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Interactional research on advice giving has described advice as normative and asymmetric. In this paper we examine how these dimensions of advice are softened by counselors on a helpline for children and young people through the use of questions. Through what we term ‘‘adviceimplicative interrogatives,’’ counselors ask clients about the relevance or applicability of a possible future course of action. The allusion to this possible action by the counselor identifies it as normatively relevant, and displays the counselor’s epistemic authority in relation to dealing with a client’s problems. However, the interrogative format mitigates the normative and asymmetric dimensions typical of advice sequences by orienting to the client’s epistemic authority in relation to their own lives, and delivering advice in a way that is contingent upon the client’s accounts of their experiences, capacities, and understandings. The demonstration of the use of questions in advice sequences offers an interactional specification of the ‘‘client-centered’’ support that is characteristic of prevailing counseling practice. More specifically, it shows how the values of empowerment and child-centered practice, which underpin services such as Kids Helpline, are embodied in specific interactional devices. Detailed descriptions of this interactional practice offer fresh insights into the use of interrogatives in counseling contexts, and provide practitioners with new ways of thinking about, and discussing, their current practices. [ABSTRACT FROM PUBLISHER]

Objective: Addressing the complex needs of callers who use helplines frequently has proved challenging for counselling helplines around the world. This paper examines the feasibility and acceptability of a telephone intervention called the Wellbeing Support Program (WSP), designed to address the needs of this group. Methods: A mixed methods approach involving quantitative clinical data and thematic analysis of semi-structured interviews with frequent callers was used to evaluate the Wellbeing Support Program (WSP). Three counsellors from SANE Australia delivered the program and collected non-identifying telephone counselling data between June 2017 and February 2018. Researchers from Monash University undertook 20 semi-structured interviews with 15 participants and conducted analysis of the data. Results: The complex and diverse needs of frequent callers posed challenges for the feasibility of the WSP. However, callers expressed a high level of acceptability with the key features of the WSP including the continuity of care; the opportunity to explore things in greater depth; regularity; reliability; safety; trust; professional competence; and empathy and human connection. Discussion: This research provides valuable insights into the ongoing support needs of people who have experienced early childhood adversity and social disadvantage, highlighting the importance of being person centred and trauma informed. The results identify gaps in a fragmented mental health system and highlight a need to design an advanced model of care that sees General Medical Practitioners, mental health professionals and crisis helplines collaborating to provide an integrated approach to improving outcomes for those in most need. [ABSTRACT FROM AUTHOR]

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 e-mail counseling exchanges. In this paper we examine e-mail exchanges involving clients and counselors through Kids Helpline, a national Australian counseling service that offers free online, e-mail, 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 e- mail to telephone counseling. This paper shows the counselors' three multilayered approaches in these e-mails 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. [ABSTRACT FROM AUTHOR]

This paper is based on an analysis of the calls to a time-limited hotline specifically set up in response to the SARS crisis in Hong Kong in 2003. The findings of the study indicate that the arena and level of concern raised by the hotline callers are associated with the situation of the callers and the developmental phase of the disaster. The authors call for welfare service organizations to adopt a differential service focus for different phases of disaster development, when they are confronted with similar public health hazards in the future. The study also identifies the special role played by women in containing the epidemic, and suggests more gender sensitive intervention planning in addressing the needs of women in their gate-keeping and care-giving roles during an epidemic. [ABSTRACT FROM AUTHOR]

ABSTRACT This paper reports the findings of a 3-month survey of young people calling the Message Home helpline. Message Home is a national freephone helpline available to people who have run away or left home which allows them to send a message to their family or carer, to seek confidential help and advice and, if necessary, to be helped to a place of safety. The paper explores the characteristics, circumstances and motivations of the young people contacting the helpline. It also considers who the young people contacted through the helpline and the kinds of messages that were relayed to parents, social services and others. This study differs from most preceding studies of runaways in recording the views of young people while they are missing. The immediacy palpable in their accounts highlights the distress and isolation experienced by many of these young people who have run away or been forced to leave home. [ABSTRACT FROM AUTHOR]

For a couple of decades telephone crisis services called hotlines or helplines have been an important instrument in the process of providing help and assistance to people in distress. The idea of providing psychological help and support over the telephone was born of sincere kindness and sympathy of human heart but with time it evolved towards a standardized scientific discipline based on rules and procedures. The paper outlines the history of telephone crisis services and points to their most important functions in contemporary, globalized world. [ABSTRACT FROM AUTHOR]

Literature on men's health help-seeking suggests that, consistent with hegemonic masculine ideals, men display a general preference for solution-focused interaction. Men's health services routinely orient to this preference, emphasising assistance in the form of practical advice. Little research, however, has examined the nature of actual interactions between men and health professionals. The present paper analyses interaction on a men's telephone relationship-counselling service, focusing on reasons for calling. We demonstrate some recurring interactional patterns relating to the helpline's institutional philosophy of solution-focused counselling. Specifically, callers routinely engaged in narrative reporting of relationship troubles rather than indicating that they were seeking advice; counsellors, however, routinely orientated to the role of advice- and information-provider, in addition to that of troubles-talk recipient. We examine the recurring interactional disfluencies around this reason-for-call talk, considering some consequences for institutional help-giving that arise from the assumption of a male preference for solution-focused healthcare. [ABSTRACT FROM AUTHOR]

This paper describes Australian counselling services which use the telephone as the medium for counselling delivery. It provides a background to telephone counselling and describes its uses as reported in the research and clinical literature. Special considerations in utilising the telephone to provide counselling are discussed. The paper also reviews the clinical and research literature to determine which counselling techniques are most applicable for use over the telephone. [ABSTRACT FROM AUTHOR]

Objective: Helplines are generally a population-level resource for providing free, timely, easy-to-access, and anonymous counseling and/or information. Helplines have been developed and widely implemented for specific use by young people. The current study aimed to systematically review the literature to determine the status of research into the use of helplines among young people.Method: Following the PRISMA checklist, 5 electronic databases were searched using relevant terms for literature published until May 2020. The extracted studies were summarized with the intention of identifying key themes that highlighted common findings, key implications, and important gaps in understanding.Results: A total of 52 articles fitting study inclusion criteria were identified. Most studies were quantitative papers from the United States and Australia. The types of helpline interactions studied were a mixture of telephone-based and SMS/text-based interactions. Three major themes were identified: awareness of and engagement with helpline services, nature of problems faced by young people, and service-related factors. Subthemes were use and awareness, barriers to help seeking, psychosocial problems, suicidality, telephone- versus text-based interactions, counselor-caller interaction, and provision of services to historically and systemically marginalized groups.Conclusion: It appears that helplines may provide a beneficial service to youths, and that myriad psychosocial concerns provide the basis for calling. The literature is limited by a lack of controlled trials, on one hand, and complex methodological/ethical barriers preventing such trials, on the other hand. However, more research is needed before conclusions regarding effectiveness in youths can be made, particularly for services provided to systemically marginalized groups and using online text-based approaches. [ABSTRACT FROM AUTHOR]

Background: Cardiac rehabilitation (CR) is recommended for patients with cardiovascular disease. However, the participation and completion rates for hospital-based CR are low, and home-based CR has been suggested as an alternative. This study aimed to develop a home-based CR program and assess the feasibility of the program over a 6-week period in patients with left ventricular dysfunction or a history of myocardial infarction. Methods: This feasibility study consisted of two phases. The initial phase (Study 1) focused on developing the home-based exercise protocol. Systematic approaches to developing evidence-based home-based exercise intervention were implemented including systematic review, patient surveys, and expert consensus. Study 2 aimed to evaluate the feasibility of a 6-week home-based CR program that was based on the results of Study 1. Study 2 included two exercise education sessions and four telephone counseling sessions. During this stage of the exercise program, the participants exercised on two separate days and their experiences while performing the aerobic and resistance exercises were surveyed. Eight participants participated in Study 1 and 16 participated in Study 2. Results: Participants expressed overall satisfaction with the exercise program in Study 1. Heart rate increased in response to exercise, but this did not correspond with perceived exertion. The aim of the home-based CR exercise program was for participants to achieve exercise goals (≥150 min/week of aerobic type exercises as well as at least twice weekly resistance exercise using own body weights). We aimed to increase compliance and adherence to the home-based CR program. In Study 2, 13 out of 16 participants (81.3%) completed the 6-week home-based CR program, with a participation rate of 100% in both exercise education and phone counseling sessions. Adherence to the home-based exercise protocol was 83.1% and no serious adverse events were observed. At the beginning of the study, only three out of 13 participants (23.1%) met the requirements for both aerobic and resistance exercises, but at the end of the 6-week program, 10 out of 13 participants (76.9%) fulfilled the requirements. Conclusion: The exercise program developed in this study was safe and feasible, and the 6-week home-based CR program was feasible for patients with cardiovascular disease without any reported adverse effects. [ABSTRACT FROM AUTHOR]

While tobacco helplines (quitlines) are thought to be effective, helplines which treat other substance use do not have an established evidence base. A review was conducted of the literature on illicit drug or alcohol (IDA) helplines. The literature search was conducted in five databases. Studies prior to 2014 were included if published in English, and involved the use of a telephone counselling helpline for the treatment of illicit drug or alcohol use. Review papers, opinion pieces, letters or editorials, case studies, published abstracts and posters were excluded. Initial searching identified 2178 articles and after removing duplicates and those meeting the exclusion criteria, there were 36 publications for review. A total of 29 articles provided descriptive information about 19 different IDA helplines which operated in the US (42%), Europe (21%), Australia (21%), Asia (11%) and Canada (5%). These services reported monthly call rates from 3.7 to over 23,000 calls per month. A total of nine articles provided evaluative information on eight different IDA helplines: four articles included a comparison of treatment outcomes against a control group and five articles included information on treatment satisfaction or service utilisation. Together they provide some evidence that these services are effective. Although there was little consistency in the measures used between articles which assessed helpline satisfaction, all but one reported high satisfaction. Although the evidence is mainly supportive of IDA helplines, further work is required to compare treatment outcomes in randomized groups. [ABSTRACT FROM PUBLISHER]

This paper explores how narrative approaches - externalising, unique-outcomes, re-membering and re-authoring conversations - have been used in work at a domestic violence hotline to assist clients in deconstructing dominant stories and getting in touch with their personal agency. Examples are drawn from experiences in Japan and highlight certain aspects of Japanese culture. However, the focus is on the applicability of narrative techniques to counselling in a single telephone conversation. [ABSTRACT FROM AUTHOR]

The Japan Atomic Energy Agency (JAEA) established a telephone consultation system at the request of the Ministry of Education, Culture, Sports, Science and Technology in response to residents' concerns about the radiation health effects following the nuclear accidents at the Fukushima Daiichi Nuclear Power Station of the Tokyo Electric Power Company (TEPCO) in March 2011. Eight toll-free telephone lines were established and employees with knowledge of radiation health effects were assigned for consultation. The JAEA expert response group for telephone inquiries comprised a telephone response team, a question-and-answer team, and a manager. Approximately 35,000 consultations were conducted from March 17, 2011 to September 18, 2012. Japan's Basic Disaster Prevention Plan was revised following the accident, where one of the JAEA's roles for nuclear emergency response was to provide telephone consultation on radiation health effects. The JAEA's system for telephone consultation was improved following this experience. The description of telephone hotlines in the International Atomic Energy Agency's guide, GSG-14, published in 2020, was discussed for further improvement in the JAEA's telephone consultation system. [ABSTRACT FROM AUTHOR]

This paper demonstrates how therapeutic letter writing and other narrative practices were implemented in a phone-based community counselling service in relation to work with regular and frequent callers. Helplines provide support for people in distress. Although the focus of these services is often on times of crisis when lives may be at stake, many callers to helplines are struggling with ongoing mental health issues, and may phone frequently, sometimes several times a day, over long periods. This can stretch helpline resources, preventing urgent calls from getting through and taxing counsellors who may be peer-support workers or volunteers. Lifeline Aotearoa's attempts to manage frequent callers raised questions about the services the organisation was offering and whether it was contributing to 'maintaining' those frequent callers. Narrative ideas were introduced to facilitate conversations that offered rich story development, for both callers and counsellors, and to situate problems callers presented in a wider social context in which they might make a contribution. [ABSTRACT FROM AUTHOR]

This paper outlines opportunities to incorporate narrative approaches in singlesession telephone counselling, with a particular focus on working with women who have experienced sexual violence. Practices described include externalising the problem, deconstruction, re-authoring, double listening, double-story development and re-membering conversations. [ABSTRACT FROM AUTHOR]

Background and aims. Health care increasingly incorporates telephone counselling, but the dynamics of interactions supporting its delivery are not well understood. This paper explores how advice was packaged and received by participants with type 2 diabetes within the context of a Pro-Active Call-Centre Treatment Support (PACCTS) system delivered to provide diabetes self-care training over the telephone. Methods. The data relate to nine participants who formed part of the qualitative evaluation within the intervention arm of a randomized controlled trial (n = 591) of PACCTS. One consultation call between the tele-carer and the participant was tape recorded towards the end of the 3-year study and each participant was interviewed by telephone within 24 hours of the consultation. The nine calls and interviews were transcribed and analysed using the constant comparative method. Results. The type of advice the participants received was packaged in six forms: advice as explanation, general information-giving, generic advice, advice in the form of practitioner self-disclosure, personalized advice and responsive advice. Variation was evident in terms of the nature of advice provided, level of generality, form and context. Conclusions. As the participants had to make multiple behavioural changes over time, advice needed to be delivered, reiterated and reinforced to achieve understanding and uptake. The more specific and personalized the information and advice, the more likely it was for the participant to give a positive and engaged response. Seizing every opportunity to deliver good quality personalized and/or responsive advice is essential in order to facilitate effective behavioural change. [ABSTRACT FROM AUTHOR]

This empirical study explores the characteristics and degree of implementation of so-called ethics hotlines in transnational companies (TNCs), which allow employees to present allegations of wrongdoing and ethical dilemmas, as well as to report concerns. Ethics hotlines have not received much attention in literature; therefore, this paper aims to fill that gap. Through the analysis of conduct/ethics codes and the compliance programs of the top 150 transnational companies ranked by the United Nations Conference on Trade and Development (UNCTAD) (), we carry out a descriptive and taxonomic study of these companies’ ethics hotlines. We analyze: (1) the basic characteristics of the mechanism, (2) the degree of exigency and the provision of safeguards, (3) the matters reported and the systems for reporting, and (4) the relationships between hotlines and economic characteristics of the firm. Our study compares financial and nonfinancial TNCs as well as North American and European TNCs. Our results show that many firms (especially from North America) have established these procedures. We also find some disparities between European and North American ethics hotlines that suggest differences in the orientation of the procedures. [ABSTRACT FROM AUTHOR]

Telephone based tobacco cessation services, or quitlines, have become central components of many comprehensive tobacco control programmes. This paper provides an overview of their history, noting milestones in the growth of quitlines. Key factors in their worldwide adoption were solid evidence from clinical trials with large community samples and strong backing from public health officials. Quitlines are now available throughout most of North America, Europe, Australia and in many other locations around the world. The paper also offers several recommendations for future directions in quitline practice and research. Benchmarks should be established for key areas of quitline implementation, such as accessibility, quality and cost efficiency. Advances in pharmacotherapy, telephony and web based applications should be investigated for opportunities to expand service offerings. Research and development are needed to determine how best to serve a diverse clientele in the most cost effective manner. Funding should be expanded and diversified to enable quitlines to serve much larger numbers of users. Healthcare providers should be targeted for quitline promotion, to engage them in a broad effort to increase the number of patients receiving cessation messages from clinicians. The goal of quitline promotion should expand to include an increase in unaided quit attempts in the population. Early research findings were quickly adopted in quitline practice, and future research to answer questions that have arisen through the implementation of quitlines will probably also find quick adoption. [ABSTRACT FROM AUTHOR]

Background: Alcohol screening, brief intervention, and referral to specialized treatment (ASBIR) reduce drinking and related harms. Unanswered questions are how to manage nondependent patients with poor response to brief interventions, how to manage dependent patients who do not obtain treatment, and how to ensure population-wide delivery of ASBIR. Telephone-administered counseling may provide answers. Methods: We conducted a 12-month randomized controlled trial of a telephone and mail intervention for non-treatment–seeking primary care patients with alcohol use disorders. We enrolled 897 subjects after systematic screening in 18 primary care clinic waiting rooms in and around Madison and Milwaukee, Wisconsin, and subsequent telephone-administered diagnostic interviews. Experimental subjects received up to six sessions of protocol-driven telephone counseling based on principles of motivational interviewing and stages of readiness to change. Control subjects received a pamphlet on healthy lifestyles. The paper reports on 3-month drinking outcomes for men and women with alcohol abuse and dependence. Results: Male experimental subjects ( N=199) manifested a 30.6% decline in risky drinking days, compared with a 8.3% decline in controls ( N=201, p<0.001). The total consumption declined by 17.3% compared with 12.9% by controls ( p=0.001). Female experimental subjects ( N=246) manifested a 17.2% decrease in risky drinking days compared with an 11.5% decrease by controls ( N=251; p=NS) and a 13.9% decline in total consumption compared with 11.0% by controls ( p=NS). Greater numbers of telephone counseling sessions were associated with greater declines in drinking. Conclusion: Following systematic screening, a six-session telephone and mail intervention is more effective than a pamphlet in reducing drinking at 3 months for non-treatment–seeking men with alcohol abuse and dependence. An intervention effect of the enrollment procedures may have obscured further intervention effectiveness. Telephone counseling shows promise for non-treatment–seeking primary care patients with alcohol use disorders. [ABSTRACT FROM AUTHOR]

The National Suicide Prevention Lifeline was launched in January 2005. Lifeline, supported by a federal grant from the Substance Abuse and Mental Health Services Administration, consists of a network of more than 120 crisis centers located in communities across the country that are committed to suicide prevention. Lifeline's Certification and Training Subcommittee conducted an extensive review of research and field practices that yielded the Lifeline's Suicide Risk Assessment Standards. The authors of the current paper provide the background on the need for these standards; describe the process that produced them; summarize the research and rationale supporting the standards; review how these standard assessment principles and their subcomponents can be weighted in relation to one another so as to effectively guide crisis hotline workers in their everyday assessments of callers to Lifeline; and discuss the implementation process that will be provided by Lifeline. [ABSTRACT FROM AUTHOR]

Lifeline Australia Inc. provides a free 24-hour telephone counselling and referral service to all Australians. The trained telephone counsellors of the service record information on many of their calls in Lifeline's Client Service Management Information System (CSMIS). This paper presents a descriptive summary of a national CSMIS data set, which was compiled during a 3-month period in 2003. The CSMIS data provided a clear national profile of the callers to the service. The results of this study support the hypothesis that callers are generally seeking social support from the service. The discussion explores the implications of this finding for Lifeline and other generalist counselling and referral services and their capacity to offer suicide intervention to the community. [ABSTRACT FROM AUTHOR]

Jefford M., Black C., Grogan S., Yeoman G., White V., Akkerman D. (2005) European Journal of Cancer Care 14, 113–123 Information and support needs of callers to the Cancer Helpline, The Cancer Council Victoria The broad aims of the present evaluation were, firstly, to describe the information and support needs of callers to a Cancer Helpline and, secondly, to describe the response of the service to these needs. A further aim was to use these results to develop strategies to improve the service. Anonymous caller information collected over a 6-year period was analysed. The setting of the study was the Cancer Helpline service operated by the Cancer Council Victoria within the state of Victoria, Australia. The caller profile was similar to that described in the literature, with the majority of callers being women, younger than the general cancer population and enquiring most commonly about breast cancer. Patients and their relatives called to obtain information about cancer diagnosis, treatment and management and to obtain psychological and emotional support. Callers received emotional support, were supplied with verbal and written information and were referred to a variety of support services. Some population groups are underrepresented in the data. Changes to the Helpline and other services over the 6-year period are described. The pattern of callers to the Cancer Helpline appears similar to that described in the USA and Europe. Many issues and challenges are common. The paper discusses additional strategies for meeting the information and support needs of those affected by cancer and describes current and suggested research areas. [ABSTRACT FROM AUTHOR]

This paper aims to explicate analytically telephone-counseling interactions using the methods of conversation analysis, specifically the one method inspired by logico-grammatical analysis. The data is comprised of more than twenty telephone-counseling interviews that are mainly concerned with callers' seeking advice on health issues. First, the activity components of the interviews are identified. Those activities usually occur in a set order, having an a priori character. If things should occur in different orders, participants always invoke practices of recovery to restore the set order. Second, the interviews are examined in terms of the way the category pair is used. This pair is one example of what Sacks called a "membership categorization device (MCD)." In addition to the features Sacks has found with MCD, three distinctive features are found with the pair. The pair, firstly, works to asymmetrically entitle the participants of the interview to claim knowledge about what is being discussed in the interview. Secondly, the participants' normative orientation to the device sometimes works to inhibit interactional troubles, and sometimes to engender them. Finally, in the latter cases, when interactional troubles do occur, the participant occupying the position of attempts to limit that role to lessen his/her responsibility. Third, the adviser explicitly referred to an MCD of , which provides symmetrical entitlements to the both participants. Although this reference seemingly makes it difficult to provide advice, the adviser deals with this difficulty by establishing a category pair of through sequential organization. The paper is concluded with a discussion of the implications for actual telephone-counseling practices. [ABSTRACT FROM AUTHOR]

Public reaction to paedophilic behaviour is generally one of outrage, fear and anger, followed by a desire for revenge or punishment. The reaction from the paedophile is frequently one of withdrawal, denial, fear, secrecy and isolation. This may inadvertently be responsible for further victims by inhibiting requests for treatment. In the summer of 2000, a helpline was established in the northwest of England aimed at encouraging offending paedophiles, and those with the disposition to offend, to seek help and advice. This paper will assess responses to this invitation by reviewing the nature of these calls over an 18-month period. [ABSTRACT FROM AUTHOR]

Background: Despite the abundant availability of effective medication adherence interventions, uptake of these interventions into routine care often lacks. Examples of effective medication adherence interventions include telephone counseling, consult preparation and the teach-back method. Assessing context is an important step in understanding implementation success of interventions, but context is often not reported or only moderately described. This study aims to describe context-specific characteristics in four living labs prior to the implementation of evidence-based interventions aiming to improve medication adherence. Methods: A qualitative study was conducted within four living labs using individual interviews (n = 12) and focus groups (n = 4) with project leaders and involved healthcare providers. The four living labs are multidisciplinary collaboratives that are early adopters of medication adherence interventions in the Dutch primary care system. Context is defined as the environment or setting in which the proposed change is to be implemented. Interview topics to assess context were formulated based on the 'inner setting' and 'outer setting' domains of the Consolidated Framework for Implementation Research (CFIR). Interviews were recorded and transcribed verbatim. Transcripts were deductively analyzed. Results: A total of 39 community pharmacists, pharmacy technicians, general practitioners and a home care employee participated in the (focus group) interviews. All four living labs proved to be pharmacy-driven and characterized by a high regard for innovation by staff members, a positive implementation climate, high levels of leadership engagement and high compatibility between the living labs and the interventions. Two living labs were larger in size and characterized by more formal communication. Two living labs were characterized by higher levels of cosmopolitanism which resulted in more adaptable interventions. Worries about external policy, most notably lack of reimbursement for sustainment and upscaling of the interventions, were shared among all living labs. Conclusions: Contextual characteristics of four living labs that are early adopters of medication adherence interventions provide detailed examples of a positive implementation setting. These can be used to inform dissemination of medication adherence interventions in settings less experienced in implementing medication adherence interventions. [ABSTRACT FROM AUTHOR]

Background: Persistent opioid use following surgery is common especially in patients with preoperative opioid use. This study aims to determine the long‐term effect of an individualised opioid tapering plan versus standard of care in patients with a preoperative opioid use undergoing spine surgery at Aarhus University Hospital, Denmark. Methods: This is the 1‐year follow‐up of a prospective, single‐centre, randomised trial of 110 patients who underwent elective spine surgery for degenerative disease. The intervention was an individualised tapering plan at discharge and telephone counselling 1 week after discharge, compared to standard of care. Postoperative outcomes after 1 year include opioid use, reasons for opioid use and pain intensity. Results: The overall response rate to the 1‐year follow‐up questionnaire was 94% (intervention group 52/55 patients and control group 51/55 patients). Forty‐two patients (proportion = 0.81, 95% CI 0.67–0.89) in the intervention group compared to 31 (0.61, 95% CI 0.47–0.73; p =.026) patients in the control group succeeded in tapering to zero 1 year after discharge (p =.026). One patient (0.02, 95% CI 0.01–0.13) in the intervention group compared to seven patients (0.14, 95% CI 0.07–0.26) in the control group were unable to taper to their preoperative dose 1 year after discharge (p =.025). Back/neck and radicular pain intensity was similar between study groups. Conclusion: These results suggest that an individualised tapering plan at discharge combined with telephone counselling 1 week after discharge can reduce opioid use 1 year after spine surgery. [ABSTRACT FROM AUTHOR]

Several Migrant Resource Centres (MRCs) have been set up in South Asia jointly by national governments of origin and destination countries. Their objectives include encouragement of potential migrants to seek regular rather than irregular routes and to ensure the safety of those migrating, regardless of status. Of theoretical note, their activities utilise innovative, highly personalised counselling. This article provides quasi‐experimental evidence of the effect of four activities – telephone and online counselling, and college outreach and pre‐departure sessions – on 2215 randomly allocated users of the MRCs' services across six MRCs in four countries: Afghanistan, Bangladesh, Iraq and Pakistan. The effects are a large reduction in self‐reported likelihood of migrating irregularly, and a strong increase in awareness of safe options and who to contact for assistance whilst migrating. The effects are consistent across activity type and MRC location, although magnitudes vary. These findings have implications for our understanding of how the decision to migrate is made, what interventions are effective and why. [ABSTRACT FROM AUTHOR]

The telephone conference call group is growing in popularity. The convenience, the anonymity, and the increased accessibility offered by this type of group enlarges the scope of group work practice. Along with its advantages, the telephone conference call group can present the worker and the members with challenges not encountered in a face-to-face situation. This paper looks at a telephone conference call group with four homebound elderly women and discusses five areas of difficulty identified during that experience. Illustrations depicting these difficulties are provided. Anticipating and preparing for the challenges can help the social worker to maximize the benefits of a telephone conference call group and to facilitate a rewarding experience for all of the participants. [ABSTRACT FROM AUTHOR]

This paper summarizes the calls received on a national helpline promoted after the screening of a television programme on ritual abuse in the Dispatches series on Channel 4 in February 1992. The helpline was organized by the educational charity Broadcasting Support Services. The helpline dealt with 191 calls of which nearly half concerned ritual abuse. Thirty-nine per cent of all calls were from current victims or survivors of ritual abuse. [ABSTRACT FROM AUTHOR]

Introduction: Tuberculosis (TB) causes one‐third of HIV‐related deaths worldwide, making TB preventive treatment (TPT) a critical element of HIV programmes. Approximately 16% of people living with HIV (PLHIV) on antiretrovirals in Zimbabwe are enrolled in the Fast Track (FT) differentiated service delivery model, which includes multi‐month dispensing of antiretrovirals and quarterly health facility (HF) visits. We assessed the feasibility and acceptability of utilizing FT to deliver 3HP (3 months of once‐weekly rifapentine and isoniazid) for TPT by aligning TPT and HIV visits, providing multi‐month dispensing of 3HP, and using phone‐based monitoring and adherence support. Methods: We recruited a purposive sample of 50 PLHIV enrolled in FT at a high‐volume HF in urban Zimbabwe. At enrolment, participants provided written informed consent, completed a baseline survey, and received counselling, education and a 3‐month supply of 3HP. A study nurse mentor called participants at weeks 2, 4 and 8 to monitor and support adherence and side effects. When participants returned for their routine 3‐month FT visit, they completed another survey, and study staff conducted a structured medical record review. In‐depth interviews were conducted with providers who participated in the pilot. Results: Participants were enrolled between April and June 2021 and followed through September 2021. Median age = 32 years (IQR 24,41), 50% female, median time in FT 1.8 years (IQR 0.8,2.7). Forty‐eight participants (96%) completed 3HP in 13 weeks; one completed in 16 weeks, and one stopped due to jaundice. Most participants (94%) reported "always" or "almost always" taking 3HP correctly. All reported they were very satisfied with the counselling, education, support and quality of care they received from providers and FT service efficiency. Almost all (98%) said they would recommend it to other PLHIV. Challenges reported included pill burden (12%) and tolerability (24%), but none had difficulty with phone‐based counselling or wished for additional HF‐based visits. Discussion: Using FT to deliver 3HP was feasible and acceptable. Some reported tolerability challenges but 98% completed 3HP, and all appreciated the efficiency of aligning TPT and HIV HF visits, multi‐month dispensing and phone‐based counselling. Conclusions: Scaling up this approach could expand TPT coverage in Zimbabwe. [ABSTRACT FROM AUTHOR]

Purpose We developed a comprehensive return to work (RTW) intervention covering physical, psycho-social and practical issues for patients newly diagnosed and evaluated its efficacy in terms of RTW. Materials and Methods A multi-center randomized controlled trial was done to evaluate the efficacy of the intervention conducted at two university-based cancer centers in Korea. The intervention program comprised educational material at diagnosis, a face-to-face educational session at completion of active treatment, and three individualized telephone counseling sessions. The control group received other education at enrollment. Results At 1-month post-intervention (T2), the intervention group was more likely to be working compared to the control group after controlling working status at diagnosis (65.4% vs. 55.9%, p=0.037). Among patients who did not work at baseline, the intervention group was 1.99-times more likely to be working at T2. The mean of knowledge score was higher in the intervention group compared to the control group (7.4 vs. 6.8, p=0.029). At the 1-year follow-up, the intervention group was 65% (95% confidence interval, 0.78 to 3.48) more likely to have higher odds for having work. Conclusion The intervention improved work-related knowledge and was effective in facilitating cancer patients' RTW. [ABSTRACT FROM AUTHOR]

Tobacco control methods differ by country, with telephonic counseling being one of them. The effectiveness of telephone counseling in smoking cessation has been discussed on several occasions. India's tobacco problem is more complex than that of any other country in the world. To begin with, tobacco is consumed in a variety of ways, and India is a large multilingual country with remarkable cultural diversity. In India, the National Tobacco Quitline Service (NTQLS) is a government-run program. Its data from May 2016 to May 2021 were analyzed retrospectively in this cross-sectional study to determine the prevalence and pattern of tobacco use in India, as well as the abstinence rate for smoking cessation. A total of 4,611,866 calls were received by the Interactive Voice Response system (IVR). The number of calls increased from 600 to 5400 per day after the toll-free number was printed on all tobacco products. Smokeless tobacco use was discovered to be more prevalent, with males significantly more likely to use both smoking and smokeless tobacco. At one month and one year after quitting, 33.42% and 21.9%, respectively, remained tobacco-free. The study emphasizes the efficacy of behavioral counseling in increasing abstinence rates. The printing of a tollfree number on tobacco products is an effective strategy for expanding the operation of quit lines. Despite the challenges of cultural diversity and complex tobacco use, India's quit line service has been able to provide counseling to callers with prolonged abstinence and quit rates comparable to the various quit lines around the world. [ABSTRACT FROM AUTHOR]

Objectives: Physical activity (PA) adoption can reduce treatment‐related sequelae of breast cancer. Peer‐led PA interventions are a promising and relatively inexpensive approach to scaling up interventions. The current study seeks to identify mediators of PA change amongst cancer survivors enrolled in a peer‐led behavior change intervention. The study team partnered with the American Cancer Society's Reach to Recovery program (RTR) whose volunteers' provided information and support to breast cancer survivors. Methods: Participants were 76 survivors (mean age 55.6 years, 1.1 years since diagnosis) who were randomized to PA Plus RTR (12‐week PA telephone counseling delivered by RTR volunteers) or contact control. Data was collected on PA (self‐reported and objectively measured) and potential mediators (self‐efficacy, exercise decisional balance [ratio of the pros/advantages to the cons/disadvantages] and social support) at baseline and 12 weeks. Using a multiple mediation approach with bootstrapped standard errors, we examined mediators of the intervention effect on PA outcomes. Results: Compared to control, PA Plus RTR participants had higher mean self‐efficacy, lower decisional balance cons and social support at 12 weeks controlling for baseline. Higher mean self‐efficacy was associated with greater minutes of self‐reported PA, whereas higher decisional balance pros was associated with higher objectively measured PA at 12 weeks. There were significant indirect effects of self‐efficacy on self‐reported PA and decisional balance on objectively measured PA. Conclusions: PA Plus RTR increased self‐reported and objectively measured PA by changing theoretical constructs hypothesized to be associated with behavior change. Peers delivering a PA intervention should focus on increasing survivors' self‐efficacy for exercise especially in challenging circumstances such as being on vacation, and also help to overcome disadvantages of exercise such as taking time away from family. [ABSTRACT FROM AUTHOR]

Cascade testing for familial cancer syndromes has historically been difficult to execute. As part of a facilitated cascade testing pathway, we evaluated barriers to completion of cascade testing. Our previously published study evaluated a facilitated cascade testing pathway whereby a genetics team facilitated at-risk relative (ARR) cascade testing through telephone genetic counseling and mailed saliva kit testing. This follow-up study evaluated barriers to completion of cascade genetic testing through six-month follow-up telephone interviews. Probands identified 114 ARRs, of whom 97 were successfully contacted by telephone. Among those contacted, 83 (86%) reported interest in genetic testing and 14 (14%) declined. Among those reporting interest in testing, 71% (69/83) completed testing. Follow-up telephone interviews revealed that 14 ARRs did not complete testing despite reporting interest for the following reasons: concern about genetic discrimination, fear of a positive result and belief that the pathogenic variant was not relevant to his/her health. Five ARRs reported that they remained interested in testing and the telephone call prompted completion of testing. Even when facilitated by a medical team with prioritization of relative convenience, significant barriers to cascade testing ARRs for hereditary breast and ovarian cancer syndrome persist due to concern about genetic discrimination, cost, and fear of positive test results. [ABSTRACT FROM AUTHOR]

Does market access affect information technology by shaping its diffusion and adoption? The introduction of the telephone in Bavaria is used to demonstrate that local and external market access affected both. External connections shortened the diffusion time of exchanges by 3 percent on average, while 4 percent of lines were due to such inter-city communication links. However, relatively stronger local effects from population size and demand for communication services, especially in larger cities, imply that initially, the telephone was primarily a local urban amenity that also became an external communication link when it rolled out to more rural places over time. [ABSTRACT FROM AUTHOR]

This paper aims to shed light into the operation of SafeLine, the only Greek Hotline for illegal online content, and its seventeen years of successful operation as a member of INHOPE, the International Association of Internet Hotlines. The operation of SafeLine is introduced and an analysis of the received reports during its operation is attempted, in order to reveal hidden trends over the seventeen years. Furthermore, a comparison between the reports of SafeLine and the reports of the other 48 national hotlines, members of the International Association INHOPE, operating in 43 different countries spanning six continents worldwide is presented. Another main contribution of this paper is a correlation analysis between SafeLine's reports and dark web data. Specifically, SafeLine's reports are compared against the ALTAS dataset of the Voyager system of Web-IQ, drilled from the dark web, revealing a correlation of more than 50% between the reports received by SafeLine and the domains of illegal sites discussed in the dark web. Last, but not least, an analysis of the legislative framework concerning Child Sexual Abuse Material (CSAM) in all country members of INHOPE, European and outside Europe is attempted, revealing similarities as well as differences in what is General terms: Computer security; Internet; Online Safety; Illegal behavior; Deep web; Dark net. considered illegal, the ways CSAM is tackled, and the penalty limits prescribed in various countries. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is a debilitating, non-traumatic, neurological disorder in young adults and can reduce quality of life (QoL) by interfering with the ability to work, leisure activities, and routine living tasks. Various studies have shown the dissatisfaction of people with MS in different areas of care services. Regarding the patients' weakness with care and services, we sought to identify the challenges for patients with MS in receiving care and services in Iran. Methods: This cross-sectional study was conducted in 2016-2018 using a researcher-made questionnaire (designed by MS Specialists in an MS research center). The questionnaire examined the care challenges in four areas: 1) costs of medication, hospitalization, and rehabilitation services, 2) family support, insurance system, and job protection, 3) access to transportation system and treatment team, 4) quality of the provided care and services. Results: Completed questionnaires were received from 945 respondents. The mean age of responders was 35.92 years. In total, 731 (77.8) participants were women and 208 (22.2) were men. Academic education was reported among 615 (65.3) participants and 367 (40.2) were employed during the study, while 99 (10.5) of the subjects were not able to walk a minimum of 20 meters. The prioritization of care services challenges was as follows: the cost of pharmaceutical services (49.1), lack of telephone counseling (47.4), uninsured home rehabilitation (44.7), lack of qualified care centers (41.2), and rehabilitation costs (40.2). Conclusion: We found that patients who could not walk at least 20 meters and unemployed individuals had more problems and lower QoL. The patients who had non-academic education had more challenges with the cost of medication, transportation, and lack of familial support. This study shows the challenges of MS patients in receiving health care in Iran that vary in age, education, employment, and ability to walk. As the abovementioned challenges are of great importance in determining the QoL of people with MS, an appropriate solution is provided in this study to overcome these challenges. [ABSTRACT FROM AUTHOR]

Introduction: Globally, postnatal care (PNC) is fraught with challenges. Despite high PNC coverages in Ghana's Greater Accra Region (GAR), maternal and newborn health outcomes are of great concern. In 2017, neonatal and post-neonatal mortality rates in GAR were 19 and 13 per 1000 live births respectively despite PNC coverages of 93% for at least one PNC and 87.5% for PNC within 48 hours post-delivery. Telephone follow-up has been used to improve health outcomes in some settings, however, its usefulness in improving maternal and infant health during the postnatal period is not well known in Ghana. We assessed effectiveness of telephone-based PNC on infant and maternal illness in selected hospitals in GAR.Methods: An open-label, assessor-blinded, parallel-group, two-arm superiority randomized controlled trial with 1:1 allocation ratio was conducted from September 2020 to March 2021. Mother-baby pairs in intervention arm, in addition to usual PNC, received midwife-led telephone counselling within 48 hours post-discharge plus telephone access to midwife during postnatal period. In control arm, only usual PNC was provided. Descriptive and inferential data analyses were conducted to generate frequencies, relative frequencies, risk ratios and 95% confidence intervals. Primary analysis was by intention-to-treat (ITT), complemented by per-protocol (PP) analysis.Results: Of 608 mother-baby pairs assessed for eligibility, 400 (65.8%) were enrolled. During 3 months follow-up, proportion of infants who fell ill was 62.5% in intervention arm and 77.5% in control arm (p = 0.001). Maternal illness occurred in 27.5% of intervention and 38.5% of control participants (p = 0.02). Risk of infant illness was 20% less in intervention than control arm in both ITT analysis [RR = 0.8 (95%CI = 0.71-0.92] and PP analysis [RR = 0.8 (95%CI = 0.67-0.89)]. Compared to controls, risk of maternal illness in intervention arm was 30% lower in both ITT [RR = 0.7 (95%CI = 0.54-95.00)] and PP analysis [RR = 0.7 (95%CI = 0.51-0.94)].Conclusion: Telephone-based PNC significantly reduced risk of maternal and infant illness within first 3 months after delivery. This intervention merits consideration as a tool for adoption and scale up to improve infant and maternal health.Trial Registration: This trial was retrospectively registered with the International Standard Randomized Controlled Trial Number (ISRCTN) Registry with number ISRCTN46905855 on 09/04/2021. [ABSTRACT FROM AUTHOR]

Background: Excess gestational weight gain (GWG) is associated with short-term perinatal complications and longer term cardiometabolic risks for mothers and their babies. Dietitian counselling and weight gain monitoring for women at risk of high pregnancy weight gain is recommended by clinical practice guidelines. However, face-to-face appointments, during a time with high appointment burden, can introduce barriers to engaging with care. Telephone counselling may offer a solution. The Living Well during Pregnancy (LWdP) program is a dietitian-delivered telephone coaching program implemented within routine antenatal care for women at risk of excess GWG. This program evaluation used a hybrid implementation-effectiveness design guided by the RE-AIM framework to report on the primary outcomes (reach, adoption, implementation, maintenance) and secondary outcomes (effectiveness) of the LWdP intervention.Methods: The LWdP program evaluation compared data from women participating in the LWdP program with a historical comparison group (pregnant women receiving dietetic counselling for GWG in the 12 months prior to the study). The primary outcomes were described for the LWdP program. Between group comparisons were used to determine effectiveness of achieving appropriate GWG and pre and post intervention comparisons of LWdP participants was used to determine changes to dietary intake and physical activity.Results: The LWdP intervention group (n = 142) were compared with women in the historical comparison group (n = 49). Women in the LWdP intervention group attended 3.4 (95% CI 2.9-3.8) appointments compared with 1.9 (95% CI, 1.6-2.2) in the historical comparison group. GWG was similar between the two groups, including the proportion of women gaining weight above the Institute of Medicine recommendations (70% vs 73%, p = 0.69). Within group comparison showed that total diet quality, intake of fruit and vegetables and weekly physical activity were all significantly improved from baseline to follow-up for the women in LWdP, while consumption of discretionary food and time spent being sedentary decreased (all p < 0.05).Conclusion: The LWdP program resulted in more women accessing care and positive improvements in diet quality, intuitive eating behaviours and physical activity. It was as effective as face-to-face appointments for GWG, though more research is required to identify how to engage women earlier in pregnancy and reduce appointment burden. [ABSTRACT FROM AUTHOR]

Objective: To assess whether offering free mailed nicotine replacement therapy (NRT) and telephone counselling to smokers on elective surgery waiting lists increases quitting before surgery. Design, setting: Randomised, controlled trial at Frankston Hospital, a public tertiary referral hospital in Melbourne. Participants: Adult smokers added to elective surgery waiting lists for operations at least ten days in the future, 1 April 2019 ‒ 3 April 2020. Intervention: In addition to normal care, intervention participants received a brochure on the risks of low frequency smoking, an offer of Quitline call‐back registration, and an offer of mailed NRT according to reported daily smoking: 1‒9 cigarettes/day, 2 mg lozenges; 10‒15/day, 7‒14 mg patches [three weeks] and 2 mg lozenges; > 15/day, 7‒21 mg patches [five weeks] and 2 mg lozenges. Main outcome measures: Primary outcome: quitting at least 24 hours before surgery, verified by exhaled carbon monoxide testing. Secondary outcomes: quitting at least four weeks before surgery, adverse events, and (for those who had quit before surgery) abstinence three months after surgery. Results: Of 748 eligible participants (control, 363; intervention, 385), 516 (69%) had undergone elective surgery when the trial was terminated early (for COVID‐19‐related reasons) (intervention group, 274; control group, 242). 122 of the 385 intervention participants (32%) had accepted the offer of cessation support. The proportions of intervention participants who quit at least 24 hours before surgery (18% v 9%; odds ratio [OR], 1.97; 95% CI, 1.22‒3.15) or at least four weeks before surgery (9% v 4%; OR, 2.20; 95% CI, 1.08–4.50) were larger than for the control group. Three months after surgery, 27 of 58 intervention (47%) and 12 of 25 control participants (48%) who quit before surgery reported not smoking in the preceding seven days. No major adverse events were reported. Conclusion: Uptake of free mailed NRT and Quitline support by smokers on elective surgery waiting lists was good, and offering additional support was associated with higher proportions of smokers quitting before surgery. Trial registration: Australian New Zealand Clinical Trials Registry, ACTRN12619000032156 (prospective). [ABSTRACT FROM AUTHOR]

The number of suicides in Japan increased for the first time in 11 years during the COVID‐19 pandemic. This trend is particularly high among employed women and students. The Japanese government expanded its budget for providing telephone and social network service (SNS) counseling by prefectures and non‐profit organizations (NPOs). On the basis of interviews with the chairman as well as counselors of an NPO in Osaka (Japan) that has provided telephone counseling services on suicide for over 40 years, this study examines suicide and suicide prevention amid the COVID‐19 pandemic with a particular focus on how suicidal feelings are accepted. The results clarify that people do not wish to die just because of financial troubles or health problems; rather, they have lost the meaning in their life in the conflicts between social conditions and their personal life histories. Additionally, as volunteer counselors often experience the suicide of close relatives, their empathy for a caller may be based on their experiences of being overwhelmed by the realization of the otherness of others. They do not regard the acceptance of suicidal feelings as a "job," but act as "friends." Although modern society conceals death and suicide cases, the key to achieving a society where no one is driven into committing suicide is to place human life and human rights first as well as to talk about suicide and suicidal feelings without making the subject taboo or an aberration. [ABSTRACT FROM AUTHOR]

This article examines the current practices of welfare surveillance in Ontario Works (OW). Although neoliberal policy changes to social assistance have been well documented by a variety of scholars, the surveillance technologies behind them have received less scrutiny. The article questions how new surveillance technologies have transformed the administration and everyday practices of OW. Based on primary research of policy documents, legislation, regulations and directives, the paper explores the eight surveillance tools used to police OW recipients including the Consolidated Verification Procedure (CVP); Maintenance Enforcement with Computer Assistance (MECA); Service Delivery Model Technology (SDMT); Ontario Works Eligibility Criteria; Eligibility Review Officers (EROs); Audit of Recipients; Drug Testing and Welfare Fraud Hotlines. I argue the Ontario Works Act (OWA) 1997 justified increased surveillance, regulation and control of poor families creating new forms of surveillance. Additionally, the rationales behind the implementation of OW surveillance (anti-fraud and workfare) were unjustified and have made OW recipients, particularly racialized single mothers more vulnerable. Using a feminist political economy critique, the article endeavours to explore the gendered, classed and racialized implications of welfare surveillance and the expanding ways the state has created 'deviants' out of those who fail to be 'good market citizens'. [ABSTRACT FROM AUTHOR]