SEARCH

SEARCH BY CITATION

Keywords:

  • adolescent;
  • assault;
  • emergency department;
  • research methodology;
  • interactive voice response

Abstract

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

Background:  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.

Objectives:  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.

Methods:  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.

Results:  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.

Conclusions:  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.

A significant number of the adolescents seen in emergency departments (EDs) seek care because of injuries sustained in assaults. In 2006 alone, more than 720,000 people ages 10 to 24 years were treated in EDs for violence-related injuries.1 The weeks after a violent event may be a particularly important time for issues of safety and coping by the subject and his or her family members and friends.2–6 In 1996, the American Academy of Pediatrics Task Force on Violence called for emergency physicians to give preventive education, screen for risk, and link violently injured adolescents to necessary intervention and follow-up services after an ED visit.7 Although there are significant barriers to establishing clinical protocols that encourage prospective follow-up of these patients,8,9 ED-based researchers have introduced these efforts in a number of specific programs.10–14 With the advent of cellular phone technology and caller identification, some researchers still report considerable challenges when trying to contact patients for prospective follow-up assessments.15,16

Interactive voice response (IVR) technology requires subjects to telephone a toll-free number and answer a series of yes/no questions using the touch-tone keypad. This technology has demonstrated promise in obtaining sensitive information from adults and adolescents.17–25 IVR also has the potential to decrease the work burden on research staff, offer subjects enhanced confidentiality, and most importantly, allow subjects to initiate the contact within their own busy schedules rather than on the researchers’ schedules.

Few studies have used IVR with adolescent subjects,21,22 and none has been in the setting of high-risk assault-injured adolescents. In addition, to our knowledge, no study has compared IVR completion rates of variably timed call-in requests. Successful application of this technology would be a valuable research tool for long-term prospective follow-up of violently injured adolescents and a way to evaluate future interventions for youth violence and homicide prevention. We conducted a feasibility study to determine the rate of IVR utilization within the context of assault-injured adolescents leaving an urban ED. We also examined the differences in IVR utilization among three different call-in schedules.

Methods

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

Study Design

This was a prospective cohort pilot study examining the feasibility of using an IVR system to follow a convenience sample of assault-injured teens for 8 weeks after discharge from the ED. The institutional review board of our institution approved all research procedures. Due to the sensitive nature of the information requested from subjects, a certificate of confidentiality was obtained for this study from the National Institutes of Health.

Study Setting and Population

We conducted this study in the ED of an urban, university-affiliated, tertiary care pediatric hospital with approximately 80,000 visits per year. Subjects were eligible for inclusion if they were 12 to 19 years of age and presenting to the ED with a chief complaint of an assault injury that occurred within the previous 48 hours. We excluded those who were victims of child abuse, sexual abuse, or self-inflicted injury; were considered too ill to participate; required inpatient hospitalization; were non–English speaking; had significant hearing or cognitive impairment; did not have easy access to a telephone; were a ward of the state; or had already participated in the study. We enrolled subjects from August 2007 through February 2008.

Study Protocol

Research assistants (RAs) were responsible for patient enrollment. RAs were present in the ED for 16 hours each day of the week. They were oriented to the study procedures and received monthly feedback regarding study enrollment issues over the course of the study. RAs also received training in research ethics and patient privacy. RAs identified potentially eligible subjects through the computerized tracking system in the ED and then asked the treating physician for permission to approach the patient for study consent. RAs obtained verbal consent from patients who met inclusion criteria and administered a 10-minute questionnaire regarding details about the assault (e.g., weapon use, location), risk factors for violent injury, and current intent to retaliate. The majority of questions on the questionnaire were from assessment tools that had been previously validated in this age group.26

Once the ED questionnaire was completed, RAs obtained written informed consent from guardians and assent from subjects to participate in the IVR study. Subjects were randomized using computer-generated block randomization to one of three timing cohorts: calling in monthly, calling in every 2 weeks, or calling in weekly. Regardless of randomization assignment, the duration of follow-up was 8 weeks for all subjects. On a magnetic reminder calendar, the RA marked 1) the enrollment date, 2) the approximate dates when calls were due (varied by cohort assignment), and 3) a subject-generated personal identification number (PIN) required to access the IVR system. The RA then asked any subject carrying a personal cell phone to program the toll-free IVR number into that phone. After study enrollment procedures were completed, the RA made a final telephone call into the TeleSage IVR system (TeleSage Inc., Chapel Hill, NC) to link the chosen PIN and the randomly assigned timing cohort.

Upon study enrollment, each participant received an empty gift card to a local convenience store chain. Subsequent to the ED visit, the IVR system notified a study investigator when subjects accessed the system. The investigator then electronically wired $5 to the card for each call made and $10 for the last call if all previous calls were also completed. A similar compensation scheme was successfully used previously among adult victims of intimate partner violence.27

We piloted the IVR system and the question script with 10 adolescent ED patients prior to beginning enrollment, and all of them found the system easy to use and felt that the questions were clear. Subjects who contacted the IVR system by telephone were asked 12 yes/no questions (Data Supplement S1, available as supporting information in the online version of this paper). Skip logic was applied such that positive responses prompted additional questions. The system was programmed to lock participants out if they were calling too early or too late for their allocation assignment within a certain margin for error for each timing cohort: 5 days for the weekly calls, 7 days for 2-week calls, and 14 days for monthly calls. Subjects were permitted to skip questions, but had to complete at least eight of 12 questions to be considered a complete survey and to be included in data analysis. Subjects were permitted to call back and try again if the call was terminated before the call was complete. All IVR data were sent electronically to the principal investigator.

Research assistants attempted to contact each subject approximately 4 weeks after his or her enrollment to remind them to utilize the system. RAs used the telephone number(s) provided by subjects at the time of study enrollment. When more than one phone number was provided, all numbers were tried. If the subject could not be reached at these numbers, RAs called the contact number listed in the subjects’ medical records. This 4-week call was made irrespective of whether the subject had already accessed the system. RAs were not required to speak to the subject; they were instructed to leave messages on an answering machine or with a family member if necessary. At the conclusion of the study, RAs again attempted to contact each study participant to administer a brief satisfaction questionnaire, to identify barriers to participation and subject retention.

Data Analysis

Counts, means, standard deviations (±SDs), percentages, and 95% confidence intervals (CIs) were used to describe the patient sample and participation in the IVR survey, and the chi-square statistic and Fisher’s exact test were used to test for differences between patients who participated in the study compared to those who did not participate in the study. The primary outcome of interest was the percentage of patients who participated in the IVR study, and the mean percentage of the requested calls that were completed by patients within each cohort. A relative risk (RR) with 95% CI was calculated as a way to compare the proportion of subjects who participated in one cohort relative to the proportion of subjects who participated in another cohort. Statistical tests were conducted with α = 0.05.

Results

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

The flow chart of subjects is depicted below in Figure 1. There were 773 injured patients screened for inclusion in the study by RAs using the chief complaint on the computerized tracking board. Of these, 584 did not meet inclusion criteria because their injury either was not violence-related or occurred more than 48 hours prior to their ED visit. Of the remaining 189 patients, 31 refused consent and 27 had no parent or guardian present to provide consent. There were 131 subjects who completed the intake questionnaire, and 95 (72.5%) consented to the follow-up IVR study. Patients who completed the questionnaire but did not participate in the study did not differ from patients who participated in the study in terms of age group (Fisher’s exact p = 1.000), percent male (Fisher’s exact p = 0.664), or the percentage who were African American (Fisher’s exact p = 0.730). The mean age was 15 years (SD ± 1.64, = 12-18 years).

image

Figure 1.  Subject flow chart.

Download figure to PowerPoint

Through randomization, 33 subjects were assigned to the monthly cohort, 32 to the biweekly cohort, and 30 to the weekly cohort. We reached 30.5% of enrolled subjects for the satisfaction interview. Table 1 reports baseline characteristics of the study participants. There were high levels of exposure to violence in our study population, which has been linked to assault injury.12 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. More than three-quarters of subjects (77.9%, 95% CI = 68.2% to 85.8%) had been suspended from school at least once, which is notable because not being in school has been found to be an independent risk factor for violence-related injury.28

Table 1.    Baseline Characteristics of Study Participants (n = 95 Unless Stated Below)
Characteristics%95% CI
Demographics
 Male63.252.6–72.8
 Black or African American88.480.2–94.1
 White4.21.2–10.4
 Hispanic3.20.7–8.9
 Other4.21.2–10.4
Fight that brought them to the ED
 Weapon present (n = 93)20.412.8–30.1
 Weapon used (n = 92)16.39.4–25.5
 Plan to retaliate (n = 94)33.023.6–43.4
Prior fights
 ≥1 other fight in past year51.641.1–62.0
 >1 other fight requiring medical attention8.43.7–15.9
Friends’ behavior in past year
 Carried knife or gun
  All friends2.12.6–7.4
  Most friends3.20.7–8.9
  Some friends7.43.0–14.6
 Got into physical fight (n = 93)
  All friends14.07.7–22.7
  Most friends19.411.9–28.9
  Some friends24.716.4–35.2
High-risk behaviors
 Have heard guns being shot85.376.5–91.7
 Have seen someone beaten up84.275.3–90.8
 Have been suspended from school77.968.2–85.8

IVR Participation

Subject participation with the IVR system is summarized in Table 2. Overall, 44.2% (95% CI = 34.0% to 54.8%) of subjects made contact with the system and completed at least one call, and 13.7% (95% CI = 7.5% to 22.3%) made all of the calls requested. Contact with the system did not differ by sex (41.7% among males, 48.6% among females, χ2 = 0.427, p = 0.513) nor by age group (12–13, 14–15, and 16–18 years; Fisher’s exact p = 0.175).

Table 2.    Percent of Calls Made
 nMade at Least One Call,Made All Calls,
n,% (95% CI)n,% (95% CI)
Total9542, 44.2 (34.0–54.8)13, 13.7 (7.5–22.3)
Monthly cohort3312, 36.4 (20.4–54.9)4, 12.1 (3.4–28.2)
Biweekly cohort3214, 43.8 (26.4–62.3)3, 9.4 (3.5–29.0)
Weekly cohort3016, 53.3 (34.3–71.7)6, 20.0 (7.7–38.6)

The percentage of subjects making at least one call to the IVR system was 53.3% (95% CI = 34.3% to 71.7%) in the weekly cohort, compared to 43.8% (95% CI = 26.4% to 62.3%) in the biweekly cohort (RR = 1.22, 95% CI = 0.72 to 2.04; p = 0.454) and 36.4% (95% CI = 20.4% to 54.9%) in the monthly cohort (RR = 1.47, 95% CI = 0.83 to 2.57; p = 0.177). Because the different groups were asked to make varying numbers of calls to complete the study (i.e., two calls for monthly callers and eight for weekly), we also analyzed the percent completion of requested calls. Among those who contacted the system, monthly callers completed an average of 75.0% (95% CI = 50.5% to 99.5%) of the calls they were asked to make, whereas biweekly and weekly callers completed averages of 50.0% (95% CI = 23.8% and 76.2%, p = 0.192) and 55.0% (95% CI = 30.6% to 79.4%, p = 0.277) of the calls they were asked to make, respectively. None of these differences were significant.

Because patients who were injured in fights involving weapons, and those with plans to retaliate, are at particularly high risk for violence recidivism,11,12,29 we were interested in call-in rates among these participants. Approximately one-quarter (26.3%) of the 19 subjects who were injured in fights involving weapons accessed the system compared to half (50.0%) of the 74 subjects who were not injured in fights involving weapons (Fisher’s exact p = 0.075). Approximately one-third (32.3%) of the 31 subjects with initial plans to retaliate accessed the system compared to half (49.2%) of the 63 subjects who did not have initial plans to retaliate (χ2 = 2.427, p = 0.119). These differences were not significant.

Reminder Calls

Of 95 subjects, 29 (30.5%, 95% CI = 21.5% to 40.8%) could be reached over the telephone for a personal reminder call approximately 1 month after enrollment. The RAs reached a family member or answering machine for an additional 34 (35.8%, 95% CI = 26.2% to 46.3%) subjects and left a reminder message using these contacts. Therefore, a total of 63 (66.3%, 95% CI = 55.9% to 76.0%) subjects received a reminder telephone call. Of those subjects who were reminded, either by direct conversation or through a message, 31.7% (95% CI = 20.5% to 44.7%) made at least one more call after being contacted. Thirteen (13.7%) of the telephone numbers given to our research team during the ED visit were listed as disconnected at the time of this reminder call approximately 4 weeks later. We were not more likely to reach a subject if he or she had called using the IVR system at least once, compared to those who had not ever called in (69.0% vs. 64.2%, p = 0.623).

Satisfaction Interview

Twenty-eight subjects (29.5%, 95% CI = 20.6% to 39.7%) were reached for exit interviews 2 months after enrollment in the ED. All of the contacted teens found the system easy to use and all but one said they would use it again. When asked what would have made them utilize the IVR system more often, most respondents did not know. One respondent suggested automated reminders to his cell phone. No subjects mentioned that their financial compensation was inadequate, but when asked if more money would have helped them remember to call, many said yes. They suggested amounts ranging from $5 to $100 per call. At the time of the 2-month satisfaction interview, 23 (24.2%, 95% CI =16.0% to 34.1%) of the phone numbers provided by the subjects during the initial ED visits were disconnected. Of these, 13 (56.5%, 95% CI = 35.5% to 76.8%) had still completed at least one contact using the IVR system.

Discussion

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

To our knowledge, this feasibility study is the first study to evaluate the utility of IVR in an assaulted adolescent population and is one of the largest reported adolescent IVR studies overall. We addressed the specific challenge of obtaining follow-up information in this high-risk group. The majority of adolescent patients who were approached in the ED were willing to participate in what was described as a study involving IVR follow-up; almost half of our enrolled subjects completed at least one call with the IVR system, and two-thirds of these subjects went on to complete at least one additional call. This may provide a mechanism for researchers and potentially clinicians to obtain prospective data on specific cohorts or patients in the ED with relatively few personnel and work hours. Overall, participants were satisfied with this system, but did suggest some specific ways of improving the response rate.

Because the optimal timing of IVR participation is not known, we also looked at the sustainability of response in three different call-in schemes: monthly, biweekly, and weekly. In the case of an assault-injured adolescent, variability in the timing of important outcomes such as retaliation and safety may warrant more frequent (i.e., weekly) call-in requirements to pinpoint the highest risk time periods for these outcomes. This study was underpowered to compare the rates of responses between these groups; this requires further study.

Our study also supports the notion that a single reminder call, whether a message or a direct conversation, may enhance call-in rates. It is unclear whether reminder calls actually increased subject participation or whether the ability to reach the subject simply suggests that he or she may be living in a less chaotic, less transient household. These participants may have been more likely to call regardless of the reminder. That said, the high rates of unanswered calls and disconnected telephone numbers support the notion that investigator-initiated contacts are challenging. As suggested by one participant, automated reminder calls to each subject’s cellular phone may provide a technologic solution.

We did not study how differences in subject compensation may alter participation rates. Future researchers may want to give higher incentives to ensure higher subject retention. We offered an additional financial disbursement if all calls were completed, but it may also be effective to prorate the disbursements in proportion to how many of the requested calls are made. In our current scheme, subjects might have recognized a potential disincentive to call in if they already failed to make a prior call.

There are some data to support the exploration of novel techniques to prospectively follow high-risk populations. Cunningham and colleagues15 attempted to contact adult inner-city substance abusers for follow-up after an ED visit and, despite gathering several phone numbers from study participants, expended considerable effort in the process. Through multiple telephone calls, certified letters, and even home visits, 78% of subjects completed a 3-month follow-up interview with an average of 10 and a range of 3–44 contact attempts per participant. The authors noted that the young adults were among the more difficult to contact. In our study, the low rate of investigator-initiated contact 2 months after the ED visit, and the large percentage of phone numbers that were disconnected at both the 1-month and the 2-month contact periods, underscores the need for the exploration of subject-initiated follow-up methods. Over half of the patients with disconnected numbers did contact the IVR system at least once, thereby providing data that likely would not have been obtained using traditional investigator-initiated methods.

Limited time and funding have led other researchers to try to reduce the cost of travel and the burden of face-to-face interviewing for prospective follow-up using technologic solutions. IVR technology has been shown to be an affordable and effective tool for research studies in an adult population.18 In our study, the cost of the entire IVR system was $2,500. Pediatric patients have demonstrated capability comparable to adults in using this technology with success.30 In support of this capability for adolescent subjects, Cheng and colleagues12 used digit-grabber technology to complete interviews of 147 assault-injured adolescents. Using in-person or investigator-initiated telephone interviews, they were able to obtain information on 80% of eligible assaulted teens and 99% of those they enrolled. It is unclear how many contact attempts were required for telephone interviews. Furthermore, these adolescents only had to be contacted once, and they were well compensated, receiving a Sony Walkman for their participation.12

Interactive voice responses have been validated in comparison to those obtained through standard techniques.17–20,23–25 When it comes to gathering sensitive information, these technologies have the added benefit of enhancing rates of disclosure. These investigations have shown that telephone interviews are at least as accurate as in-person interviews.31–33 Audio–computer-assisted self-interviews have resulted in greater disclosure of sensitive information than written questionnaires.34 Automated telephonic data collection systems have likewise been shown to produce at least as much disclosure of sensitive information as traditional in-person and written interview conditions.31,35 Recent studies looking at using IVR for the assessment of adolescent depression and addiction suggest that IVR is also a valid, efficient, and potentially less costly alternative to face-to-face interviews.36,37

Interactive voice response systems hold other advantages over traditional and newer follow-up techniques in terms of gathering sensitive information. Because subjects can control when and from where they access the IVR system, they can optimize their surroundings to maximize privacy; prior research has shown this feature is crucial to the success of IVR for victims of intimate partner violence.27 More research is needed to determine if this aspect of IVR enhances the validity of survey responses in assault-injured adolescents. Furthermore, some research on sexual behaviors and substance abuse has suggested that the simple process of self-monitoring and reporting through IVR may change behavior.38 It would be interesting to know if this is also true for adolescent victims of interpersonal violence.

Limitations

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

One potential limitation is that subject recruitment for our convenience sample of assaulted teens was confined to the hours when RAs were available, between the hours of 8am and midnight. However, reviews of our hospital records indicate that the majority of assault-injured adolescents arrive at the ED before midnight. Further selection bias is of concern given that this assault-injured population arrived at a children’s hospital rather than a general ED and were well enough to be discharged from the ED. Our ED serves a largely urban, underserved, African American community, and our results may not be generalizable to different settings. Further study is needed to determine if these results apply to more severely injured subjects or other socioeconomic and ethnic subpopulations. In addition, these studies could further examine the differences between call-in times. Our study was not powered to detect a difference between call-in groups and therefore must be considered hypothesis-generating work with regard to the question of optimal call-in timing. Further studies should examine this more closely. The response rate for the follow-up satisfaction interview was low (31%), which could affect the results of this interview. Those subjects whom we were unable to reach may have been less or more satisfied with the IVR system than those we reached.

Conclusions

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

We examined the feasibility of a novel technology, interactive voice response, for prospectively following assault-injured adolescents discharged from the ED. Almost half of these subjects contacted our interactive voice response system, and two-thirds of these went on to call in at least once more, some calling as many as eight times. Many adolescent subjects found the system easy to use and said they would use it again. These findings suggest that interactive voice response is a viable option for future ED-based longitudinal research with the assault-injured teen population. As interactive voice response is known to enhance convenience and confidentiality, while potentially decreasing work on the part of researchers, future research should further investigate the optimal timing schemes for interactive voice response in the violently injured population and explore the relative cost compared to traditional methods of adolescent follow-up.

Acknowledgments

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

The authors thank the academic associates in the emergency department of the Children’s Hospital of Philadelphia for their help enrolling patients in this study.

References

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information
  • 1
    Centers for Disease Control and Prevention. Youth Violence. Available at: http://www.cdc.gov/ViolencePrevention/youthviolence/index.html. Accessed Jul 2, 2009.
  • 2
    Fein JA, Kassam-Adams N, Gavin M, Huang R, Blanchard D, Datner EM. Persistence of posttraumatic stress in violently injured youth seen in the emergency department. Arch Pediatr Adolesc Med. 2002; 156:83640.
  • 3
    McCart MR, Phelps LF, Davies WH, Bradish E, Melzer-Lange M. Psychosocial distress among adolescent assault victims: implications for pediatric emergency medicine. J Adolesc Health. 2003; 36:70.e770.e7.
  • 4
    McCart MR, Davies WH, Phelps LF, Heuermann W, Melzer-Lange M. Psychosocial needs of African American youth presenting to a pediatric emergency department with assault-related injuries. Pediatric Emerg Care. 2006; 22:1549.
  • 5
    Pailler ME, Kassam-Adams N, Datner EM, Fein JA. Depression, acute stress and behavioral risk factors in violently injured adolescents. Gen Hosp Psychiatry. 2007; 29:35763.
  • 6
    Phelps LF, Davies WH, McCart MR, Klein-Tasman BP, Melzer-Lange MD, Heuermann W. Concerns and coping of African-American mothers after youth assault requiring emergency medical treatment. J Pediatr Psychol. 2006; 31:38896.
  • 7
    American Academy of Pediatrics. Adolescent assault victim needs: a review of issues and a model protocol. American Academy of Pediatrics Task Force on Adolescent Assault Victim Needs. Pediatrics. 1996; 98:9911001.
  • 8
    Melzer-Lange M, Lye PS. Adolescent health care in a pediatric emergency department. Ann Emerg Med. 1996; 27:6337.
  • 9
    Wilkinson DL, Kurtz EM, Lane P, Fein JA. The emergency department approach to violently injured patient care: a regional survey. Inj Prev. 2005; 11:2068.
  • 10
    Becker MG, Hall JS, Ursic CM, Jain S, Calhoun D. Caught in the crossfire: the effects of a peer-based intervention program for violently injured youth. J Adolesc Health. 2004; 34:17783.
  • 11
    Cheng TL, Johnson S, Wright JL, et al. Assault-injured adolescents presenting to the emergency department: causes and circumstances. Acad Emerg Med. 2006; 13:6106.
  • 12
    Cheng TL, Schwarz DF, Brenner RA, et al. Adolescent assault injury: risk and protective factors and locations of contact for intervention. Pediatrics. 2003; 112:9318.
  • 13
    Melzer-Lange MD, Van Thatcher CD, Liu J, Zhu S. Urban community characteristics and adolescent assault victims. WMJ. 2007; 106:3946.
  • 14
    Zun LS, Downey LV, Rosen J. Violence prevention in the ED: linkage of the ED to a social service agency. Am J Emerg Med. 2003; 21:4547.
  • 15
    Cunningham R, Walton MA, Tripathi SP, Outman R, Murray R, Booth BM. Tracking inner city substance users from the emergency department: how many contacts does it take? Acad Emerg Med. 2008; 15:13643.
  • 16
    Woolard RH, Carty K, Wirtz P, et al. Research fundamentals: follow-up of subjects in clinical trials: addressing subject attrition. Acad Emerg Med. 2004; 11:85966.
  • 17
    Corkrey R, Parkinson L. A comparison of four computer-based telephone interviewing methods: getting answers to sensitive questions. Behav Res Methods Instrum Comput. 2002; 34:35463.
  • 18
    Corkrey R, Parkinson L. Interactive voice response: review of studies 1989-2000. Behav Res Methods Instrum Comput. 2002; 34:34253.
  • 19
    Corkrey R, Parkinson L, Bates L. Pressing the key pad: trial of a novel approach to health promotion advice. Prev Med. 2005; 41:65766.
  • 20
    Greist JH, Marks IM, Baer L, et al. Behavior therapy for obsessive-compulsive disorder guided by a computer or by a clinician compared with relaxation as a control. J Clin Psychiatry. 2002; 63:13845.
  • 21
    Kaminer Y, Litt MD, Burke RH, Burleson JA. An interactive voice response (IVR) system for adolescents with alcohol use disorders: a pilot study. Am J Addict. 2006; 15(Suppl 1):1225.
  • 22
    Krukowski RA, Solomon LJ, Naud S. Triggers of heavier and lighter cigarette smoking in college students. J Behav Med. 2005; 28:33545.
  • 23
    Mundt JC, Kobak KA, Taylor LV, et al. Administration of the Hamilton Depression Rating Scale using interactive voice response technology. MD Comput. 1998; 15:319.
  • 24
    Rodriguez HP, Von Glahn T, Rogers WH, Chang H, Fanjiang G, Safran DG. Evaluating patients’ experiences with individual physicians: a randomized trial of mail, internet, and interactive voice response telephone administration of surveys. Med Care. 2006; 44:16774.
  • 25
    Toll BA, Cooney NL, McKee SA, O’Malley SS. Do daily interactive voice response reports of smoking behavior correspond with retrospective reports? Psychol Addict Behav. 2005; 19:2915.
  • 26
    Dahlberg LL, Toal SB, Swahn M, Behrens CB. Measuring Violence-related Attitudes, Behaviors, and Influences Among Youths: A Compendium of Assessment Tools, 2nd ed. Atlanta, GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control, 2005.
  • 27
    Wiebe DJ, Carr BG, Datner EM, Elliott MR, Richmond TS. Feasibility of an automated telephone survey to enable prospective monitoring of subjects whose confidentiality is paramount: a four-week cohort study of partner violence recurrence after emergency department discharge. Epidemiol Perspect Innov. 2008; 5:1.
  • 28
    Sege R, Stringham P, Short S, Griffith J. Ten years after: examination of adolescent screening questions that predict future violence-related injury. J Adolesc Health. 1999; 24:395402.
  • 29
    Mollen CJ, Fein JA, Localio AR, Durbin DR. Characterization of interpersonal violence events involving young adolescent girls vs events involving young adolescent boys. Arch Pediatr Adolesc Med. 2004; 158:54550.
  • 30
    Stritzke WG, Dandy J, Durkin K, Houghton S. Use of interactive voice response (IVR) technology in health research with children. Behav Res Methods. 2005; 37:11926.
  • 31
    Boekeloo BO, Schamus LA, Simmens SJ, Cheng TL. Ability to measure sensitive adolescent behaviors via telephone. Am J Prev Med. 1998; 14:20916.
  • 32
    McCormick MC, Workman-Daniels K, Brooks-Gunn J, Peckham GJ. When you’re only a phone call away: a comparison of the information in telephone and face-to-face interviews. J Dev Behav Pediatr. 1993; 14:2505.
  • 33
    Rintala DH, Willems EP. Telephone versus face-to-face mode for collecting self-reports of sequences of behavior. Arch Phys Med Rehabil. 1991; 72:47781.
  • 34
    Kim J, Dubowitz H, Hudson-Martin E, Lane W. Comparison of 3 data collection methods for gathering sensitive and less sensitive information. Ambul Pediatr. 2008; 8:25560.
  • 35
    Reddy MK, Fleming MT, Howells NL, Rabenhorst MM, Casselman R, Rosenbaum A. Effects of method on participants and disclosure rates in research on sensitive topics. Violence Vict. 2006; 21:499506.
  • 36
    Brodey BB, Rosen CS, Winters KC, et al. Conversion and validation of the Teen-Addiction Severity Index (T-ASI) for Internet and automated-telephone self-report administration. Psychol Addict Behav. 2005; 19:5461.
  • 37
    Moore HK, Hughes CW, Mundt JC, et al. A pilot study of an electronic, adolescent version of the quick inventory of depressive symptomatology. J Clin Psychiatry. 2007; 68:143640.
  • 38
    Schroder KE, Johnson CJ, Wiebe JS. Interactive voice response technology applied to sexual behavior self-reports: a comparison of three methods. AIDS Behav. 2007; 11:31323.

Supporting Information

  1. Top of page
  2. Abstract
  3. Methods
  4. Results
  5. Discussion
  6. Limitations
  7. Conclusions
  8. Acknowledgments
  9. References
  10. Supporting Information

Data Supplement S1. IVR follow-up questions.

Please note: Wiley Periodicals Inc. are not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing material) should be directed to the corresponding author for the article.

FilenameFormatSizeDescription
ACEM_519_sm_DataSupplementS1.pdf15KSupporting info item

Please note: Wiley Blackwell is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.