discussion lasted approximately 90 minutes and was audiotape-recorded with participants’ permission. The recordings were transcribed verbatim. A framework approach was used to analyse the transcripts.ResultsThe findings from this research uncovered a range of barriers and facilitators that impact upon the uptake of NHS Direct. ‘Non-users’ were unaware of the range of services that NHS Direct provided. Furthermore, ‘non-users’ highlighted a preference for face-to face communication, identifying a lack of confidence in discussing healthcare over the telephone. This was particularly evident among older people with cognitive difficulties. The cost to telephone a ‘0845’ number from a mobile was also viewed to be a barrier to access NHS Direct, expressed more often by ‘non-users’ from deprived communities. NHS Direct ‘users’ identified that awareness, ease of use and convenience were facilitators which influenced their decision to use the service.ConclusionsAn understanding of the barriers and facilitators which impact on the access and uptake of telephone-based healthcare is essential to move patients towards the self-care model. This research has highlighted the need for telephone-based healthcare services to increase public awareness; through the delivery of more targeted advertising to promote the service provision available.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-014-0487-3) contains supplementary material, which is available to authorized users.

Sleep disturbance in cancer patients and caregivers who contact telephone-based help services.

Insomnia is highly prevalent in people who are affected by cancer. However, options available to receive support for insomnia are limited. Telephone-based help services, such as cancer helplines, may be ideally placed to meet unmet needs regarding insomnia after cancer. The present study describes the prevalence and predictors of insomnia in patients and caregivers who call cancer helplines seeking support. Participants (N = 500 patients, N = 234 caregivers) were recruited through an Australian state-based telephone-delivered cancer helpline. In addition to routine screening with the Distress Thermometer, participants were administered the Insomnia Severity Index. Most participants were female, older than 50 years of age, and were three (caregivers) to four (patients) months post-diagnosis. Insomnia symptoms were reported by 59.4 % of patients and 62.9 % of caregivers, with moderate to severe levels of insomnia reported by 27 % of patients and 30 % of caregivers. Insomnia was predicted by distress level for both patients (β = .31, p < .001) and caregivers (β = .32, p < .001) and age for patients only (β = -.13, p < .01). Insomnia symptoms are common in patients and caregivers who call cancer helplines and appear to be related to distress. Telephone-based helplines have the potential to act as the first line of support in a stepped care approach addressing insomnia.

A profile of callers to the New South Wales Quitline, Australia, 2008-2011.

One population-level solution to smoking cessation are quitlines, telephone-based services to aid quitting. Monitoring the profile of quitline callers in a changing tobacco policy environment is important for informing future policy strategies and identifying target groups to improve the reach and impact of quitline services. De-identified data from 43,618 new callers to the New South Wales Quitline, Australia between January 2008 and October 2011 (inclusive) were extracted from the Quitline database. Regression analyses explored the effect of year of first call on the distribution of demographic and smoking-related variables. Men calling the Quitline increased proportionately (prevalence ratio [PR] = 1.05, 95% CI = 1.03-1.08), but callers from non-major city areas fell (PR = 0.90, 95% CI = 0.87-0.93) in 2011 versus 2008. The proportion of callers not working demonstrated a significant increasing linear trend (PR = 1.08, p < .001), although area-level socioeconomic status did not change. The proportions of new Quitline callers who had stopped smoking (relative to still smoking) (relative risk ratio [RRR] = 1.29, 95% CI = 1.14-1.46) and who were classified as low nicotine dependent (vs. high nicotine dependent, RRR = 1.60, 95% CI = 1.39-1.83) were higher in 2011 versus 2008. Proportionately, more callers nominated "money" as a motivation to quit in 2010 (PR = 1.58, 95% CI = 1.49-1.66) and 2011 (PR = 1.70, 95% CI = 1.62-1.79) compared with 2008. Quitline callers showed decreasing tobacco consumption and dependence 2008 to 2011, but remained more addicted than the average NSW smoker. Clear effects of tobacco policy were shown, as money as a motivator increased dramatically in conjunction with increased tobacco taxation, highlighting the importance of promoting cessation services concurrent with policy change to capitalize on increased motivation to quit.

Older adults recently started on psychotropic medication: where are the symptoms?

The objective of this study is to understand the characteristics of older adults on newly prescribed psychotropic medication with minimal psychiatric symptoms. Naturalistic cohort study of non-institutionalized older adults in Pennsylvania participating in the Pharmaceutical Assistance Contract for the Elderly. Persons newly prescribed antidepressant or anxiolytic monotherapy or combination therapy were contacted for clinical assessment by a telephone-based behavioral health service. The initial assessment included standardized mental health screening instruments and scales including the Blessed Orientation-Memory-Concentration test, Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Medical Outcomes Survey (SF-12). In addition, patients were asked for their understanding of the prescription indication. Of the 254 participants who met minimal symptom criteria (Patient Health Questionnaire-9 < 5 and Generalized Anxiety Disorder-7 < 5), women comprised slightly more of the anxiolytic compared with antidepressant monotherapy group (88.9% vs. 76.7%, p = 0.04). The most common self-reported reason for prescription of an antidepressant or anxiolytic was depression or anxiety, respectively, despite near-absence of these symptoms on clinical assessment. Comparing monotherapy to combination therapy groups, those with combination therapy were more likely to report a history of depression (12.6% vs. 1.8%, p < 0.001) and also report depression as the reason for the prescription (40.2% vs. 21.0%, p < 0.01). In this sample of older adults on new psychotropic medication with minimal psychiatric symptoms, there are few patient characteristics that distinguish those on antidepressant versus anxiolytic monotherapy or those on monotherapy versus combination therapy. While quality of care in late-life mental health has focused on improving detection and treatment, there should be further attention to low-symptom patients potentially receiving inappropriate pharmacotherapy.

A randomized clinical trial of a financial education intervention with nicotine replacement therapy (NRT) for low socio-economic status Australian smokers: a study protocol.

Reducing smoking prevalence among smokers from low socio-economic status (SES) is a preventative health priority. Financial stress (e.g. shortage of money or inability to pay bills) may be a major barrier to quitting smoking. This study evaluates the efficacy of a financial education and support programme coupled with pharmacotherapy at improving cessation rates at 8-month follow-up among Australian low SES smokers (people receiving a government pension or allowance). A two-group parallel block randomized (ratio 1 : 1) open-label clinical trial (RCT) with allocation concealment will be conducted. Allocation will be concealed to interviewers at data collection-points. The study will be conducted primarily by telephone with baseline, follow-up interviews and telephone-based support sessions. Nicotine replacement therapy (NRT) delivery will be mail-based. Daily smokers who are interested in quitting smoking and are currently in receipt of government benefits (n = 1046) will be recruited through study advertisements placed in newspapers, posters placed in government social assistance agencies and Quitline telephone-based cessation support services. After completion of a baseline computer-assisted telephone interview, participants will be allocated randomly to control or intervention group using a permuted block approach. Participants in both groups will receive 8 weeks of free combination NRT plus Quitline support. Participants in the intervention group will also receive four telephone-delivered financial education and support sessions. The primary outcome measure will be prolonged abstinence (at 8-month follow-up) assessed using Russell Standard criteria and biochemically verified (urine cotinine). This is the first intervention study to evaluate the potential of co-managing financial stress as a means of enhancing smokers' capacity to quit smoking. Such an intervention may provide a scalable intervention to help low SES smokers to quit.

Get In Motion: An Evaluation of the Reach and Effectiveness of a Physical Activity Telephone Counseling Service for Canadians Living With Spinal Cord Injury

Telephone-based counseling is an efficacious intervention strategy for maintaining leisure-time physical activity (LTPA) intentions and increasing LTPA behavior among adults with spinal cord injury (SCI). However, no research has examined the real-world application of this intervention strategy within the SCI community. To assess the individual-level impact of a previously tested telephone-based counseling intervention among adults within the SCI community by using the first 2components of the Reach, Effectiveness, Adoption, Implementation, and Maintenance framework. A prospective study. General community, tertiary care. Community-dwelling adults with SCI (n= 65; 57% men; mean [standard deviation], 50.4 ± 12.8 years; mean (standard deviation) years after injury, 14.5 ± 12.7 years) living in Canada who enrolled in a national telephone-based counseling service. Of the 65 clients who enrolled, 53 participated in the effectiveness evaluation component of the Get In Motion service. A 6-month, individualized telephone-counseling program with a trained exercise counselor. The program was based on a previously tested intervention that used aspects of the Health Action Process Approach model, with a particular focus on developing and strengthening clients' social cognitions for engaging in self-managed LTPA. On enrollment, all 65 clients completed demographics and staging questionnaires. The 53 clients who participated in the effectiveness evaluation also completed a validated LTPA intentions item, and the 7-day, self-report LTPA Questionnaire for People with SCI over the telephone at baseline, and 2, 4, and 6 months. In terms of the reach of Get In Motion, a total of 65 clients enrolled in the service between June 2008 and June 2011, and were representative of the larger Canadian SCI population on most measured demographic characteristics. Evaluation of the effectiveness of the service showed that, as hypothesized, intentions for engaging in LTPA remained highthroughout enrollment (P= .44), with a trend for more clients engaging in moderate-to-heavy-intensity LTPA at 6 months (52%) versus baseline (35%) (P= .09). Telephone-based counseling is a promising strategy for promoting community-based LTPA behavior among Canadian adults with SCI. Continued evaluation of all 5 Reach, Effectiveness, Adoption, Implementation, and Maintenance framework components of Get In Motion will help establish the real-world impact of this intervention strategy on community-based LTPA participation within the SCI population.