Division of Emergency Medicine, Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Acad Emerg Med. 2009 Oct;16(10):956-62. doi: 10.1111/j.1553-2712.2009.00519.x.
Assault-injured adolescents who are seen in the emergency department (ED) are difficult to follow prospectively using standard research techniques such as telephone calls or mailed questionnaires. Interactive voice response (IVR) is a novel technology that promotes active participation of subjects and allows automated data collection for prospective studies.
The objective was to determine the feasibility of IVR technology for collecting prospective information from adolescents who were enrolled in an ED-based study of interpersonal violence.
A convenience sample of assault-injured 12- to 19-year-olds presenting to an urban, tertiary care ED was enrolled prospectively. Each subject completed a brief questionnaire in the ED and then was randomly assigned to use the IVR system in differently timed schedules over a period of 8 weeks: weekly, biweekly, or monthly calls. Upon discharge, each subject received a gift card incentive and a magnetic calendar with his or her prospective call-in dates circled on it. Each time a subject contacted the toll-free number, he or she used the telephone's keypad to respond to computer-voice questions about retaliation and violence subsequent to the ED visit. Using Internet access, we added $5 to the gift card for each call and $10 if all scheduled calls were completed. The primary outcome was the rate of the first utilization of the IVR system. The numbers of completed calls made for each of the three call-in schedules were also compared.
Of the 95 subjects who consented to the follow-up portion of the study, 44.2% (95% confidence interval [CI] = 34.0% to 54.8%) completed at least one IVR call, and 13.7% (95% CI = 7.5% to 22.3%) made all of their scheduled calls. There were no significant differences among groups in the percentage of subjects calling at least once into the system or in the percentage of requested calls made. The enrolled subjects had a high level of exposure to violence. At baseline, 85.3% (95% CI = 76.5% to 91.7%) had heard gunshots fired, and 84.2% (95% CI = 75.3% to 90.9%) had seen someone being assaulted. Twenty-eight adolescents (29.5%, 95% CI = 20.6% to 39.7%) were reached for satisfaction interviews. All of those contacted found the IVR system easy to use and all but one would use it again.
Interactive voice response technology is a feasible means of follow-up among high-risk violently injured adolescents, and this relatively anonymous process allows for the collection of sensitive information. Further research is needed to determine the optimal timing of calls and cost-effectiveness in this population.
在急诊科（ED）就诊的遭受袭击受伤的青少年很难通过电话或邮寄问卷等标准研究技术进行前瞻性随访。交互式语音应答（IVR）是一种新颖的技术，可促进受试者的积极参与，并允许对前瞻性研究进行自动化数据收集。
旨在确定 IVR 技术用于从参加基于急诊科的人际暴力研究的青少年中收集前瞻性信息的可行性。
采用便利抽样法，前瞻性招募了 12 至 19 岁的遭受袭击受伤的青少年。每位受试者在 ED 完成一份简短的问卷，然后随机分配使用 IVR 系统，在 8 周内以不同的时间间隔进行：每周、每两周或每月打电话。出院时，每位受试者都收到一张礼品卡作为激励，并收到一张带有磁贴的日历，上面圈出了他/她的预期回电日期。每次受试者拨打免费电话号码时，他/她都会使用电话键盘回答有关 ED 就诊后报复和暴力的电脑语音问题。通过互联网访问，我们为每次通话增加了 5 美元的礼品卡，如果完成了所有预定的通话，则增加了 10 美元。主要结果是首次使用 IVR 系统的比率。还比较了三种回叫计划中每个计划完成的通话次数。
在同意参加研究随访部分的 95 名受试者中，44.2%（95%置信区间 [CI] = 34.0%至 54.8%）至少完成了一次 IVR 通话，13.7%（95% CI = 7.5%至 22.3%）完成了所有预定的通话。在至少拨打一次系统或完成请求通话的百分比方面，各组之间没有显著差异。入组的受试者暴力暴露水平较高。基线时，85.3%（95% CI = 76.5%至 91.7%）听到枪声，84.2%（95% CI = 75.3%至 90.9%）看到有人被袭击。28 名青少年（29.5%，95% CI = 20.6%至 39.7%）接受了满意度访谈。所有联系到的人都认为 IVR 系统易于使用，除一人外，所有人都愿意再次使用。
交互式语音应答技术是一种可行的高危暴力受伤青少年的随访方法，这种相对匿名的过程允许收集敏感信息。需要进一步研究以确定该人群中电话的最佳时间间隔和成本效益。
