H&alth Briefs Utilization of a Cancer Telephone Information Facility: A Comparison of Callers and Non-Caller Controls GREGG S. WILKINSON, PHD, EDWIN A. MIRAND, PHD, DSc, DEBRA L. WALSH, MA, JOHN L. WILSON, MS, AND SAXON GRAHAM, PHD
Previous papers have described the Can-Dial cancer telephone public information service' 2 and presented preliminary evaluation findings.3 4This report presents findings from a comparison of a sample of callers with non-caller controls which was conducted as part of an in depth evaluation of the program. The Can-Dial service is a dial access system comprised of a library of 51 pre-recorded tapes concerning various topics about cancer. The tapes are played over the telephone in response to requests from members of the community. Data used to monitor the program were collected from all callers when they contacted the system. Analyses based upon these data showed that: females called more often than males, use varied inversely with age and distance of residence from the program's location, socioeconomic status was equivocally related to use of the system, and consistent patterns existed in hourly, daily, and monthly response. The results of several small experiments suggested that increases in promotion would produce corresponding increases in utilization. Additional data for a more complete evaluation of the program were collected by means of telephone interviews with randomly selected callers and non-caller controls. Every third caller who was at least 20 years of age and who called during the months of January through September 1976 was interviewed. Interviews were conducted one to four From Roswell Park Memorial Institute, Buffalo, NY. Address reprint requests to Dr. Edwin A. Mirand, Associate Institute Director, Roswell Park Memorial Institute, New York State Department of Health, 666 Elm Street, Buffalo, NY 14263. Dr. Wilkinson was Associate Cancer Research Scientist and Associate Professor at the time of the study; he is now with the Health Effects Research Laboratory, EPA, Research Triangle Park, NC. Ms. Walsh is Research Analyst, Mr. Wilson is Research Affiliate, at Roswell Institute. Dr. Graham is Professor, SUNY at Buffalo, and Principal Scientist, Roswell Institute. This paper, submitted to the Journal April 22, 1977, was revised and accepted for publication April 11, 1978.
AJPH December 1978, Vol. 68, No. 12
months after these individuals contacted the program, with the average time between a call and a subsequent interview being two months. Upon the completion of interviews with callers, similar interviews were conducted with non-callers selected from the telephone directory. The manner of selection entailed choosing every twenty-fifth name from the top of the first column on every fourth page and every seventh name from the bottom of the third column on every third page. We then decided to increase the number of non-callers interviewed by selecting every tenth name from the top in the second column of every second page. Seventy-three per cent of the callers contacted were successfully interviewed, 4 per cent refused, and 23 per cent could not be reached because of having moved, inadequate or incomplete telephone information. Seventy-two per cent of the control interviews initiated were completed, 15 per cent refused, and 13 per cent had moved, had their telephones disconnected, etc. A total of 1,228 caller and 2,034 control interviews were
completed. It was hypothesized that more callers than non-callers would be of higher education and socioeconomic status, younger, female, and from professional or managerial occupations, would be more knowledgeable about cancer-related health matters as a result of personal experience with the disease, and would demonstrate a somewhat better preventive health orientation. We also investigated possible differences in the use of media between callers and controls.
Results A considerable age difference was found between calland non-callers. This complements earlier findings1' 4 demonstrating an inverse association between age and utilization. Because of the strong influence exerted by age, it was necessary to adjust for this variable when conducting addiers
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tional analyses. We also decided to control for sex because of the possible influence sex differences could exert upon some of the variables examined.* Upon adjusting for age and sex, no differences between callers and non-callers were found for such demographic characteristics as education, occupation, socioeconomic status, marital status, or for use of media. However, as expected, more callers than controls reported experiencing *The samples of cases and controls were weighted to reflect the
age and sex composition of Erie County. This was accomplished by stratifying the county population by age and sex, and dividing these strata by the respective sample populations. The ratios that resulted were then used to weigh the observations obtained in the caller, noncaller comparisons.
health problems they felt could be attributed to cancer (see Table 1). Furthermore, more callers than non-callers reported having known a friend or family member who developed cancer. Since the presence of health problems would be expected to influence use of the program, we decided to compare callers and non-callers who reported having an illness that increased their concern about cancer.** As shown in Table 2, more such callers than non-callers were married, high school graduates, knew someone with cancer, reported
**Cancer suspicious health problems were perceived by callers as possibly being cancer-related with symptoms often corresponding to one of the seven danger signals.
TABLE 1-Differenees between Callers and Non-Callers for Selected Variables Controlling for Sex Males (N = 779) (N = 333)
Non-Callers (N = 446)
57.4 30.3 12.3
28.3 31.4 40.4
16.7 29.6 53.6
6.9 20.9 72.2
71.7 28.3 55.8 44.2
58.8 41.2 47.2 52.8
Callers
Selected Variables
Age 20-34 35-54 55+ Health Problems* Cancer suspicious Not cancer suspicious None Health Awareness* Knew a cancer patient Did not know a cancer patient Member of family had cancer No family had cancer
Females (N
=
2412)
Callers (N = 873)
Non-Callers
Chi Square (P)
92.62 (
Previous papers have described the Can-Dial cancer telephone public information service' 2 and presented preliminary evaluation findings.3 4This report presents findings from a comparison of a sample of callers with non-caller controls which was conducted as part of an in depth evaluation of the program. The Can-Dial service is a dial access system comprised of a library of 51 pre-recorded tapes concerning various topics about cancer. The tapes are played over the telephone in response to requests from members of the community. Data used to monitor the program were collected from all callers when they contacted the system. Analyses based upon these data showed that: females called more often than males, use varied inversely with age and distance of residence from the program's location, socioeconomic status was equivocally related to use of the system, and consistent patterns existed in hourly, daily, and monthly response. The results of several small experiments suggested that increases in promotion would produce corresponding increases in utilization. Additional data for a more complete evaluation of the program were collected by means of telephone interviews with randomly selected callers and non-caller controls. Every third caller who was at least 20 years of age and who called during the months of January through September 1976 was interviewed. Interviews were conducted one to four From Roswell Park Memorial Institute, Buffalo, NY. Address reprint requests to Dr. Edwin A. Mirand, Associate Institute Director, Roswell Park Memorial Institute, New York State Department of Health, 666 Elm Street, Buffalo, NY 14263. Dr. Wilkinson was Associate Cancer Research Scientist and Associate Professor at the time of the study; he is now with the Health Effects Research Laboratory, EPA, Research Triangle Park, NC. Ms. Walsh is Research Analyst, Mr. Wilson is Research Affiliate, at Roswell Institute. Dr. Graham is Professor, SUNY at Buffalo, and Principal Scientist, Roswell Institute. This paper, submitted to the Journal April 22, 1977, was revised and accepted for publication April 11, 1978.
AJPH December 1978, Vol. 68, No. 12
months after these individuals contacted the program, with the average time between a call and a subsequent interview being two months. Upon the completion of interviews with callers, similar interviews were conducted with non-callers selected from the telephone directory. The manner of selection entailed choosing every twenty-fifth name from the top of the first column on every fourth page and every seventh name from the bottom of the third column on every third page. We then decided to increase the number of non-callers interviewed by selecting every tenth name from the top in the second column of every second page. Seventy-three per cent of the callers contacted were successfully interviewed, 4 per cent refused, and 23 per cent could not be reached because of having moved, inadequate or incomplete telephone information. Seventy-two per cent of the control interviews initiated were completed, 15 per cent refused, and 13 per cent had moved, had their telephones disconnected, etc. A total of 1,228 caller and 2,034 control interviews were
completed. It was hypothesized that more callers than non-callers would be of higher education and socioeconomic status, younger, female, and from professional or managerial occupations, would be more knowledgeable about cancer-related health matters as a result of personal experience with the disease, and would demonstrate a somewhat better preventive health orientation. We also investigated possible differences in the use of media between callers and controls.
Results A considerable age difference was found between calland non-callers. This complements earlier findings1' 4 demonstrating an inverse association between age and utilization. Because of the strong influence exerted by age, it was necessary to adjust for this variable when conducting addiers
1211
PUBLIC HEALTH BRIEFS
tional analyses. We also decided to control for sex because of the possible influence sex differences could exert upon some of the variables examined.* Upon adjusting for age and sex, no differences between callers and non-callers were found for such demographic characteristics as education, occupation, socioeconomic status, marital status, or for use of media. However, as expected, more callers than controls reported experiencing *The samples of cases and controls were weighted to reflect the
age and sex composition of Erie County. This was accomplished by stratifying the county population by age and sex, and dividing these strata by the respective sample populations. The ratios that resulted were then used to weigh the observations obtained in the caller, noncaller comparisons.
health problems they felt could be attributed to cancer (see Table 1). Furthermore, more callers than non-callers reported having known a friend or family member who developed cancer. Since the presence of health problems would be expected to influence use of the program, we decided to compare callers and non-callers who reported having an illness that increased their concern about cancer.** As shown in Table 2, more such callers than non-callers were married, high school graduates, knew someone with cancer, reported
**Cancer suspicious health problems were perceived by callers as possibly being cancer-related with symptoms often corresponding to one of the seven danger signals.
TABLE 1-Differenees between Callers and Non-Callers for Selected Variables Controlling for Sex Males (N = 779) (N = 333)
Non-Callers (N = 446)
57.4 30.3 12.3
28.3 31.4 40.4
16.7 29.6 53.6
6.9 20.9 72.2
71.7 28.3 55.8 44.2
58.8 41.2 47.2 52.8
Callers
Selected Variables
Age 20-34 35-54 55+ Health Problems* Cancer suspicious Not cancer suspicious None Health Awareness* Knew a cancer patient Did not know a cancer patient Member of family had cancer No family had cancer
Females (N
=
2412)
Callers (N = 873)
Non-Callers
Chi Square (P)
92.62 (
