Automated Telephone Conversations to Assess Health Behavior and Deliver Behavioral Interventions
The medical care system is not very effective in modifying health behavior of individuals, in particular, ensuring patient compliance with medication regimens, healthy diets, regular physical activity, and regular health screening, and in the avoidance of substance abuse. Telephone-Linked Care (TLC) is a telecommunications technology that enables computer-controlled telephone counseling with patients in their homes. It has been applied to the task of improving a number of different health behaviors. Randomized controlled studies suggest that use of the system for as little as 3 months is associated with improvement in adherence to medication regimens, dietary change in hypercholesterolemia, and increased physical activity among sedentary individuals. Future work involves applying the technology to other important health behaviors, optimally using health behavior theory in the system design, targeting use of TLC to the most appropriate patient groups, incorporating new computer and telecommunications technology into the system, and interfacing TLC into the health care delivery system.
Unable to display preview. Download preview PDF.
- 1.Smith, M.B., Burke, K.E., Torgerson, J.S., et al., Logical and efficient conversations between patients and the telephone-linked computer system. In R.A. Greenes, ed., Proceedings: The Twelfth Annual Symposium on Computer Applications in Medical Care. IEEE Society, Washington, D.C., 1988, pp. 463–467.Google Scholar
- 2.Friedman, R.H., Stollerman, J.E., Mahoney, D.M., Rozenblyum, L. The virtual visit: using telecommunications technology to take care of patients. JAMIA 4: 413–425, 1997.Google Scholar
- 4.Marcus, B.H., and Owen, N., Motivational readiness, self-efficacy and decision-making for exercise. J. Appl. Social Psychol. 22(1):3–16, 1992.Google Scholar
- 5.Bandura, A., Social Foundations of Thought and Action: A Social Cognitive Theory, Prentice-Hall, Englewood Cliffs, NJ, 1986.Google Scholar
- 6.Friedman, R.H., Kazis, L.E., Jette, A., Smith, M.B., Stollerman, J., Torgerson, J., and Carey, K., A telecommunications system for monitoring and counseling patients with hypertension: impact on medication adherence and blood pressure control. Am. J. Hypertension 9:285–292, 1996.Google Scholar
- 8.Dutton, J.P., Posner, B.A., Smigelski, C., Noonan, J., and Friedman, R.H., Use of an automated telephone counselor to reduce serum lipids in hypercholesterolemia. Clin. Res. 10(Suppl):99A, 1995.Google Scholar
- 9.Cullinane, P.M., Hyppolite, K., Zastawney, A.L., and Friedman, R.H., Telephone linked communication—activity counseling and tracking for older patients. J. Gen. Int. Med. 9(Suppl 2):86A, 1994.Google Scholar