Overcoming Appointment Adherence Barriers Using Social Support

 描述(由申请人提供)：预约不出席--或“不出席”--在卫生机构中很常见，阻碍了医疗保健系统的有效运作，并导致每年超过1500亿美元的成本。此外，没有预约就诊与较差的健康结果有关，因为患者放弃了关键的预防性护理，得不到必要的治疗。某些人群更有可能采取无人值守的行为，包括社会经济地位较低和英语水平有限的个人。由于这些人群已经经历了健康差距，他们最需要能够有效帮助他们解决环境和个人障碍的工具，这些障碍阻碍了他们遵守医疗预约的能力。鉴于这些挑战，目前的提案概述了制定和评估综合解决方案，以解决导致缺席行为的众多个人和环境因素。通过在社会支持结构中嵌入基于证据的行为改变技术，该系统将在交互式语音应答(IVR)、短信/文本消息和电子邮件模式中提供有针对性的、文化上合适的消息活动。这些信息将提供特定于预约性质的教育信息，与相关资源的连接，如负担得起的当地交通服务，以及关于预定访问日期、时间和地点的提醒。重要的是，这一系统还将植根于同行支持网络，提供额外的个性化帮助，以促进遵守和克服出席障碍。该系统将为导致预约不遵守的一系列因素提供全面的支持，利用外部资源和已知的内部认知过程，促进患者更多地参与和了解自己的医疗保健需求。

 DESCRIPTION (provided by applicant): Appointment non-attendance - or, "no shows" - is common across health institutions, hindering efficient functioning of healthcare systems and contributing to over $150 billion in annual costs. Further, appointment non-attendance is associated with poorer health outcomes, as patients forgo critical preventative care and fail to receive necessary treatment. Certain populations are more likely to engage in non-attendant behavior, including individuals with low socio-economic status and limited English proficiency. As these populations already experience health disparities, they have the greatest need for tools that can effectively help them address the environmental and personal barriers that hinder their ability to keep healthcare appointments. In light of these challenges, the current proposal outlines the development and evaluation of a comprehensive solution to address the numerous personal and environmental factors contributing to no-show behavior. By embedding evidence-based behavior change techniques within a social support structure, the system will deliver targeted, culturally appropriate message campaigns across interactive voice response (IVR), SMS/text message, and email modalities. The messages will offer educational information specific to the nature of the appointment, connection to relevant resources such as affordable local transportation services, and reminders for scheduled visit date, time, and location. Importantly, this system will also be rooted in a peer support network, providing additional personalized assistance to promote adherence and overcome attendance barriers. The resultant system will provide comprehensive support for the range of factors contributing to appointment non-adherence, leveraging external resources and known internal cognitive processes to facilitate patients' increased participation and understanding of their own health care needs.