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Objective To evaluate the effectiveness of telephone based peer support in the prevention of postnatal depression.Design Multisite randomised controlled trial.Setting Seven health regions across Ontario, Canada.Participants 701 women in the first two weeks postpartum identified as high risk for postnatal depression with the Edinburgh postnatal depression scale and randomised with an internet based randomisation service.Intervention Proactive individualised telephone based peer (mother to mother) support, initiated within 48-72 hours of randomisation, provided by a volunteer recruited from the community who had previously experienced and recovered from self reported postnatal depression and attended a four hour training session.Main outcome measures Edinburgh postnatal depression scale, structured clinical interview-depression, state-trait anxiety inventory, UCLA loneliness scale, and use of health services.Results After web based screening of 21 470 women, 701 (72%) eligible mothers were recruited. A blinded research nurse followed up more than 85% by telephone, including 613 at 12 weeks and 600 at 24 weeks postpartum. At 12 weeks, 14% (40/297) of women in the intervention group and 25% (78/315) in the control group had an Edinburgh postnatal depression scale score >12 (χ2=12.5, P<0.001; number need to treat 8.8, 95% confidence interval 5.9 to 19.6; relative risk reduction 0.46, 95% confidence interval 0.24 to 0.62). There was a positive trend in favour of the intervention group for maternal anxiety but not loneliness or use of health services. For ethical reasons, participants identified with clinical depression at 12 weeks were referred for treatment, resulting in no differences between groups at 24 weeks. Of the 221 women in the intervention group who received and evaluated their experience of peer support, over 80% were satisfied and would recommend this support to a friend.Conclusion Telephone based peer support can be effective in preventing postnatal depression among women at high risk.Trial registration ISRCTN 68337727.

The telephone and the internet have become popular sources of psychological help in various types of distress, including a suicide crisis. To gain more insight into the unique features of these media, we compared characteristics of calls to three technologically mediated sources of help that are part of the volunteer-based Israeli Association for Emotional First Aid (ERAN): Telephonic hotline (n = 4426), personal chat (n = 373) and an asynchronous online support group (n = 954). Threats of suicide were much more frequent among participants in the asynchronous support group than the telephone and personal chat. These findings encourage further research into suicide-related interpersonal exchanges in asynchronous online support groups.

In this article the Chief Executive of the UK's only teleconferencing charity, Community Network, examines the problem of loneliness and social isolation that growing numbers of older people are now experiencing, and how telephone support and befriending groups can help to alleviate these feelings. As well as highlighting the scale and causes of the problem, the article takes a look at different types of telephone befriending groups and why the telephone is currently a far better solution for delivering this type of support than web-based alternatives. The article also explains how telephone befriending groups work; how much they cost; evaluating the success of the groups; and, most importantly, what the groups can achieve.

Objective: To increase walking activity in sedentary women. Methods: Women (N = 253) were randomly assigned to 1 of 3 groups: video education/control, brief telephone calls with no counseling, and telephone calls with counseling. Assessments were made at baseline, 6 months, and 1 year. Results: All interventions increased the number of reported minutes walked and decreased the time to walk a mile. Conclusions: The variability in the telephone counseling and brief telephone call groups seemed to suggest a group of participants who were high responders.

A model is presented for a telephone support group for bereaved mothers scattered geographically. Twelve monthly sessions are described, including the plan for the group and examples of conversations and insights. Group dynamics are discussed. The descriptive data and discussion of process provide an evaluation of group effectiveness. (EMK)

The results suggest that participation in the study and in personal assessment interviews at home were probably morale enhancing, and that additional telephone contact did not significantly add to that effect. Evidence also indicates that, in this sample, low perceived family support was significantly related to poor mental health, so it is possible that a program designed to increase friend support may have been the wrong intervention. 9 commentaries, offering a variety of perspectives, follow this article. (Abstract amended)

BackgroundColorectal cancer patients undergoing postoperative chemotherapy often exhibit symptoms of depression that in turn may negatively affect outcome. The aim of this study was to assess the efficacy of telephone-based reminiscence therapy on the depression, anxiety, subjective well-being, and social support of colorectal cancer patients undergoing postoperative chemotherapy complicated with depression.MethodsPatients were divided randomly into a control group (CON, n = 45), telephone support group (TS, n = 45), and telephone-based reminiscence therapy group (TBR, n = 45). Patients in TS and TBR groups received six 20–40-min telephone intervention sessions conducted weekly. Patients were assessed at baseline and at 6 weeks. The primary outcomes were changes on the Self-Rating Depression Scale (SDS) and Hamilton Depression Scale (HAMD), which were used to evaluate depression symptoms. Secondary outcomes were changes in Self-Rating Anxiety Scale (SAS), Hamilton Anxiety Scale (HAMA), Memorial University of Newfoundland Scale of Happiness (MUNSH), and Perceived Social Support Scale (PSSS) scores, which were used to evaluate anxiety symptoms, subjective well-being, and social support, respectively.ResultsAfter 6 weeks, SDS and HAMD scores were significantly lower than pre-intervention baseline in the TBR group but not in the CON and TS groups (P < 0.05). Both SAS and HAMA scores were significantly reduced in TBR and TS groups but not the CON group (P < 0.05) following intervention; however, there was no significant difference in post-intervention scores between TS and TBR groups (P > 0.05). Neither telephone support nor telephone-based reminiscence therapy improved subjective well-being or social support (P > 0.05).ConclusionsThese findings suggest that telephone-based reminiscence therapy can reduce depression symptoms in colorectal cancer patients undergoing postoperative chemotherapy. Telephone-based reminiscence therapy may also improve anxiety, but no better than telephone support. Alternatively, telephone-based reminiscence therapy did not improve subjective well-being or social support. We suggest that clinicians provide appropriate telephone-based reminiscence therapy in long-term care institutions based on patient mental health status.

One-third of US adults, 86 million people, have prediabetes. Two-thirds of adults are overweight or obese and at risk for diabetes. Effective and affordable interventions are needed that can reach these 86 million, and others at high risk, to reduce their progression to diagnosed diabetes. The aim was to evaluate the effectiveness of a fully automated algorithm-driven behavioral intervention for diabetes prevention, Alive-PD, delivered via the Web, Internet, mobile phone, and automated phone calls. Alive-PD provided tailored behavioral support for improvements in physical activity, eating habits, and factors such as weight loss, stress, and sleep. Weekly emails suggested small-step goals and linked to an individual Web page with tools for tracking, coaching, social support through virtual teams, competition, and health information. A mobile phone app and automated phone calls provided further support. The trial randomly assigned 339 persons to the Alive-PD intervention (n=163) or a 6-month wait-list usual-care control group (n=176). Participants were eligible if either fasting glucose or glycated hemoglobin A1c (HbA1c) was in the prediabetic range. Primary outcome measures were changes in fasting glucose and HbA1c at 6 months. Secondary outcome measures included clinic-measured changes in body weight, body mass index (BMI), waist circumference, triglyceride/high-density lipoprotein cholesterol (TG/HDL) ratio, and Framingham diabetes risk score. Analysis was by intention-to-treat. Participants' mean age was 55 (SD 8.9) years, mean BMI was 31.2 (SD 4.4) kg/m(2), and 68.7% (233/339) were male. Mean fasting glucose was in the prediabetic range (mean 109.9, SD 8.4 mg/dL), whereas the mean HbA1c was 5.6% (SD 0.3), in the normal range. In intention-to-treat analyses, Alive-PD participants achieved significantly greater reductions than controls in fasting glucose (mean -7.36 mg/dL, 95% CI -7.85 to -6.87 vs mean -2.19, 95% CI -2.64 to -1.73, P<.001), HbA1c (mean -0.26%, 95% CI -0.27 to -0.24 vs mean -0.18%, 95% CI -0.19 to -0.16, P<.001), and body weight (mean -3.26 kg, 95% CI -3.26 to -3.25 vs mean -1.26 kg, 95% CI -1.27 to -1.26, P<.001). Reductions in BMI, waist circumference, and TG/HDL were also significantly greater in Alive-PD participants than in the control group. At 6 months, the Alive-PD group reduced their Framingham 8-year diabetes risk from 16% to 11%, significantly more than the control group (P<.001). Participation and retention was good; intervention participants interacted with the program a median of 17 (IQR 14) of 24 weeks and 71.1% (116/163) were still interacting with the program in month 6. Alive-PD improved glycemic control, body weight, BMI, waist circumference, TG/HDL ratio, and diabetes risk. As a fully automated system, the program has high potential for scalability and could potentially reach many of the 86 million US adults who have prediabetes as well as other at-risk groups. Clinicaltrials.gov NCT01479062; https://clinicaltrials.gov/ct2/show/NCT01479062 (Archived by WebCite at http://www.webcitation.org/6bt4V20NR).

Numerous studies have investigated the relationship between social support and problematic mobile phone use among adolescents, yet a definitive consensus remains elusive. The high prevalence of problematic mobile phone use among children and adolescents requires urgent clarity on this issue. However, previous meta-analyses on this topic have primarily focused on college students, overlooking this association in younger age groups. The present study thus concentrated on children and adolescents, conducting a three-level meta-analysis to combine existing research findings and analyze various moderators to identify sources of research heterogeneity. A systematic literature search retrieved a total of 33 studies with 135 effect sizes for this meta-analysis, and 25,537 students (53.83% female, age range 7–19, grades range 3rd–12th) were included. The results showed a negative correlation ( r  = −0.139) between social support and problematic mobile phone use in children and adolescents. Age, social support measurement, sources of social support, and symptoms of problematic mobile phone use were found to have a significant moderating influence. Specifically, social support showed a stronger negative correlation with problematic mobile phone use in older adolescents compared to their younger counterparts. The correlation was more pronounced when using the Multidimensional Scale of Perceived Social Support than other scales. Family support exhibited a stronger negative correlation with problematic mobile phone use compared to other sources of support. Among the symptoms of problematic mobile phone use, the inability to control craving has the strongest negative correlation with social support. This meta-analysis suggested that providing more social support, particularly in the form of family support, during the development of children and adolescents may help alleviate problematic mobile phone use.