Motivação e desempenho de tarefas num trabalho de Contact Center

Mestrado em Ciências Empresariais

Comparison of two modes of delivery of an exercise prescription scheme

AIM: Green Prescription (GRx) referrals from health professionals have been shown to be effective for increasing the physical activity levels of patients. Little is known about which methods of delivering the programme represents the best value for money. The purpose of this paper was to compare the cost and outcomes of two modes of delivery of a GRx programme. One mode offered phone support involving monthly telephone calls over a 3-4 month period to encourage physical activity participation. A second mode offered community support via weekly face-to-face support group meetings in which physical activities were offered. METHODS: The evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year. RESULTS: There was a large rate of drop-out (68%) from GRx referral to registration. For those who registered, there was a clear preference for community support, and engagement of Maori and Pacific peoples was higher in this mode of delivery. The proportion (but not absolute number) of people who successfully completed their mode of delivery was higher with phone support. However, participants in community support self-reported a significantly greater number of days of exercise per week than those in phone support. The total expected cost per person for phone support was $102.07 and $108.15 for community support. A greater proportion of participants in community support were very satisfied overall with their mode of delivery. CONCLUSION: The two modes were comparable in cost and outcomes, though there was greater penetration of target ethnic populations in community support. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.

Comparison of two modes of delivery of an exercise prescription scheme

SummaryGreen Prescription (GRx) is a referral from a health professional for a patient to become more physically active. In Auckland, GRx is delivered either on the telephone or face-to-face. A comparison of the two modes of delivery (telephone vs. face-to-face) was conducted. This evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year. Results indicated that the modes of delivery were similar in terms of costs as well as outcomes. However, the face-to-face mode of delivery was more popular with Maori and Pacific peoples. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.AbstractAimGreen Prescription (GRx) referrals from health professionals have been shown to be effective for increasing the physical activity levels of patients. Little is known about which methods of delivering the programme represents the best value for money. The purpose of this paper was to compare the cost and outcomes of two modes of delivery of a GRx programme. One mode offered phone support involving monthly telephone calls over a 3-4 month period to encourage physical activity participation. A second mode offered community support via weekly face-to-face support group meetings in which physical activities were offered.MethodThe evaluation involved staff interviews, patient interviews and analysis of GRx records for the 2007 calendar year.ResultsThere was a large rate of drop-out (68%) from GRx referral to registration. For those who registered, there was a clear preference for community support, and engagement of Māori and Pacific peoples was higher in this mode of delivery. The proportion (but not absolute number) of people who successfully completed their mode of delivery was higher with phone support. However, participants in community support self-reported a significantly greater number of days of exercise per week than those in phone support. The total expected cost per person for phone support was $102.07 and $108.15 for community support. A greater proportion of participants in community support were very satisfied overall with their mode of delivery.ConclusionThe two modes were comparable in cost and outcomes, though there was greater penetration of target ethnic populations in community support. Providing a choice of GRx mode of delivery allows participants to choose based on their personal and cultural needs.

A randomized controlled trial of a nurse-led supportive care package (SurvivorCare) for survivors of colorectal cancer

INTRODUCTION: Colorectal cancer (CRC) and its treatments can cause distressing sequelae. We conducted a multicenter randomized controlled trial aiming to improve psychological distress, supportive care needs (SCNs), and quality of life (QOL) of patients with CRC. The intervention, called SurvivorCare (SC), comprised educational materials, needs assessment, survivorship care plan, end-of-treatment session, and three follow-up telephone calls.

METHODS: At the end of treatment for stage I-III CRC, eligible patients were randomized 1:1 to usual care (UC) or to UC plus SC. Distress (Brief Symptom Inventory 18), SCNs (Cancer Survivors' Unmet Needs measure), and QOL (European Organization for Research and Treatment of Cancer [EORTC] QOL questionnaires C30 and EORTC CRC module CR29) were assessed at baseline and at 2 and 6 months (follow-up 1 [FU1] and FU2, respectively). The primary hypothesis was that SC would have a beneficial effect on distress at FU1. The secondary hypotheses were that SC would have a beneficial effect on (a) SCN and QOL at FU1 and on (b) distress, SCNs, and QOL at FU2. A total of 15 items assessed experience of care.

RESULTS: Of 221 patients randomly assigned, 4 were ineligible for the study and 1 was lost to FU, leaving 110 in the UC group and 106 in the SC group. Patients' characteristics included the following: median age, 64 years; men, 52%; colon cancer, 56%; rectal cancer, 35%; overlapping sites of disease, 10%; stage I disease, 7%; stage II, 22%; stage III, 71%. Baseline distress and QOL scores were similar to population norms. Between-group differences in distress at FU1 (primary outcome) and at FU2, and SCNs and QOL at FU1 and FU2 were small and nonsignificant. Patients in the SC group were more satisfied with survivorship care than those in the UC group (significant differences on 10 of 15 items).

CONCLUSION: The addition of SC to UC did not have a beneficial effect on distress, SCNs, or QOL outcomes, but patients in the SC group were more satisfied with care.

IMPLICATIONS FOR PRACTICE: Some survivors of colorectal cancer report distressing effects after completing treatment. Strategies to identify and respond to survivors' issues are needed. In a randomized controlled trial, the addition of a nurse-led supportive care package (SurvivorCare) to usual posttreatment care did not impact survivors' distress, quality of life, or unmet needs. However, patients receiving the SurvivorCare intervention were more satisfied with survivorship care. Factors for consideration in the design of subsequent studies are discussed.

What you can do about unsolicited telephone marketing calls, faxes /

Mode of access: Internet.

Mobile phone use while driving : an investigation of the beliefs influencing drivers’ hands-free and hand-held mobile phone use.

This study explored the psychological influences of hands-free and hand-held mobile phone use while driving. Participants were 796 Australian drivers aged 17 to 76 years who owned mobile phones. A cross-sectional survey assessed frequency of calling and text messaging while driving (overall, hands-free, hand-held) as well as drivers’ behavioural, normative, and control beliefs relating to mobile phone use while driving. Irrespective of handset type, 43% of drivers reported answering calls while driving on a daily basis, followed by making calls (36%), reading text messages (27%), and sending text messages (18%). In total, 63.9% of drivers did not own hands-free kits and, of the drivers that owned hand-free kits, 32% did not use it most or all of the time. Significant differences were found in the behavioural, normative, and control beliefs of frequent and infrequent users of both types of handset while driving. As expected, frequent users reported more advantages of, more approval from others for, and fewer barriers that would prevent them from, using either a hands-free or a hand-held mobile phone while driving than infrequent users. Campaigns to reduce mobile phone use while driving should attempt to minimise the perceived benefits of the behaviour and highlight the risks of this unsafe driving practice.

Electronic telephone directory listings : preferred sampling frame for a population-based study of childhood cancer in Australia

PURPOSE: We report our telephone-based system for selecting community control series appropriate for a complete Australia-wide series of Ewing's sarcoma cases. METHODS: We used electronic directory random sampling to select age-matched controls. The sampling has all listed telephone numbers on an up-dated CD-Rom. RESULTS: 95% of 2245 telephone numbers selected were successfully contacted. The mean number of attempts needed was 1.94, 58% answering at the first attempt. On average, we needed 4.5 contacts per control selected. Calls were more likely to be successful (reach a respondent) when made in the evening (except Saturdays). The overall response rate among contacted telephone numbers was 92.8%. Participation rates among female and male respondents were practically the same. The exclusion of unlisted numbers (13.5% of connected households) and unconnected households (3.7%) led to potential selection bias. However, restricting the case series to listed cases only, plus having external information on the direction of potential bias allow meaningful interpretation of our data. CONCLUSION: Sampling from an electronic directory is convenient, economical and simple, and gives a very good yield of eligible subjects compared to other methods.

Living well with diabetes: a randomized controlled trial of a telephone-delivered intervention for maintenance of weight loss, physical activity and glycaemic control in adults with type 2 diabetes

Background By 2025, it is estimated that approximately 1.8 million Australian adults (approximately 8.4% of the adult population) will have diabetes, with the majority having type 2 diabetes. Weight management via improved physical activity and diet is the cornerstone of type 2 diabetes management. However, the majority of weight loss trials in diabetes have evaluated short-term, intensive clinic-based interventions that, while producing short-term outcomes, have failed to address issues of maintenance and broad population reach. Telephone-delivered interventions have the potential to address these gaps. Methods/Design Using a two-arm randomised controlled design, this study will evaluate an 18-month, telephone-delivered, behavioural weight loss intervention focussing on physical activity, diet and behavioural therapy, versus usual care, with follow-up at 24 months. Three-hundred adult participants, aged 20-75 years, with type 2 diabetes, will be recruited from 10 general practices via electronic medical records search. The Social-Cognitive Theory driven intervention involves a six-month intensive phase (4 weekly calls and 11 fortnightly calls) and a 12-month maintenance phase (one call per month). Primary outcomes, assessed at 6, 18 and 24 months, are: weight loss, physical activity, and glycaemic control (HbA1c), with weight loss and physical activity also measured at 12 months. Incremental cost-effectiveness will also be examined. Study recruitment began in February 2009, with final data collection expected by February 2013. Discussion This is the first study to evaluate the telephone as the primary method of delivering a behavioural weight loss intervention in type 2 diabetes. The evaluation of maintenance outcomes (6 months following the end of intervention), the use of accelerometers to objectively measure physical activity, and the inclusion of a cost-effectiveness analysis will advance the science of broad reach approaches to weight control and health behaviour change, and will build the evidence base needed to advocate for the translation of this work into population health practice.

Extending client-centered support : counselors’ proposals to shift from email to telephone counseling

The availability and use of online counseling approaches has increased rapidly over the last decade. While research has suggested a range of potential affordances and limitations of online counseling modalities, very few studies have offered detailed examinations of how counselors and clients manage asynchronous email counseling exchanges. In this paper we examine email exchanges involving clients and counselors through Kids Helpline, a national Australian counseling service that offers free online, email and telephone counseling for young people up to the age of 25. We employ tools from the traditions of ethnomethodology and conversation analysis to analyze the ways in which counselors from Kids Helpline request that their clients call them, and hence change the modality of their counseling relationship, from email to telephone counseling. This paper shows the counselors’ three multi-layered approaches in these emails as they negotiate the potentially delicate task of requesting and persuading a client to change the trajectory of their counseling relationship from text to talk without placing that relationship in jeopardy.

Adherence, adaptation and acceptance of elderly chronic heart failure patients to receiving healthcare via telephone-monitoring

Background: Although the potential to reduce hospitalisation and mortality in chronic heart failure (CHF) is well reported, the feasibility of receiving healthcare by structured telephone support or telemonitoring is not. Aims: To determine; adherence, adaptation and acceptability to a national nurse-coordinated telephone-monitoring CHF management strategy. The Chronic Heart Failure Assistance by Telephone Study (CHAT). Methods: Triangulation of descriptive statistics, feedback surveys and qualitative analysis of clinical notes. Cohort comprised of standard care plus intervention (SC + I) participants who completed the first year of the study. Results: 30 GPs (70% rural) randomised to SC + I recruited 79 eligible participants, of whom 60 (76%) completed the full 12 month follow-up period. During this time 3619 calls were made into the CHAT system (mean 45.81 SD ± 79.26, range 0-369), Overall there was an adherence to the study protocol of 65.8% (95% CI 0.54-0.75; p = 0.001) however, of the 60 participants who completed the 12 month follow-up period the adherence was significantly higher at 92.3% (95% CI 0.82-0.97, p ≤ 0.001). Only 3% of this elderly group (mean age 74.7 ±9.3 years) were unable to learn or competently use the technology. Participants rated CHAT with a total acceptability rate of 76.45%. Conclusion: This study shows that elderly CHF patients can adapt quickly, find telephone-monitoring an acceptable part of their healthcare routine, and are able to maintain good adherence for a least 12 months. © 2007.

A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer : exercise for health

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas. This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer. A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70). Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity. Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions.

The effect of recording situation on the echolocation calls of the New Zealand Lesser short-tailed bat (Mystacina tuberculata Gray).

Using a broad‐band recording system (150 Hz‐100 kHz) the echolocation calls of the lesser short‐tailed bat (Mystacina tuberculata) were recorded under three very different situations: free‐flying, flying within a flight cage, and on release from the hand. Calls of bats landing and feeding on a platform in Wellington Zoo were also recorded. Both the lowest frequency and frequency of peak amplitude of calls were significantly affected by the situation under which calls were recorded. Although the calls of free‐flying bats are different from those produced by bats foraging on the ground, it is unlikely that M. tuberculata uses echolocation to locate prey on the ground. No significant differences could be found between the calls emitted by male and female bats, and no consistent relationships were obvious between temporal and spectral call characteristics. There was some evidence to suggest that individual bats could be identified by their echolocation calls.

The use of telephone help-lines by lonely children and adolescents

Loneliness is a subjective distressing feeling of being disconnected from a desired group or intimate relationship. Most children and adolescents experience loneliness at some time but for 10-20% of young people it can be severe and chronic. While there are many avenues for help for distressed young people, such as friends and family as well as the professional help of counselors and psychologists, lonely young people often do not seek help. Telephone help-lines are one way to assist young people in difficulty which is cost effective, accessible and anonymous. Many countries provide this free or low cost help with specific services for youth either by telephone or online. From the call records of help-lines however, it would seem that lonely young people do not often utilize these services. The reasons for this apparent reluctance are discussed.