The Use of Implementation Intentions to Increase the Appointment Attendance of OEF/OIF Veterans

Study Overview
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Brief Summary
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The purpose of the current pilot study will be to utilize implementation intentions to increase patient compliance with appointment attendance. Participants in the current study will be individuals referred for evaluation of their treatment needs. Experimental groups will create a simple induction consisting of what/when/where statements (implementation intentions) with the intention of increasing their rate of calling to schedule and subsequently attend appointments associated with their care. It is anticipated that participants who take an active role in their plan and utilize the implementation intention procedures will be more likely to make and attend the appointments suggested by their treating clinician. This pilot project will provide valuable initial data as to the potential effectiveness of a simple, cost-effective means of increasing appointment attendance. If successful, it could lead to cost savings and a decrease in the appointment wait time for people by increasing the utilization of available appointments.

Detailed Description
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The purpose of the current pilot study will be to utilize implementation intentions to increase patient compliance with appointment attendance. It is anticipated that participants who take an active role in their plan and utilize the implementation intention procedures will be more likely to make and attend the appointments suggested by their treating clinician. Sixty participants will be recruited to participate in the research project. Participants in the current study will be individuals referred for a secondary Traumatic Brain Injury (TBI) screen. This appointment serves to develop the plan of care that will be used for determination of the treatments that would be beneficial to the Veteran and as such the appointments necessary for further assessment or treatment in affiliated clinics (i.e. mental health, physical therapy, neuropsychology). Twenty participants will serve as controls who will receive treatment planning as usual. Twenty participants will receive treatment as usual but will be asked to contact the clinics directly to make their appointments. Twenty participants will be provided with a simple implementation intention induction. The simple induction will consist of the creation of what/when/where statements surrounding their intention to call to schedule and to attend medical appointments associated with their care. Research staff will then monitor the participants' appointment schedule daily to determine if they made the appropriate appointments and subsequently attended those appointments. Primary data for the examination will be these yes/no data points as to whether the participant successfully adhered to their initial intention to schedule the prescribed appointments. Additionally, for those who schedule the prescribed appointments, the latency in days from the time they indicated they intended to make their appointments will serve as a measure of their compliance. Across all groups, attendance at those appointments will be recorded to determine if the procedures lead to an increase in their attendance at their appointments compared to the treatment as usual group. This pilot project will provide valuable initial data as to the potential effectiveness of a simple, cost-effective means of increasing appointment attendance. If successful, it could lead to cost savings to the VA system and a decrease in the appointment wait time for Veterans by increasing the utilization of available appointments.

Official Title
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The Use of Implementation Intentions to Increase the Appointment Attendance of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans

Conditions
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Brain Injuries

Intervention / Treatment
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* Behavioral: Implementation Intention
* Behavioral: Contact Clinic


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Completed appointment for secondary TBI screen English speaker Exclusion Criteria: Neurological injury leading to dementia In ability to consent owing to cognitive barriers Non-English speaker Unable to schedule appointments the next working day after their secondary screen

Ages Eligible for Study
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Minimum Age: 22 Years
Maximum Age: 50 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| No Intervention: Scheduling as Usual<br>Participants will be subject to the current appointment scheduling procedures. | |
| Experimental: Contact Clinic<br>This group will be required to contact the clinic themselves to make appointments. | Behavioral: Contact Clinic<br>* Participants will be asked to sign a form indicating their need to contact the recommended clinics to make their appointments.<br>|
| Experimental: Implementation Intentions<br>This group will create Implementation Intentions to contact the clinic to make their appointments and to attend those appointments. | Behavioral: Implementation Intention<br>* Implementation Intentions are a series of what/when/where statements that a participant will make to create automatic cues to complete a behaviorally advantageous action.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Attendance at Scheduled Appointments | The attendance of the participants at their scheduled appointments will be measured. | Over a 60 Day Period | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Appointments and Schedules