Telephone Interview Study Research Articles

Healthy aging in a cross-sectional study of Australian men: what has sex got to do with it?

Aim: To identify lifestyle factors associated with healthy aging in middle-aged and older Australian men.Methods: A cross-sectional, population-based, computer-assisted telephone interview study explored self-reported health outcomes, and associated determinants for general and reproductive health (the Men in Australia Telephone Survey) in men aged 40 years and older (n = 5990). “Good health” was defined by self-reported health (excellent/very good) combined with absence of self-reported high blood pressure, heart disease, stroke, diabetes and depression symptoms. Categories of sexual activity frequency in the previous four weeks ranged from zero to 12+ times.Results: “Good health” declined with increasing age with 17% of men over 70 years reporting “good health”. In multivariable logistic regression models, significant inverse associations were found between modifiable lifestyle factors – both underweight and overweight/obesity, physical inactivity, smoking and high alcohol consumption – and “good health”. Low-risk alcohol intake and living with a partner were positively associated with “good health”. Sexual activity was also positively associated with “good health” (p < 0.001) with elevated odds ratios (ORs) for each category of frequency of sexual activity (1–4, 5–8, 9–12 or 12+ times in the past 4 weeks) relative to zero frequency (ORs 1.68 to 2.16).Conclusion: This study suggests that sexual activity is an important correlate of retaining good health in middle- and older-aged men, independent of other behavioral determinants.

Access to care outcomes: a telephone interview study of a suburban safety net program for the uninsured.

Access DuPage (AD) currently provides primary care for about 14,000 low income, uninsured residents of suburban DuPage County, IL, an area with a very limited healthcare safety net infrastructure. A telephone interview survey evaluated health care utilization, satisfaction, and health status outcomes and compared recent enrollees to individuals in the program for at least 1year. Sequential new AD enrollees (n=158) were asked about the previous year when uninsured, while randomly selected established AD enrollees (n=135) were asked the same questions about the previous year when actively enrolled in AD. Established enrollees reported being more likely to get 'any kind of tests or treatment' (96.3 vs. 46.2%, p<0.0001), fewer cost (78.5 vs. 21.3%, p<0.0001) and transportation barriers to care, more preventive and mental health services, and better self-management care. However, established enrollees also reported 14% greater use of hospital inpatient and 9% greater use of emergency room care, as well as continued difficulty in accessing needed specialty and dental care services. Despite more (diagnosed) conditions, established enrollees were over 2.5 times more likely to report good to excellent health status and over three times more likely to rate their satisfaction with health care as good to excellent. Findings illustrate the substantial benefits of assuring access to care for the uninsured, but do not reflect immediate savings from reduced hospital utilization. Access to care programs will be an important tool to address the needs of the 30 million people who will continue to be uninsured in the United States.

Polysomnographic Sleep and Circadian Temperature Rhythms as a Function of Prior Shift Work Exposure in Retired Seniors.

In an earlier published telephone interview study (n > 1,000) we have shown that retired shift workers subjectively report worse sleep than retired day workers. This laboratory study sought to determine whether these findings held up when objective polysomnograhic (PSG) measures of sleep were taken and whether retirees' circadian temperature rhythms differed as a function of shift work exposure. All completers of the telephone interview were invited to attend a 36-hour laboratory study for which participants were paid. This involved continuous core body temperature measurement (using an ingestible pill-based system) and 2 nights of PSG. Shift work exposure (plus other measures) was collected by taking a detailed work history. The second laboratory night was scored into sleep stages. Post hoc, we divided participants into 4 shift work exposure groups: 0 years (ie, no exposure to shift work), 1 to 7 years, 7 to 20 years, and >20 years. Sample sizes were 11, 16, 15, and 15, respectively, with approximate equality in mean age (71.7 years of age, 69.1 years of age, 70.0 years of age, and 70.4 years of age, respectively) and percent male (63%, 50%, 67%, and 73%, respectively). Shift work exposure was associated with worse PSG sleep in a dose-related fashion. The percentages of participants with sleep efficiency, 80% for the 0 years, 1 to 7 years, 7 to 20 years, and >20 years groups were 36%, 63%, 67%, and 73%, respectively (P < 0.01), and the percentages with total sleep time (TST), 6 hours were 36%, 56%, 53%, and 73%, respectively (P < 0.01). From the circadian rhythm record, shift work exposure appeared to result (P = 0.06) in an increased spread of phase angles (difference between habitual bedtime and time of temperature trough). In conclusion, it appears likely that shift work may be related to a scarring of sleep and circadian rhythms. This may be associated with a change in the relationship between habitual sleep timing and the phase of the circadian pacemaker.

Race and ethnicity in decisions about unrelated hematopoietic stem cell donation

Large international registries of potential unrelated hematopoietic stem cell (HSC) donors, including the National Marrow Donor program (NMDP), continue to face difficulties finding matched donors for racial/ethnic minorities. One reason, in addition to the generally less common HLA types among minority patients, is the much higher registry attrition rate of racial/ethnic minorities compared with whites. Reasons for the higher attrition among minority potential donors remain unexplained. The goal of our cross-sectional telephone interview study was to generate a diverse sample of potential HSC donors who have preliminarily matched a patient and to identify factors associated with race/ethnicity and with the decision to continue toward potential donation or to opt out of the registry. Multiple culturally related, psychosocial, and donation-related factors were associated both with race/ethnic group membership and attrition from the registry. The most consistent factor associated with opting out of the registry across all race/ethnic groups was ambivalence about donation: doubts and worries, feeling unsure about donation, wishing someone else would donate in one's place. Our findings suggest that universal donor recruitment and management approaches based on reducing donation-related ambivalence and tailored messages and strategies for each of the individual race/ethnic groups are important.

Usefulness of a virtual community of practice and Web 2.0 tools for general practice training: experiences and expectations of general practitioner registrars and supervisors

General practice training is a community of practice in which novices and experts share knowledge. However, there are barriers to knowledge sharing for general practioner (GP) registrars, including geographic and workplace isolation. Virtual communities of practice (VCoP) can be effective in overcoming these barriers using social media tools. The present study examined the perceived usefulness, features and barriers to implementing a VCoP for GP training. Following a survey study of GP registrars and supervisors on VCoP feasibility, a qualitative telephone interview study was undertaken within a regional training provider. Participants with the highest Internet usage in the survey study were selected. Two researchers worked independently conducting thematic analysis using manual coding of transcriptions, later discussing themes until agreement was reached. Seven GP registrars and three GP supervisors participated in the study (average age 38.2 years). Themes emerged regarding professional isolation, potential of social media tools to provide peer support and improve knowledge sharing, and barriers to usage, including time, access and skills. Frequent Internet-using GP registrars and supervisors perceive a VCoP for GP training as a useful tool to overcome professional isolation through improved knowledge sharing. Given that professional isolation can lead to decreased rural work and reduced hours, a successful VCoP may have a positive outcome on the rural medical workforce.

Parent satisfaction with early parenting residential services: A telephone interview study

Early parenting residential units provide a child and family health support and education service for parents experiencing parenting difficulties. An ongoing concern of nursing staff and management is whether the parenting knowledge and skills gained are translated into sustainable parenting practices after discharge. This paper explores the response to a post discharge telephone interview about parents’ experience of nursing care during their residential stay and their parenting experience since discharge. A descriptive qualitative approach identified four themes in the parents’ responses: greater confidence, greater knowledge about their babies, changing expectations of parenting and their infants, and sustainability of parenting skills.

Parent satisfaction with early parenting residential services: a telephone interview study

Parent satisfaction with early parenting residential services: a telephone interview study

Qualitative evaluation of a diabetes electronic decision support tool: views of users

BackgroundQuality care of type 2 diabetes is complex and requires systematic use of clinical data to monitor care processes and outcomes. An electronic decision support (EDS) tool for the management of type 2 diabetes in primary care was developed by the Australian Pharmaceutical Alliance. The aim of this qualitative study was to evaluate the uptake and use of the EDS tool as well as to describe the impact of the EDS tool on the primary care consultation for diabetes from the perspectives of general practitioners and practice nurses.MethodsThis was a qualitative study of telephone interviews. General Practitioners and Practice Nurses from four Divisions of General Practice who had used the EDS tool for a minimum of six weeks were invited to participate. Semi-structured interviews were conducted and the interview transcripts were coded and thematically analysed using NVivo 8 software.ResultsIn total 15 General Practitioners and 2 Practice Nurses completed the interviews. The most commonly used feature of the EDS tool was the summary side bar; its major function was to provide an overview of clinical information and a prompt or reminder to diabetes care. It also assisted communication and served an educational role as a visual aide in the consultation. Some participants thought the tool resulted in longer consultations. There were a range of barriers to use related to the design and functionality of the tool and to the primary care context.ConclusionsThe EDS tool shows promise as a way of summarising information about patients’ diabetes state, reminder of required diabetes care and an aide to patient education.

Caring for Grandparents With Alzheimer’s Disease

This study examined adolescent grandchildren’s contributions to caregiving for grandparents with Alzheimer’s disease. It was predicted that grandchildren would provide more care when parents experienced greater burden, and when adolescents had higher quality relationships with parents and grandparents. It was also hypothesized that these factors would predict higher levels of social commitment and more positive attitudes toward the provision of long-term care. Twenty-nine adolescents and their parents participated in the telephone interview study. Adolescents rated the amount of care they provided to grandparents, relationship quality with grandparents and parents, social responsibility, and attitudes toward the provision of long-term care. Parents reported levels of caregiver burden. Results indicated that grandchildren provided more help when parents provided more care and when grandchildren had greater affection for grandparents. Adolescent grandchildren exhibited lower levels of social responsibility and more negative attitudes toward the provision of long-term care when fathers experienced higher subjective burden.

Uptake and implementation of Advance Care Planning in Australia: findings of key informant interviews

Advance Care Planning (ACP) has an important role in enhancing patient autonomy and guiding end-of-life care. However, there is low uptake of ACP and evidence that advance care plans are often not implemented. We explored these issues in interviews with expert clinicians and representatives of key stakeholder organisations with interest in end-of-life care. Qualitative descriptive study of semi-structured telephone interviews with 23 participants. Participants thought that the low uptake of ACP in Australia is a result of inadequate awareness, societal reluctance to discuss end-of-life issues, and lack of health professionals' involvement in ACP. Problems in implementation of advance care plans were thought to be a result of problems in accessing ACP documents; interpreting written documents; making binding decisions for future unpredictable situations; and paternalistic attitudes of health professionals and families. Participants had different perspectives on how advance care plans should be implemented, with some believing in strict implementation, whereas others believed in a more flexible approach. Low uptake and poor implementation of advance care plans may be addressed by (1) increasing community awareness; (2) encouraging health professional involvement; and (3) system-wide implementation of multi-faceted interventions. A patient-centred approach to ACP is required to resolve the differences in views on how advance care plans should be implemented.

Infant care practices related to sudden infant death syndrome in South Asian and White British families in the UK

In the UK, infants of South Asian parents have a lower rate of sudden infant death syndrome (SIDS) than White British infants. Infant care and life style behaviours are strongly associated with SIDS risk. This paper describes and explores variability in infant care between White British and South Asian families (of Bangladeshi, Indian or Pakistani origin) in Bradford, UK (the vast majority of which were Pakistani) and identifies areas for targeted SIDS intervention. A cross-sectional telephone interview study was conducted involving 2560 families with 2- to 4-month-old singleton infants enrolled in the Born in Bradford cohort study. Outcome measures were prevalence of self-reported practices in infant sleeping environment, sharing sleep surfaces, breast feeding, use of dummy or pacifier, and life style behaviours. We found that, compared with White British infants, Pakistani infants were more likely to: sleep in an adult bed (OR = 8.48 [95% CI 2.92, 24.63]); be positioned on their side for sleep (OR = 4.42 [2.85, 6.86]); have a pillow in their sleep environment (OR = 9.85 [6.39, 15.19]); sleep under a duvet (OR = 3.24 [2.39, 4.40]); be swaddled for sleep (OR = 1.49 [1.13, 1.97]); ever bed-share (OR = 2.13 [1.59, 2.86]); regularly bed-share (OR = 3.57 [2.23, 5.72]); ever been breast-fed (OR = 2.00 [1.58, 2.53]); and breast-fed for 8+ weeks (OR = 1.65 [1.31, 2.07]). Additionally, Pakistani infants were less likely to: sleep in a room alone (OR = 0.05 [0.03, 0.09]); use feet-to-foot position (OR = 0.36 [0.26, 0.50]); sleep with a soft toy (OR = 0.52 [0.40, 0.68]); use an infant sleeping bag (OR = 0.20 [0.16, 0.26]); ever sofa-share (OR = 0.22 [0.15, 0.34]); be receiving solid foods (OR = 0.22 [0.17, 0.30]); or use a dummy at night (OR = 0.40 [0.33, 0.50]). Pakistani infants were also less likely to be exposed to maternal smoking (OR = 0.07 [0.04, 0.12]) and to alcohol consumption by either parent. No difference was found in the prevalence of prone sleeping (OR = 1.04 [0.53, 2.01]). Night-time infant care therefore differed significantly between South Asian and White British families. South Asian infant care practices were more likely to protect infants from the most important SIDS risks such as smoking, alcohol consumption, sofa-sharing and solitary sleep. These differences may explain the lower rate of SIDS in this population.

Do targeted child health promotion services meet the needs of the most disadvantaged? A qualitative study of the views of health visitors working in inner-city and urban areas in England

The aim of this study was to explore health visitors' views on the effects of policy change on the services they offer to preschool children in areas of high health inequalities in England. Child health promotion services are offered throughout the world to maintain and improve children's health. It is not known how the policy shift to a more overtly targeted service, which has occurred in some countries, has affected child health promotion practice in areas of deprivation. An in-depth telephone interview study was conducted between October 2006 and January 2007. All participants (n = 25) were registered health visitors who had taken part in a 2005 National Survey of Child Health Promotion Practice in England and were delivering health promotion services to preschool children in inner-city and urban areas. Despite high levels of need, some children who would have benefited from an enhanced health visiting service were offered only the core programme. Local interpretation of national policy is a key factor in determining the level of service offered, and the extent of targeting. This study illustrates the importance, in any country, of exploring the effects of national policy change from the perspective of practitioners, to identify unintended outcomes. Reductions in the core child health promotion programme can lead to difficulties in monitoring and improving children's health outcomes in areas of deprivation.

Secular trends in child and adult sexual violence - one decreasing and the other increasing: a population survey in Ireland

Sexual violence is a worldwide problem affecting children and adults. Knowledge of trends in prevalence is essential to inform the design and evaluation of preventive and intervention programmes. We aimed to assess the prevalence of lifetime sexual violence for both sexes and to document the prevalence of adult and child abuse by birth year in the general population. National cluster-randomized telephone interview study of 3120 adults in Ireland was done. Child sexual abuse involving physical contact was reported by 20% of women and 16% of men. In adulthood, figures were 20% and 10% for women and men, respectively. Prevalence of any form of sexual violence across the lifespan was 42% (women) and 38% (men). Analysis by year of birth indicated a curvilinear pattern for child sexual abuse with lower prevalence in the oldest and youngest participants. Sexual violence in young adulthood showed a linear pattern with higher prevalence in the youngest participants. The trend of lower rates of experience of child sexual abuse in younger adults in the sample is in keeping with findings from other countries. The trend of higher rates of adult sexual violence in younger adults is worrying, particularly since the same participants reported less experience of child sexual abuse than the preceding generations. There is a paucity of international data addressing the issue of cohort differences in exposure to sexual violence. Within-study analysis, and follow-up studies designed to maximize replicability, are needed to inform discussion about societal trends in different types of sexual violence.

Development and Validation of the Chestnut Global Partners Workplace Outcome Suite

This article describes the development and validation of a five-item scale Workplace Outcome Suite designed as an open access instrument aimed at facilitating empirical research on Employee Assistance Program (EAP) interventions. The suite contains five-item measures of absenteeism, presenteeism, work engagement, life satisfaction, and workplace distress. All but the absenteeism measures are effect-indicator structures derived from classical psychometric theory. The absenteeism measure used a formative model that captures the individual components of being away from the job site because of personal problems. These components are not thought to be internally consistent with one another but rather represent distinct manners that force time off. Two separate validation studies of the suite, one with a paper-and-pencil modality (N = 220) and another with a telephone interview modality (N = 228) tested the reliability of the scales, the structural validity of the items, and the construct validity of the unit-weighted scale scores. The effect-indicator scales were found to have moderate (in the range of .75) to excellent levels (in the range of .90) of internal consistency. Only two items in the Work Engagement scale produced low factor loading for the telephone interview study, but the low loading did not replicate in the paper-and-pencil study and thus was considered spuriously low for the time being. None of the items produced factor loading below .30 in the paper-and-pencil study. Correlations of the scale scores with self-reported measures of relevant behavior and emotions provided limited evidence of construct validity for all five scales. The results suggest support for the use of the Workplace Outcome Suite to evaluate EAP services and interventions.

Medically-enhanced normality: an alternative perspective on the use of medicines for non-medical purposes

Abstract Objective To consider public perspectives on the use of medicines for non-medical purposes, a usage called medically-enhanced normality (MEN). Method Examples from the literature were combined with empirical data derived from two Danish research projects: a Delphi internet study and a Telebus (telephone interview) study with a stratified random representative sample. Results The results of these studies indicate an acceptance of medicine usage where “enhancement” strategies are part of the rationale for medicine use. These strategies include an overall desire to enhance the quality of life, eg, to optimise economic, working and family conditions. The term “doping” does not cover or explain the use of medicines as enhancement among healthy non-athletes. Conclusion We recommend wider use of the term medically-enhanced normality as a conceptual framework for understanding and analysing perceptions of what is considered rational medicine use in contemporary society.

Police hiring and retention of sexual minorities in Georgia and Texas after Lawrence v. Texas

In this telephone interview study, hiring and retention policies and practices relevant to sexual minority officers among twenty selected police departments in Georgia and Texas were examined. The authors examined policies and practices in place before and after the U.S. Supreme Court's 2003 decision in Lawrence v. Texas, in which the Court struck down Texas' sodomy law on grounds that it violated due process and the right to privacy, in effect decriminalizing homosexual conduct throughout the nation. Conclusions and policy implications for law enforcement hiring practices in light of this landmark decision are discussed.

Office Visit Copayments

There is limited information on patients' knowledge about their cost-sharing requirements and how that influenced their care-seeking behavior. To examine patients' knowledge of their office visit copayments, their self-reported responses to perceived and actual copayments, and discussions with physicians about costs. Cross-sectional telephone interview study with a 71% response rate. Stratified random sample of 479 adult members of a prepaid, integrated delivery system: equal sample of members with and without a chronic disease. Perceived and actual office visit copayment amounts, patient self-reported behavioral responses to copayments, cost discussions with a physician, and patient attitudes about discussing costs. Overall, 50% of respondents correctly reported their copayment amount, with 39% underestimating and 11% overestimating. Among respondents who reported having copayments, 27% reported delaying or avoiding a visit altogether, or talking to a physician/advice nurse instead of attending an in-person visit because of their copayment. Perceived office visit copayment amounts were significantly associated with self-reported behavior changes (OR, 1.47 per $10; 95% CI, 1.06-2.05). Only 4% of respondents reported talking with their physician about their costs, with 79% believing that their providers cannot help them with their costs, and 51% believing that it is inappropriate to discuss costs with their physician. Patients have limited knowledge of their office visit copayment amounts, and are changing their care-seeking behavior in response to perceived costs. Moreover, most patients are making these changes without discussing their cost concerns with their physician.

Symptom Burden for Patients with Metastatic Colorectal Cancer Treated with First-Line FOLFOX or FOLFIRI with and Without Bevacizumab in the Community Setting

FOLFOX (oxaliplatin/leucovorin/5-fluorouracil) and FOLFIRI (irinotecan/leucovorin/5-fluorouracil) with or without bevacizumab have become standard-of-care regimens in first-line treatment of metastatic colorectal cancer. However, there is a paucity of symptom burden information regarding these regimens from the patient perspective in community oncology. This retrospective chart review and telephone interview study examined patients with first-line metastatic colorectal cancer from 5 community oncology centers treated with FOLFOX or FOLFIRI with and without bevacizumab. Patientreported outcomes were taken from the Patient Care Monitor 1.0 Revised, a validated tablet computer-based questionnaire that measures symptom burden and several scales of functioning and quality of life. A subset of patients completed structured telephone interviews about the impact of treatment on practical activities and income. Eighty-eight patients with an average age of 62 years were included. Patients completed a median of 8 cycles of treatment. The most common moderate to severe symptom complaint was fatigue. Gastrointestinal symptoms were common but did not cluster in one regimen versus another. Neuropathyrelated symptoms were also common across all regimens except FOLFIRI without bevacizumab. Nausea and neutropenia were common indications for concomitant medications. One third reported work and other activity interference, and care produced outof- pocket expenditures in excess of $1000. Although sample size was small in the FOLFIRI-based regimens, patient reports and chart records suggested that there was not a systematic difference between FOLFOX and FOLFIRI regimens in type of symptom. The addition of bevacizumab did not appear to increase symptom burden.

Fathers and their children's health: a telephone interview study

To study fathers' perception of, and involvement in, their children's health. Telephone interviews according to a structured guide. County of Skåne, Sweden. Answers regarding care and upbringing of child, child's health and ill health, and role of father. 237 fathers of small children. Fathers seem to be involved in their children to a large extent, both in caring and playing activities with their children. Most of them (82%) think that the child's health is good, and half of them (55%) have, at some time, contacted a doctor. The fathers mention security, love and commitment as important factors for being a good father, and almost all (97%) think that they are good fathers. Yet, only slightly more than half of them (54%) state that they have sufficient time for the child. Today, fathers are subject to quite different expectations to participate actively in their children's everyday life than was the case for previous generations. Therefore, more studies of fathers' involvement in their children are needed, as well as a new approach within the health care system to fathers' participation.

Potential work‐related exposures to bloodborne pathogens by industry and occupation in the United States Part II: A telephone interview study

The companion surveillance portion of this study [Chen and Jenkins, 2007] reported the frequency and rate of potential work-related exposures to bloodborne pathogens (BBP) treated in emergency departments (EDs) by industry and occupation, but it lacks details on the circumstances of the exposure and other relevant issues such as BBP safety training, use of personal protective equipment (PPE) or safety needles, or reasons for seeking treatment in a hospital ED. Telephone interviews were conducted with workers who had been treated in EDs for potential work-related exposures to BBP in 2000-2002. Respondents were drawn from the National Electronic Injury Surveillance System. Of the 593 interviews, 382 were from hospitals, 51 were from emergency medical service/firefighting (EMS/FF), 86 were from non-hospital healthcare settings (e.g., nursing homes, doctors' offices, home healthcare providers, etc.), 22 were from law enforcement (including police and correctional facilities), and 52 were from other non-healthcare settings (i.e., schools, hotels, and restaurants). Needlestick/sharps injuries were the primary source of exposure in hospitals and non-hospital healthcare settings. Skin and mucous membrane was the primary route of exposure in EMS/FF. Human bites accounted for a significant portion of the exposures in law enforcement and other non-healthcare settings. In general, workers from non-hospital settings were less likely to use PPE, to have BBP safety training, to be aware of the BBP standards and exposure treatment procedures, and to report or seek treatment for a work-related exposure compared to hospital workers. This study suggests that each industry group has unique needs that should be addressed.