Future Attendance Research Articles

Modeling Patient No-Show History and Predicting Future Appointment Behavior at the Veterans Administration's Outpatient Mental Health Clinics: NIRMO-2.

No-shows are detrimental to both patients' health and health care systems. Literature documents no-show rates ranging from 10% in primary care clinics to over 60% in mental health clinics. Our model predicts the probability that a mental health clinic outpatient appointment will not be completed and identifies actionable variables associated with lowering the probability of no-show. We were granted access to de-identified administrative data from the Veterans Administration Corporate Data Warehouse related to appointments at 13 Veterans Administration Medical Centers. Our modeling data set included 1,206,271 unique appointment records scheduled to occur between January 1, 2013 and February 28, 2017. The training set included 846,668 appointment records scheduled between January 1, 2013 and December 31, 2015. The testing set included 359,603 appointment records scheduled between January 1, 2016 and February 28, 2017. The dependent binary variable was whether the appointment was completed or not. Independent variables were categorized into seven clusters: patient's demographics, appointment characteristics, patient's attendance history, alcohol use screening score, medications and medication possession ratios, prior diagnoses, and past utilization of Veterans Health Administration services. We used a forward stepwise selection, based on the likelihood ratio, to choose the variables in the model. The predictive model was built using the SAS HPLOGISTIC procedure. The best indicator of whether someone will miss an appointment is their historical attendance behavior. The top three variables associated with higher probabilities of a no-show were: the no-show rate over the previous 2 years before the current appointment, the no-show probability derived from the Markov model, and the age of the appointment. The top three variables that decrease the chance of no-showing were: the appointment was a new consult, the appointment was an overbook, and the patient had multiple appointments on the same day. The average of the areas under the receiver operating characteristic curves was 0.7577 for the training dataset, and 0.7513 for the test set. The National Initiative to Reduce Missed Opportunities-2 confirmed findings that previous patient attendance is one of the key predictors of a future attendance and provides an additional layer of complexity for analyzing the effect of a patient's past behavior on future attendance. The National Initiative to Reduce Missed Opportunities-2 establishes that appointment attendance is related to medication adherence, particularly for medications used for treatment of mood disorders or to block the effects of opioids. However, there is no way to confirm whether a patient is actually taking medications as prescribed. Thus, a low medication possession ratio is an informative, albeit not a perfect, measure. It is our intention to further explore how diagnosis and medications can be better captured and used in predictive modeling of no-shows. Our findings on the effects of different factors on no-show rates can be used to predict individual no-show probabilities, and to identify patients who are high risk for missing appointments. The ability to predict a patient's risk of missing an appointment would allow for both advanced interventions to decrease no-shows and for more efficient scheduling.

The Relationships Between Patient Experience and Quality and Utilization of Primary Care Services.

We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA1c [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.

Understanding Exercise Adherence: The Predictability of Past Experience and Motivational Determinants.

Background: An unresolved debate lingers over the effect of past behavior on motivational patterns and future behavior stability in the exercise context. Theorists argue that past behavior has a residual effect on future behavior; however, empirical studies have shown that past behavior displays significant power in predicting behavior recurrence in the future. The present research aimed to examine the effect of past behavior and motivational determinants on future exercise adherence. Methods: Data from 437 Portuguese gym exercisers (female = 235; male = 202) aged between 18 and 53 years (M = 31.14; SD = 9.47), with exercise experience ranging from 6 to 12 months (M = 9.41; SD = 1.33) were considered for research. Participants completed a multi-section survey measuring interpersonal behaviors, basic psychological needs, behavioral regulations, and intentions. Data from past behavior and future exercise adherence were collected using computerized records of their attendance at the gym. Results: Positive and significant correlations paths were evidenced among perceived supportive behaviors, needs satisfaction, autonomous motivation, intentions and future exercise adherence. Similar results were presented among perceived thwarting behaviors, needs frustration, and controlled motivation. Regression paths showed that perceived supportive behavior, basic needs satisfaction, and autonomous motivation displayed positive and significant effects on future behaviors; thus, past behavior displayed the highest coefficient on future exercise adherence. Fitness professionals should aim at creating supportive environments, thus, improving the likelihood of being perceived by exercisers as need-supportive individuals. By doing so, as a result, exercisers would experience increased levels of autonomous motivation and higher rates of future exercise attendance at the gym. Hence, exercisers will gradually form their positive past exercise experience, increasing the probability of engaging in an exercise in the future.

Anticipating special events in Emergency Department forecasting

Accurate daily forecast of Emergency Department (ED) attendance helps roster planners in allocating available resources more effectively and potentially influences staffing. Since special events affect human behaviours, they may increase or decrease the demand for ED services. Therefore, it is crucial to model their impact and use them to forecast future attendance to improve roster planning and avoid reactive strategies. In this paper, we propose, for the first time, a forecasting model to generate both point and probabilistic daily forecast of ED attendance. We model the impact of special events on ED attendance by considering real-life ED data. We benchmark the accuracy of our model against three time-series techniques and a regression model that does not consider special events. We show that the proposed model outperforms its benchmarks across all horizons for both point and probabilistic forecasts. Results also show that our model is more robust with an increasing forecasting horizon. Moreover, we provide evidence on how different types of special events may increase or decrease ED attendance. Our model can easily be adapted for use not only by EDs but also by other health services. It could also be generalised to include more types of special events.

Individual and healthcare system factors influencing antenatal care attendance in Saudi Arabia

BackgroundThe World Health Organisation recommends women have at least four antenatal care visits (ANC) during a low risk pregnancy. However, in Saudi Arabia, many mothers miss these appointments, placing their health and that of their baby at risk. Limited research which has explored why this is happening has focused on low maternal education or personal barriers such as lack of transport. The aim of the current research was therefore to understand what factors at the individual and healthcare systems level were associated with missing antenatal care in Saudi Arabia.MethodsTwo hundred and forty-two pregnant women in their third trimester completed a questionnaire examining their care attendance (appointments missed, planned future attendance, timing of first appointment) alongside barriers to attending care. These included maternal demographic background, health literacy, personal barriers, health care system factors and staff communication).ResultsOver half of women surveyed had missed at least one appointment and a third had delayed their care. Mothers who had missed or delayed appointments blamed health care system factors such as poor clinic facilities and waiting times. Attending care was not associated with maternal education or literacy, although mothers with a lower level of literacy were more likely to delay care. However, perceptions of staff communication, consistency and care were lower amongst mothers who had missed at least one appointment.ConclusionsAlthough in previous research health professionals believe it is maternal education that leads to poor attendance, in our sample at least, perceptions of staff communication and clinic facilities were instead associated with attendance. Making changes at the health care level e.g. through adapting clinic times and investing in staff training may increase antenatal care attendance in Saudi Arabia.

Are Fair Weather Fans Affected by Weather? Rainfall, Habit Formation, and Live Game Attendance

We analyze habit formation in sports attendance utilizing rainfall as an unexpected, transitory shock to attendance costs. Using attendance data from Major League Baseball (MLB) and National Oceanic and Atmospheric Administration weather data, we analyze the impact of variation in game day weather conditions on current and future MLB attendance. The empirical strategy permits identification of both the formation and persistence of habit from exogenous weather shocks. Past adverse weather shocks increase future attendance by about 200 fans per game. This contributes to the literature developing empirical evidence of habit formation in the field and provides policy implications for optimal ticket-pricing strategies.

Understanding sport media spectators’ preferences: The relationships among motivators, constraints and actual media consumption behaviour

The purpose of the study was to provide clarifications regarding the connection among motivators, constraints and sport media consumption, and to experimentally measure the application of the balance proposition in the field of sports. A total of 1704 questionnaires were successfully completed and analysed by means of STATA. The results indicate that previous attendance, attachment to the community and the team, level of sport, the fans' need to escape from stress as well as socialisation, aesthetics, media advertising and players' behaviour all positively impact fans' future attendance intention. Also, the lack of knowledge of the rules and regulations of the game, the cost, other sport and leisure alternatives and the lack of fans' favourite team's athletic success are factors that reduce fans' intention to attend future Euroleague matches.

Experiences With IoT and AI in a Smart Campus for Optimizing Classroom Usage

Increasing demand for university education is putting pressure on campuses to make better use of their real-estate resources. Evidence indicates that enrollments are rising, yet attendance is falling due to diverse demands on student time and easy access to online content. This paper outlines our efforts to address classroom under-utilization in a real university campus arising from the gap between enrollment and attendance. We do so by instrumenting classrooms with Internet of Things (IoT) sensors to measure real-time usage, using AI to predict attendance, and performing optimal allocation of rooms to courses so as to minimize space wastage. Our first contribution undertakes an evaluation of several IoT sensing approaches for measuring class occupancy, and comparing them in terms of cost, accuracy, privacy, and ease of deployment/operation. Our second contribution instruments nine lecture halls of varying capacity across campus, collects and cleans live occupancy data spanning about 250 courses over two sessions, and draws insights into attendance patterns, including identification of canceled lectures and class tests, while also releasing our data openly to the public. Our third contribution is to use AI techniques for predicting classroom attendance, applying them to real data, and accurately predicting future attendance with an root-mean-square error as low as 0.16. Our final contribution is to develop an optimal allocation of classes to rooms based on predicting attendance rather than enrollment, resulting in over 10% savings in room costs with very low risk of room overflows.

Assessing the determinants of antenatal care adherence for Indigenous and non-Indigenous women in southwestern Uganda

BackgroundWith an increasing number of women attending antenatal care for the recommended number of contacts, focus now must be placed on the quality and utility of care; without understanding adherence, the true contribution of antenatal care to improved maternal health outcomes is difficult to determine. ObjectiveThis research explored the practicality of antenatal care recommendations for women and the factors which facilitate or hinder adherence and shape the overall utility of care. DesignQualitative data were collected using a community-centred approach by means of focus group discussions with women and key informant interviews with healthcare providers throughout May and June of 2017. Data were analysed via thematic analysis guided by an essentialist/realist paradigm. SettingKanungu District, Uganda; a district in southwestern Uganda. ParticipantsA convenience sample of 38 Indigenous Batwa and non-Indigenous Bakiga women from four matched communities and three healthcare providers. FindingsA number of barriers to antenatal care adherence were identified which included a lack of monetary and material resources, a lack of a shared understanding and perceived value of care, and gender and position-based power dynamics, all of which were compounded by previous experiences with antenatal care. The factors identified which influenced adherence were highly complex and non-linear, affected by individual, community, health centre, and health system-level factors. Promotion of spousal involvement in antenatal care had different effects based on pre-existing individual levels of spousal support, either improving or hindering adherence. A lack of resources created a double burden for women through which maternal health was jeopardized by the inability to adhere to antenatal care recommendations and the poor quality patient-provider relationships which resulted and deterred future antenatal care attendance. Key conclusions and implications for practiceThe capacity to avail oneself of antenatal care varied significantly for women based on their socio-economic status, levels of autonomy, and spousal support. Strategies to improve antenatal care need to focus on health equity to ensure care has a high degree of utility for all women. The interconnectedness of care and those who deliver care necessitates healthcare providers to develop strong patient-provider relationships through their attitudes, behaviours, and the delivery of equitable care. In light of a historical emphasis on attendance, this research highlights the significance of improving the quality and utility of antenatal care, inclusive of Indigenous perspectives, to deliver high-value care.

College expectations of eighth grade students: The role of learning approaches and parent influences

The development of expectations to attend college is the first step toward future college attendance, yet its predictors are not fully understood. The current study seeks to identify individual and parent predictors of expectations for college completion among eighth grade students and examine inter-relationships between the independent variables. Data were used from the Early Childhood Longitudinal Study-Kindergarten Cohort (ECLS-K), a nationally representative and longitudinal study of 21,260 kindergarteners. Logistic regression models were employed to predict college expectations of eighth grade students from child and parent characteristics. Youth were more likely to expect to complete college when they had greater learning approaches (OR = 1.82, 95% CI = 1.05–3.15) and higher school competence/liking (OR = 1.60, 95% CI = 1.13–2.26). Controlling for demographic covariates, the odds of students expecting to complete college were nearly four times greater for youth whose parents expected them to complete a bachelor's degree (OR = 3.82, 95% CI = 2.34–6.23), compared to parents who expected their children to complete high school or less. A generalized structural equation model was then specified to understand the inter-relationships between child's behavior, learning approaches, and reading and math abilities. Child's self-control (β = 0.57, 95% CI = 0.53–0.60) and internalizing behavior (β = −0.15, 95% CI = -0.19 - -0.12) significantly predicted learning approaches, which then predicted child's reading ability (β = 0.24, 95% CI = 0.20–0.28) and math ability (β = 0.26, 95% CI = 0.00–0.53). Future research should examine effectiveness of programs seeking to increase student learning abilities and feelings of competence.

A Library’s Partnership Experience with University Extension to Provide Program Content

Many public libraries reply on forming partnerships with other institutions in their communities to expand and strengthen their educational public programing. The Land-Grant University Extension Service can be a natural partner for public libraries, as both organizations share the common goal of providing lifelong learning opportunities to the public. A year-long study based at the St. Martin Public Library in Jackson County, Mississippi shows the impact of programs led by Mississippi State University Extension faculty and staff on library activity at that branch, including new library card sign-ups, use of materials, and future program attendance and growth. From the results of surveys distributed, Extension-led educational programs appeared to have an overall positive impact on library activity at the St. Martin branch.

Acceptability of receiving lifestyle advice at cervical, breast and bowel cancer screening

Cancer screening could be an opportunity to deliver cancer prevention advice, but it is not known how such information would be received. We explored willingness to receive lifestyle advice in the context of the English National Health Service cervical, breast, and bowel (FS; flexible sigmoidoscopy) screening programmes. A population-based survey was conducted in 2016 to collect nationally representative data on willingness to receive lifestyle advice across cervical (n = 768), breast (n = 420) and FS (n = 308) screening programmes. Additional items assessed the impact of lifestyle advice on screening attendance, preference for receiving advice in the event of an abnormal screening result, and timing of advice. Most respondents were willing to receive lifestyle advice around the time of cancer screening (cervical 78.9%, breast 79.4%, FS 81.8%), and if their results were abnormal (cervical 86.3%, breast 83.0%, FS 85.1%). A small proportion indicated it may discourage future attendance (cervical 4.9%, breast 7.0%, FS 8.8%). Most preferred information to be delivered at the screening appointment (cervical 69.8%, breast 72.6%, FS 70.7%). There were no associations between sociodemographic characteristics and willingness to receive lifestyle advice at breast screening. For those intending to attend cervical screening, non-White ethnicity and higher education were associated with increased willingness to receive lifestyle advice. Women were more likely to be willing to receive advice at FS screening than men. Providing lifestyle advice at cancer screening is likely to be acceptable to the general population. The optimal approach for delivery needs careful consideration to minimise potential negative effects on screening attendance.

QR BASED ATTENDANCE SYSTEM

In higher education institutions, student participation in the classroom is directly related to their academic performance. However, the majority of student attendance registration is still conventionally done, which is tedious and time-consuming, especially for those courses that involve large numbers of students. Over the years, attendance management has been conducted manually at most of the universities. To overcome the manual attendance issues, we proposed and implemented a smart attendance system with the aim to encourage the potential use of the Quick Response (QR) code as a future attendance management system, to track and record student attendance in lectures and exercises for all relevant courses, as an aim of this paper.

Experimental and Non-Experimental Evidence on Limited Attention and Present Bias at the Gym

We show that limited attention and present bias contribute to low levels of exercise. First, in a large randomized experiment, we find that email reminders increase gym visits by 13 % and that they benefit nearly all types of individuals. Limited attention can explain these effects. Second, using a novel dataset, we find that many bookings for gym classes are canceled, and that bookings are made even for classes that never have a waiting list. Comparing these findings to the predictions of a dynamic discrete choice model, we conclude that many gym members use bookings to commit themselves to future attendance.

Factors influencing patient uptake of an exercise referral scheme: a qualitative study.

Exercise referral schemes aim to increase physical activity amongst inactive individuals with or at risk of long-term health conditions. Yet many patients referred to these schemes (by health professionals) fail to take up the exercise opportunities on offer. Understanding factors influencing uptake to exercise referral schemes may help improve future attendance. Using the Socio-Ecological Model as a framework, this qualitative study aimed to explore factors influencing uptake to an exercise referral scheme based in the North West of England. Semi-structured interviews were conducted with referred patients (n = 38) about their reasons for referral, interactions with referring health professionals, events following referral and ideas to improve future uptake. Data were analysed thematically and mapped onto the constructs of the Socio-Ecological Model. Factors reported to influence uptake included intrapersonal (past PA experiences, motivation, competing priorities), interpersonal (scheme explanations, support) and organizational influences (scheme promotion, communication between service, cost). Whilst several intrapersonal-level factors influenced patient decisions to uptake the exercise referral scheme, modifiable interpersonal and organizational factors were identified as potential targets for intervention. Recommendations are made for improving awareness of exercise referral schemes and for enhancing communication between referring practitioners, patients and referral scheme staff.

Feeling That In-Group Feeling at a Sponsored Sporting Event: Links to Memory and Future Attendance

Sports, the arts, and events are products in their own right, and when sponsored, they become marketing and communication platforms. The current research examines the role of event emotions on sponsor recall and intent to attend the event in the future. An important theoretical argument is that feeling to be part of an in-group, measured as in-group entitativity, moderates the relationship between emotions and outcomes of memory and intentions. To test our theoretical model, we surveyed attendees at a multiday international track and field event. A total of 282 individuals were surveyed, and 232 of these attendees qualified as audience members and were included in the analysis. Moderated regression analyses revealed that excitement, joy, boredom, and overall tone of the group atmosphere impact event outcomes for the sport and the sponsor, and furthermore, that in-group entitativity can function as an important moderator. Contributions to theory and practice are discussed.

Current Inmate Expected Post-Release Needs and Perceived Barriers to Future Voluntary After-Care Program Attendance

When attendance in after-care programs that may help ex-offenders successfully reenter society is not a mandated condition of prison release, getting individuals to voluntarily attend these programs is challenging. In order to help social service agencies better encourage ex-offenders to participate in these programs, it is important to understand ex-offenders’ anticipated needs (thereby increasing possible motivation for attendance) and perceived barriers to program attendance prior to their actual release. Consequently, 256 individuals incarcerated in a county prison in northeastern Pennsylvania were surveyed to address these issues. Findings suggest that women, Hispanics, and parents of children under age 18 anticipate the greatest number of needs upon their future prison release. The most commonly anticipated post-release needs were obtaining food, clothing, education, and child care, although there are group differences. Regarding anticipated programing issues, all inmates foresee transportation barriers to post-release program attendance, and bus passes were the most preferred form of assistance. Scheduling and child care issues were also anticipated programing obstacles and were most pronounced for parents of young children, who report the greatest amount of anticipated needs but also the most barriers to voluntary post-release program attendance. Other group variations and programing implications for voluntary after care are discussed.

The attendance at sporting events: A generalized theory and its implications

This article generalizes the well-known negative binomial distribution (NBD) theory to attendance behavior at sporting events. Using data from a large national survey across a range of sporting events in Australia, including Australian football, rugby league, soccer (outdoor), horse racing, motor sports, rugby union, cricket (outdoor), netball (indoor and outdoor), basketball (indoor and outdoor), harness racing, and dog racing, we show that the NBD is very robust in describing sporting event attendance behavior. This result has implications for sporting event marketing activities, such as which attendee segments should be targeted, how to increase ticket sales, as well as predicting future attendance behavior.

Understanding Barriers and Solutions Affecting Preschool Attendance in Low-Income Families

ABSTRACTPreschool attendance problems negatively impact children's school readiness skills and future school attendance. Parents are critical to preschoolers’ attendance. This study explored parental barriers and solutions to preschool attendance in low-income families. School-district administrative data from a racially/ethnically diverse sample of parents with children attending the district's half-day preschool program were obtained (N = 111). Subsamples of parents participated in a phone interview and follow-up, in-person interview. Parents valued early learning and preschool. Children missed school due to illness, problems with child care, transportation, and family life. Differences in attendance rates appeared by school, family demographics, and race/ethnicity. African-Americans and Hispanics experienced more barriers than Whites and Asians, and were more likely to miss school because of illness and medical appointments. Hispanics were more likely to miss for vacation. Parents noted a lack of social connection with other parents in the school/neighborhood, making seeking help to resolve attendance barriers difficult.

Nursing and Biochemistry: An Evaluation Strategy Using a Basic Discipline to Present to Freshman Students Their Future Professional Environment

Nursing is a career that involves more than taking care of sick patients, especially when working in health institutions (e.g. Clinics and Hospitals). According to the current curriculum guidelines for nurse graduation, it is necessary for this professional to develop different skills to work in several health care environments, including decision-making, communication, leadership, among others. Therefore, our objective was to plan a strategy to approximate Nursing freshmen students to their professional environment already in the very beginning of their graduate course. On that purpose we planned an evaluation strategy for the discipline Biochemistry using an active methodology to simulate a professional experience. Initially the students were divided into pairs, and had to analyze two different professional situations, both using Biochemical concepts. According to our results, as the evaluation strategy was applied, the students showed surprise and curiosity. The analysis of the questionnaire about the strategy revealed that most of the participants enjoyed the activity using positive words. Thus the strategy showed a good acceptance and presented the desired characteristic of correlating Biochemistry, a basic discipline, with the nurse professional skills. This strategy may allow they become more aware of their responsibilities sooner, as it allows using earlier their competence of seeking solutions to solve situations regarding the professional practices using biochemical basic concepts. This experience may improve them to a future better attendance of their patients.