Overcoming Appointment Adherence Barriers Using Social Support

 描述（由申请人提供）：预约不出席-或“不显示”-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1500亿美元的费用。此外，预约不出席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，未能接受必要的治疗。某些人群更有可能从事非服务性行为，包括社会经济地位低和英语水平有限的人。由于这些人群已经经历了健康差距，他们最需要的工具，可以有效地帮助他们解决环境和个人障碍，阻碍他们保持医疗保健预约的能力。鉴于这些挑战，目前的提案概述了一个全面解决方案的开发和评估，以解决导致未出现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，该系统将通过交互式语音应答（IVR）、短信/短信和电子邮件方式提供有针对性的、文化上适当的信息活动。这些消息将提供针对预约性质的教育信息，与相关资源的连接，例如负担得起的当地交通服务，以及对预定访问日期，时间和地点的提醒。重要的是，这一系统还将植根于一个同伴支持网络，提供额外的个性化援助，以促进遵守和克服出勤障碍。由此产生的系统将为导致不遵守预约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，以促进病人更多地参与和了解自己的医疗保健需要。

 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.