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Medical Care Oct 2021The objective of this study was to compare results of using web-based and mail (postal) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
The objective of this study was to compare results of using web-based and mail (postal) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) data collection protocols.
RESEARCH DESIGN
Patients who had been hospitalized in a New England Hospital were surveyed about their hospital experience. Patients who provided email addresses were randomized to 1 of 3 data collection protocols: web-alone, web with postal mail follow-up, and postal mail only. Those who did not provide email addresses were surveyed using postal mail only. Analyses compared response rates, respondent characteristics, and patient-reported experiences.
SUBJECTS
For an 8-week period, patients were discharged from the study hospital to home.
MEASURES
Measures included response rates, characteristics of respondents, 6 composite measures of their patient experiences, and 2 ratings of the hospital.
RESULTS
Response rates were significantly lower for the web-only protocol than the mail or combined protocols, and those who had not provided email addresses had lower response rates. Those over 65 were more likely than others to respond to all protocols, especially for the mail-only protocols. Respondents without email addresses were older, less educated, and reported worse health than those who provided email addresses. After adjusting for respondent differences, those in the combined protocol differed significantly from the mail (postal) only respondents on 2 measures of patient experience; those in the web-only protocol differed on one. Those not providing an email address differed from those who did on one measure.
CONCLUSION
If web-based protocols are used for HCAHPS surveys, adjustments for a mode of data collection are needed to make results comparable.
Topics: Electronic Mail; Female; Health Care Surveys; Humans; Male; New England; Patient Discharge; Patient Reported Outcome Measures; Postal Service
PubMed: 34334736
DOI: 10.1097/MLR.0000000000001627 -
Contraception Mar 2022To estimate the effectiveness, acceptability, and feasibility of medication abortion with mifepristone dispensed by a mail-order pharmacy after in-person clinical...
OBJECTIVE(S)
To estimate the effectiveness, acceptability, and feasibility of medication abortion with mifepristone dispensed by a mail-order pharmacy after in-person clinical assessment.
STUDY DESIGN
This is an interim analysis of an ongoing prospective cohort study conducted at five sites. Clinicians assessed patients in clinic and, if they were eligible for medication abortion and ≤ 63 days' gestation, electronically sent prescriptions for mifepristone 200 mg orally and misoprostol 800 mcg buccally to a mail-order pharmacy, which shipped medications for next-day delivery. Participants completed surveys three and 14 days after enrollment, and we abstracted medical chart data.
RESULTS
Between January 2020 and April 2021 we enrolled 240 participants and obtained clinical outcome information for 227 (94.6%); 3 reported not taking either medication. Of those with abortion outcome information (N = 224), 216 (96.4%) completed day-3 and 212 (94.6%) day-14 surveys. Of the 224 that took medications, none reported taking past 70 days' gestation, and complete medication abortion occurred for 217 participants (96.9%, 95% CI 93.7%-98.7%). Most received medications within three days (82.1%, 95% CI 76.5%-86.9%). In the day-3 survey, 95.4% (95% CI 91.7%-97.8%) reported being very (88.4%) or somewhat (6.9%) satisfied with receiving medications by mail. In the day-14 survey, 89.6% (95% CI 84.7%-93.4%) said they would use the mail-order service again if needed. Eleven (4.9%, 95% CI 2.5%-8.6%) experienced adverse events; two were serious (one blood transfusion, one hospitalization), and none were related to mail-order pharmacy dispensing.
CONCLUSIONS
Medication abortion with mail-order pharmacy dispensing of mifepristone appears effective, feasible, and acceptable to patients.
IMPLICATIONS
The in-person dispensing requirement for mifepristone, codified in the drug's Risk Evaluation and Mitigation Strategy, should be removed.
Topics: Abortion, Induced; Female; Humans; Mifepristone; Misoprostol; Pharmacy; Postal Service; Pregnancy; Prospective Studies
PubMed: 34555420
DOI: 10.1016/j.contraception.2021.09.008 -
BMJ (Clinical Research Ed.) May 2002To identify methods to increase response to postal questionnaires. (Review)
Review
OBJECTIVE
To identify methods to increase response to postal questionnaires.
DESIGN
Systematic review of randomised controlled trials of any method to influence response to postal questionnaires.
STUDIES REVIEWED
292 randomised controlled trials including 258 315 participants INTERVENTION REVIEWED: 75 strategies for influencing response to postal questionnaires.
MAIN OUTCOME MEASURE
The proportion of completed or partially completed questionnaires returned.
RESULTS
The odds of response were more than doubled when a monetary incentive was used (odds ratio 2.02; 95% confidence interval 1.79 to 2.27) and almost doubled when incentives were not conditional on response (1.71; 1.29 to 2.26). Response was more likely when short questionnaires were used (1.86; 1.55 to 2.24). Personalised questionnaires and letters increased response (1.16; 1.06 to 1.28), as did the use of coloured ink (1.39; 1.16 to 1.67). The odds of response were more than doubled when the questionnaires were sent by recorded delivery (2.21; 1.51 to 3.25) and increased when stamped return envelopes were used (1.26; 1.13 to 1.41) and questionnaires were sent by first class post (1.12; 1.02 to 1.23). Contacting participants before sending questionnaires increased response (1.54; 1.24 to 1.92), as did follow up contact (1.44; 1.22 to 1.70) and providing non-respondents with a second copy of the questionnaire (1.41; 1.02 to 1.94). Questionnaires designed to be of more interest to participants were more likely to be returned (2.44; 1.99 to 3.01), but questionnaires containing questions of a sensitive nature were less likely to be returned (0.92; 0.87 to 0.98). Questionnaires originating from universities were more likely to be returned than were questionnaires from other sources, such as commercial organisations (1.31; 1.11 to 1.54).
CONCLUSIONS
Health researchers using postal questionnaires can improve the quality of their research by using the strategies shown to be effective in this systematic review.
Topics: Data Collection; Data Interpretation, Statistical; Humans; Motivation; Postal Service; Randomized Controlled Trials as Topic; Research Design; Surveys and Questionnaires
PubMed: 12016181
DOI: 10.1136/bmj.324.7347.1183 -
Medical Decision Making : An... Jan 2021Widespread, convenient access to COVID-19 testing has been challenging in the United States. We make a case for provisioning COVID-19 tests through the United States...
Widespread, convenient access to COVID-19 testing has been challenging in the United States. We make a case for provisioning COVID-19 tests through the United States Postal Service (USPS) facilities and demonstrate a simple method for selecting locations to improve access. We provide quantitative evidence that even a subset of USPS facilities could provide broad access, particularly in remote and at-risk communities with limited access to health care. Based on daily travel surveys, census data, locations of USPS facilities, and an established care-seeking model, we estimate that more than 94% of the US population would be willing to travel to an existing USPS facility if warranted. For half of the US population, this would require traveling less than 2.5 miles from home; for 90%, the distance would be less than 7 miles. In Georgia, Illinois, and Minnesota, we estimate that testing at USPS facilities would provide access to an additional 4.1, 3.1, and 1.3 million people and reduce the median travel distance by 3.0, 0.8, and 1.2 miles, respectively, compared with existing testing sites per 28 July 2020. We also discuss the option of distributing test-at-home kits via USPS instead of private carriers. Finally, our proposal provides USPS an opportunity to increase revenues and expand its mission, thus improving its future prospects and relevance.
Topics: COVID-19; COVID-19 Testing; Health Services Accessibility; Humans; Postal Service; Rural Population; SARS-CoV-2; United States
PubMed: 33124494
DOI: 10.1177/0272989X20969690 -
Journal of Medical Internet Research Mar 2017Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians,... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Web-based surveys have become a new and popular method for collecting data, but only a few studies have directly compared postal and Web-based surveys among physicians, and none to our knowledge among general practitioners (GPs).
OBJECTIVE
Our aim is to compare two modes of survey delivery (postal and Web-based) in terms of participation rates, response times, and completeness of questionnaires in a study assessing GPs' preventive practices.
METHODS
This randomized study was conducted in Western Switzerland (Geneva and Vaud) and in France (Alsace and Pays de la Loire) in 2015. A random selection of community-based GPs (1000 GPs in Switzerland and 2400 GPs in France) were randomly allocated to receive a questionnaire about preventive care activities either by post (n=700 in Switzerland, n=400 in France) or by email (n=300 in Switzerland, n=2000 in France). Reminder messages were sent once in the postal group and twice in the Web-based group. Any GPs practicing only complementary and alternative medicine were excluded from the study.
RESULTS
Among the 3400 contacted GPs, 764 (22.47%, 95% CI 21.07%-23.87%) returned the questionnaire. Compared to the postal group, the participation rate in the Web-based group was more than four times lower (246/2300, 10.70% vs 518/1100, 47.09%, P<.001), but median response time was much shorter (1 day vs 1-3 weeks, P<.001) and the number of GPs having fully completed the questionnaire was almost twice as high (157/246, 63.8% vs 179/518, 34.6%, P<.001).
CONCLUSIONS
Web-based surveys offer many advantages such as reduced response time, higher completeness of data, and large cost savings, but our findings suggest that postal surveys can be still considered for GP research. The use of mixed-mode approaches is probably a good strategy to increase GPs' participation in surveys while reducing costs.
Topics: Adult; Age Factors; Aged; Attitude of Health Personnel; Female; General Practitioners; Humans; Internet; Male; Middle Aged; Postal Service; Sex Factors; Surveys and Questionnaires
PubMed: 28330830
DOI: 10.2196/jmir.6308 -
Contemporary Clinical Trials Jan 2022The human and financial costs of dementia care are growing exponentially. Over five and a half million older Americans are estimated to be living with Alzheimer's...
The human and financial costs of dementia care are growing exponentially. Over five and a half million older Americans are estimated to be living with Alzheimer's disease and related dementia (ADRD). By 2050, this is expected to increase to over 13 million, and persons of color are at the highest risk. Considerable funds have been committed to research to prevent, treat, and care for persons at risk for ADRD. However, enrollment of research participants, particularly those coming from diverse backgrounds, is a perennial challenge and has serious implications. This paper quantitatively details the results of a community-based multi-modal outreach effort to recruit a racially diverse sample for non-pharmacological dementia intervention, including referral and participant sources and yield, total recruitment costs and cost per enrolled dyad, and a qualitative description of lessons learned, with particular attention to the recruitment of Black participants. The largest number of referrals and referrals converting to study participants, for both Black and White persons, were from a Maryland Department of Health mailing to Medicaid recipients. There was an important difference in the most effective strategies, proportionally, for white and Black participants. The MDH mailing had the highest yield for our Black referrals and participants, while professional referrals had the highest yield for white referrals and participants. The total estimated cost of recruitment was $101,058, or $156.19 per enrolled dyad. Ultimately 646 persons with dementia and care partner dyads were enrolled, 323 (50%) of whom were Black.
Topics: Aged; Alzheimer Disease; Cohort Studies; Community-Institutional Relations; Humans; Patient Selection; Postal Service
PubMed: 34785304
DOI: 10.1016/j.cct.2021.106622 -
Scientific Reports Apr 2023The international postal network is one of the most widely used methods for correspondence throughout the world. Most postal traffic across the globe consists of...
The international postal network is one of the most widely used methods for correspondence throughout the world. Most postal traffic across the globe consists of legitimate interpersonal, business-consumer, and business-business communications. However, the global postal system is also utilized for criminal activity. In particular, it is often utilized to ship and distribute contraband, including illegal psychoactive drugs such as fentanyl and heroin, to consumers. Existing technological solutions are capable of identifying synthetic opioids and other illegal drugs within packages, but are accompanied by several disadvantages that make them unsuitable for large-scale authentication of international mail traffic. This paper presents a novel method for non-invasive authentication of mail packages that overcomes these challenges. The approach uses nuclear quadrupole resonance (NQR) spectroscopy to detect and quantify the presence of known active pharmaceutical ingredients (APIs) within the package. It has been experimentally demonstrated using a bench top prototype. Test results from a variety of package types demonstrate the effectiveness of the proposed authentication approach.
Topics: Postal Service; Magnetic Resonance Spectroscopy; Heroin; Analgesics, Opioid; Technology
PubMed: 37015953
DOI: 10.1038/s41598-023-31497-9 -
Nicotine & Tobacco Research : Official... Oct 2022Direct-mail advertising is a crucial channel through which tobacco companies deliver price incentives that lower the barrier to tobacco use while promoting tobacco...
INTRODUCTION
Direct-mail advertising is a crucial channel through which tobacco companies deliver price incentives that lower the barrier to tobacco use while promoting tobacco products via thematic appeals not legally permitted on other marketing channels. We examine the prevalence of price incentives and ad characteristics used in tobacco product advertisements (ads) mailed directly to US consumers.
AIMS AND METHODS
We analyzed the content of direct-mail tobacco ads (N = 1047) in circulation between January 2018 and December 2020 as captured by Mintel Comperemedia Direct. These ads were coded for product type, manufacturer/brand type, model characteristics, price incentives, and themes known to appeal to vulnerable subgroups.
RESULTS
Ads across all tobacco products included price incentives (96%) and contained themes that appealed to rural white (40%) and black audiences (15%). Themes known to appeal to youth and young adults were present in 40% of ads across all products, including 78% of ads promoting electronic nicotine delivery systems (ENDS). Moreover, the ENDS ads featuring youth appealing themes (51%), also featured young models.
DISCUSSION
Expanding on previous research which focused on combustible and smokeless tobacco products, this analysis examines direct-mail ads across the full range of tobacco products. Our findings highlight the need for regulations to address (1) the high prevalence of price incentives that undermine the effectiveness of excise taxes on tobacco use, and (2) ad themes and characteristics that appeal to groups vulnerable to tobacco use, both of which have the potential to further exacerbate tobacco-related health disparities.
IMPLICATIONS
This study reinforces the importance of examining direct-mail as the dominant medium for tobacco advertising, particularly by including coupons and discount codes that reduce product price and thus circumventing the effect of tobacco-related tax legislation. Direct-mail encourages continued product loyalty and use and engages new consumers using price incentives and advertising strategies likely to appeal to price-sensitive consumers and other vulnerable populations. Substantial use of youth-appealing elements in ENDS ads contradicts the tobacco industry's mandate to not appeal to youth, warranting highlighting the gaps in current regulations that allows them to continue appealing to this population.
Topics: Adolescent; Advertising; Electronic Nicotine Delivery Systems; Humans; Postal Service; Tobacco Industry; Tobacco Products; Young Adult
PubMed: 35417549
DOI: 10.1093/ntr/ntac095 -
Journal of Clinical Microbiology Mar 2022At-home testing with rapid diagnostic tests (RDTs) for respiratory viruses could facilitate early diagnosis, guide patient care, and prevent transmission. Such RDTs are... (Review)
Review
Flu@home: the Comparative Accuracy of an At-Home Influenza Rapid Diagnostic Test Using a Prepositioned Test Kit, Mobile App, Mail-in Reference Sample, and Symptom-Based Testing Trigger.
At-home testing with rapid diagnostic tests (RDTs) for respiratory viruses could facilitate early diagnosis, guide patient care, and prevent transmission. Such RDTs are best used near the onset of illness when viral load is highest and clinical action will be most impactful, which may be achieved by at-home testing. We evaluated the diagnostic accuracy of the QuickVue Influenza A+B RDT in an at-home setting. A convenience sample of 5,229 individuals who were engaged with an on-line health research platform were prospectively recruited throughout the United States. "Flu@home" test kits containing a QuickVue RDT and reference sample collection and shipping materials were prepositioned with participants at the beginning of the study. Participants responded to daily symptom surveys. If they reported experiencing cough along with aches, fever, chills, and/or sweats, they used their flu@home kit following instructions on a mobile app and indicated what lines they saw on the RDT. Of the 976 participants who met criteria to use their self-collection kit and completed study procedures, 202 (20.7%) were positive for influenza by qPCR. The RDT had a sensitivity of 28% (95% CI = 21 to 36) and specificity of 99% (98 to 99) for influenza A, and 32% (95% CI = 20 to 46) and 99% (95% CI = 98 to 99), for influenza B. Our results support the concept of app-supported, prepositioned at-home RDT kits using symptom-based triggers, although it cannot be recommended with the RDT used in this study. Further research is needed to determine ways to improve the accuracy and utility of home-based testing for influenza.
Topics: Diagnostic Tests, Routine; Fever; Humans; Influenza, Human; Mobile Applications; Postal Service; Sensitivity and Specificity
PubMed: 35107302
DOI: 10.1128/JCM.02070-21 -
Ciencia & Saude Coletiva May 2013Dog bites are the third most common cause of absenteeism among postal workers of the Brazilian National Postal Service in Southern Brazil, with an average off-work time...
Dog bites are the third most common cause of absenteeism among postal workers of the Brazilian National Postal Service in Southern Brazil, with an average off-work time of approximately two days for each biting episode. The objective of this study was to evaluate the neighborhood characteristics involving dog bites that occurred during work time in postal workers, its impact on work and consequent preventive alternatives. A descriptive and analytical cross-sectional study was designed for all Curitiba postal workers. Data were descriptively analyzed and the hypothesis of correlation between median monthly income, population density and occurrence of dog bites was tested. A total of 34.9% of the postal workers answered the questionnaire and 64.6% of them had been bitten while working. The odds of bites occurring in a neighborhood increase by 1.035 times for every increase in one unit in the population density and decrease by 0.998 times for every increase of US$ 1.00 in the neighborhood median monthly income of the head of the family. The occurrence of dog bites among postal workers in Curitiba is related to income and population density and prevention strategies should address mailbox position and adequate fencing to provide protection for postal workers.
Topics: Animals; Bites and Stings; Brazil; Cross-Sectional Studies; Dogs; Humans; Occupational Injuries; Postal Service; Prevalence; Residence Characteristics
PubMed: 23670465
DOI: 10.1590/s1413-81232013000500022