Table 2.

Key Factors to Increasing Acceptability and Usability of IVR Calls as Identified by Focus Group Participants

Key Factor	Patient Recommendations	Illustrative Participant Quotes
Immediate and Clear Identification of Call Source and Purpose	- name healthcare organization immediately to increase credibility of call and distinguish it from a telemarketing call	-“I think they should say the call is from [HEALTHPLAN] first, real quick and upfront, other wise people may hang up thinking it is a marketing type call.”
	- immediately identify who the call is for and provide a succinct and clear description of call purpose and benefit to recipient	-“I think they ought to start off and explain immediately who is calling and why they are calling so that the person recognizes it is a benefit.”
Personalization and Relevancy of Message	- correctly record pronunciation of recipients’ name	-“If my name is not said right, I might be more likely to hang up…”
	- specifically name any medications or conditions and avoid generic language wherever possible	-“It will get my attention more if the call is real personal…say exactly what the medication is I need to refill.”
	- use call recipients’ preferred phone number (e.g. home, work, cell)	-“Can I tell them what number I want the call on…’cause I’m more likely to use my cell than my home [phone].”
	- time the call to an event/experience meaningful to the recipient to increase utility (e.g. near medication refill date or during allergy season)	-“‘This is [HEALTHPAN] and we just noticed it’s time to renew your medication. Because we know it is cold and flu season we just wanted to remind you of…’ a simple call like that will get my attention [participant’s suggestion for a useful call].”
	- incorporate language/events reflective of the local/regional culture	‘I thought adding ‘aloha’ was a real nice touch. Will the call end with ‘mahalo’?…because if they start with call with ‘aloha’, they have to end it with ‘mahalo.’”
Acknowledgement of Automated Technology	- within first few seconds of call identify the call as “automated” or “computerized”	-“Say this is a computerized voice or recorded voice right away in the message.”
	- acknowledgement orients recipient to computerized nature and structure of the call (yes/no format)	-“Say it is a computerized message and tell us how we need to respond ‘yes’ or ‘no’ to the questions – that way it feels less patronizing.”
	- acknowledgement focuses recipients’ attention to call content rather than to wondering whether or not the caller is a “real person”	-“You have to identify the call as automated so you know where you are at with it. ‘Do you have this, yes/no?’…this will help you identify right away you are speaking to a computer and need to be a little more patient.”
Delivery Style of Call	- record content in a business-like style reflecting professionalism and friendliness	-“The voice needs to be more businesslike, you know. Friendly, but not overly friendly – still serious.”
	- avoid an overly cheerful or “sing- song” style of delivery and voice	-“I found the speaker’s voice hard to understand at times – the sing-song quality to it made it hard to focus on.”
	- record voice at a slightly slower speaking pace to assist comprehension, especially for older and non-native recipients	-“I really couldn’t understand the call. It went too fast. I couldn’t follow that fast of pace…slow it down a bit.”
Voice Personality	- use a voice personality reflective of local/regional culture to increase sense of friendliness and familiarity	-“If the voice on the call sounds more localish in styling, it’s more friendly…a mainland voice doesn’t have the natural rhythms…it doesn’t sound as friendly.”
	- local/regional voice makes call feel more personalized and increases credibility of call	-“If the call is going to be used in Hawaii, understand that not everyone here went past high school. And so most people feel more comfortable hearing these terms in a voice that sounds real local.”
Duration of Call	- keep all calls to under 5 minutes and say how long the call will last in first few sentences	-“Get the call down to 5 minutes or less and tell us that early in the call…I have a few minutes to give, but I don’t have 10 minutes!”
	- eliminate redundancy from call content	-“I became impatient with the redundancy. The recorded voice repeated herself on more than one point and I don’t have patience with that.”
Written Information	- supply accompanying information (letter/brochure) prior to receiving calls to explain call purpose and relevancy	-“Some written information could help explain some things, like if you don’t have time to answer the call, what will happen?”
	- explain in more detail why the calls use automated technology rather than a “real person”	-“Do you have a letter of introduction going to all the people saying that there will be these automated calls? I think that’s important…to make us aware of it in advance.”