Sheridan Phillips

Parent Interview Findings Regarding the Impact of Cystic Fibrosis on Families.

An assessment of the impact of cystic fibrosis (CF) was conducted with 43 families. Semistructured parental interviews on family functioning, parent-child interactions, sibling and peer relationships, and medical issues were coded by two independent raters to identify “major,” “minor”, or “no” problems. Of the 62 questions presented, only 8 were viewed by more than 10% of parents as “major problems.” The impact of hospitalization upon parents was the most prevalent “major problem.” Parental communication was a “major problem” for 28% of the mothers but for only one father. Ten to 15% of the parents described “major problems” related to: their marital relationship, accepting the illness, feeling they should do more for their child with CF, feeling their other children had been deprived or complained about inattention, or their relationship with the ill childs grandparents. While most families were generally coping successfully, health care professionals should be alert to specific areas of potential problems.

Increasing Appointment Compliance through Telephone Reminders: Does It Ring True?

This study evaluated the effectiveness of telephone reminders on appointment-keeping in young people treated for gonorrhea. Compliance with scheduled follow-up was recorded for a total of 339 patients during three two-week periods, namely, initial baseline phase, intervention phase during which attempts were made to remind the patients by telephone, and repeat baseline phase. There was no overall improvement in compliance with follow-up during intervention (31%), compared to baseline (32%). However, data from the intervention phase revealed a significantly higher rate of appointment-keeping for those patients who were contacted (44%) than for patients who were not reachable (20%). Furthermore, when we reanalyzed the data as a function of telephone ownership for all patients who did not receive a reminder, return rates were significantly higher for patients owning telephones (32%) than for those denying phone ownership (18%). Thus, we conclude that the likelihood for appointment compliance was related more to sociobehavioral factors reflected in telephone ownership than to the telephone reminders. J Dev Behav Pediatr 8:133–135, 1987. Index terms: appointment compliance, adolescents, gonorrhea.

Failure of a lottery incentive to increase compliance with return visit for test-of-cure culture for Neisseria gonorrhoeae.

The impact of the financial incentive of playing a lottery on the rate of return for test-of-cure cultures was evaluated at a clinic for sexually transmitted diseases. All teenagers and young adults treated for gonorrhea (or as contacts of patients with gonorrhea) who were given a test-of-cure appointment were eligible to participate; in order to win, they had to keep the appointment. The return rate was documented during a baseline and a lottery phase for 519 patients. Females were significantly more likely to keep the appointment (47%) than males (27%), regardless of intervention, but there was no improvement in the return appointment rates with the lottery (baseline, 31% vs. lottery, 33%). Although teenaged males were more likely to participate in the lottery than young adult males and all females, only young adult females who participated were significantly more likely to return (68%). Reasons for failure of the lottery are discussed. Thus, despite the successful use of a lottery in previous studies, it is not always helpful in improving compliant behavior in certain populations.

Test of cure for gonorrhea in teenagers. Who complies and does continuity of care help

This study evaluates factors influencing test of cure (TOC) compliance for gonorrhea in teenagers attending a public sexually transmitted disease (STD) clinic. The efficacy of providing continuity of care to improve the TOC rate is also evaluated. Overall, females complied better (54%) than males (33%), and younger males better than older males (greater than 16 years of age). Of patients with a prior history of gonorrhea, the TOC rates were significantly higher for those who had previously kept their TOC appointment. Continuity of care did not improve the TOC rate, but initial contact with a clinician appeared to influence the return rate of female adolescents. Male adolescents will apparently require a different intervention strategy to improve their appointment keeping.

Adolescent health in Russia: A view from Moscow and St. Petersburg

PURPOSE The purpose of this study was to report on the current state of adolescent health in Russia. METHODS By means of site visits, literature review, discussions with Russian colleagues, and a scientific meeting in Moscow, data were collected on health status of youth, the organization of health services, and professional training. RESULTS Youth over the age of 14 are served in the adult health care system. Youth clinics are just now emerging. Substance abuse is a major issue; AIDS is rare. Rates of sexual intercourse parallel many western European countries; however, contraception is expensive by Russian standards and often not used. Those with behavioral, physical, and intellectual impairments tend to be educated in special settings and managed by psychiatrists. CONCLUSION The Russian health care system is undergoing radical transformation. The traditional Soviet system, with its heavy reliance on medical interventions and prolonged inpatient hospitalizations, is threatened by a lack of resources. Privatization of health care poses additional threats, as do the social transformations that are occurring. These changes create a very uncertain future for the health and well-being of youth in Russia.