Likelihood Of Attendance Research Articles

Securing public spaces: public willingness to sacrifice convenience and privacy for security at three U.S. public venues

The use of security countermeasures at public venues has escalated dramatically over the past 20 years. We present a study of public venue patrons (N = 1276) examining how public perceptions of efficacy and intrusiveness of four security measures deployed at three different public assembly venues in the U.S. impact planned attendance. Enhanced use of these countermeasures,—Closed-Circuit Televisions (CCTVs), security guards, metal detectors, and bag checks—was evaluated by customers for their effectiveness in ensuring safety against crime and terrorism. We found that the perceived efficacy of the countermeasure in reducing these risks was positively associated with an increased likelihood of customer attendance at the venue. Moreover, customer beliefs about the overall enhancement of venue security and the sense of personal safety offered by these countermeasures also predicted their likelihood of attending. Unexpectedly, the study found that attitudes towards the privacy and convenience aspects of the countermeasures were not significant predictors of venue attendance. Results indicated that both cost and the extent of risk reduction predicted willingness to pay for enhanced security countermeasures. As the cost associated with a security measure increased, customers’ willingness to pay decreased. Conversely, as the perceived risk reduction offered by the security measures increased, customers indicated an increased willingness to pay. We found customers’ beliefs, attitudes, and intentions towards security measures were generally consistent across all three venues, indicating generalizability of findings across a range of public assembly venues in the U.S. Overall, the study provides evidence that customers support security countermeasures and endorse their implementation, which offers valuable insights for venue managers and policymakers aiming to enhance security measures at public assembly venues.

Travel motives and constraints affecting student participation in a proposed study tour

ABSTRACT While experiential learning activities undertaken through study tours are a valuable component of undergraduate student training, not all students seek to participate. This paper addresses the lack of investigations into reasons for participating in study tours by higher-education students, especially among prospective study tour participants. Seven independent variables were first tested for their influence on likelihood of attendance at an International Food Expo using a sample of 315 students. In addition, an open-ended question solicited 10,000 words for thematic analysis to shed further insights on reactions to study tour participation during the COVID-19 crisis. The results show that accessibility, friendship norms, personal interest, social approval, and perceived travel risk significantly influenced the likelihood of Food Expo attendance. In turn, the qualitative data revealed deeper insights into issues of emotional anxiety, subjective norms and normative behavior. The study has implications for study tour organizers beyond Covid-19.

The role of regional health policy for socioeconomic inequality in health services utilization

Abstract Background “J1” is a preventative routine examination in Germany recommended for adolescents at the age of 12-14 years. In contrast to the well-established U1-U9 examinations for younger children, with participation rates above 90%, the attendance of the J1 examination is approximately only 40%. The most frequent reason for not attending J1 is the unawareness of this examination. “Ticket to J1” is an intervention including an information leaflet introduced in Bavaria in 2017 to inform adolescents about J1. The aims of the present analysis are to investigate (1) if the regional policy was effective in increasing the attendance in J1, (2) if the effects vary by family socioeconomic status (SES), and (3) which meso-level characteristics of the healthcare system correlate with attendance rates in J1. Methods We used anonymised data of a large statutory health insurance in Germany for the timeframe of 2016-2018. To investigate the effect of the policy, a difference-in-differences design at the individual level was used. Assuming a parallel trend at the level of federal states, the likelihood of attendance in J1 of 13- and 14-year-olds was compared between Bavaria and other federal German states before and after policy introduction. All analyses were additionally stratified by SES. Results The introduction of “Ticket to J1” increased participation in J1 by 1% after controlling for all confounders. Furthermore, the effect was stronger for children from families with lower SES (an increase of 5%). Density of pediatricians was positively significantly correlated with participation in J1. Discussion Regional health policy intervention had a significant positive impact on attendance of J1 and appears to have the potential to reduce socioeconomic inequalities in healthcare utilization. Informing adolescents about J1 seems to increase the attendance, in particular for children from families with lower SES.

LGB´s Arts Affinity: An Empirical Study of Theater Audiences Based on Motivations

ABSTRACT The extended belief of gay people being more creative and showing higher interest toward arts lacks robust empirical support. The pioneer study on this issue highlighted that LGB´s arts participation was mostly explained by demographic factors such as level of studies, residence and family situation, which suggests that differences due to sexual orientation tend to fade. In this paper, we put forward the hypothesis that sexual orientation influences motivations to participate, which emphasizes their role and heterogeneity. To do so, we conducted a survey on participants at an alternative performing arts festival collecting information on socio-demographics, including sexual orientation, motivations and other variables. Results show that being LGB increases the likelihood of attendance for emotional, social or political motives, and emphasize the heterogeneity that sexual orientation plays on cultural audiences. Particularly, we find evidence of gender differences in attendance goals within LGB performing arts consumers, supporting gender nonconformity.

Comparison of presentations to the emergency department during the COVID-19 pandemic (COPED-C).

BackgroundConcerns have been raised that patients requiring emergency care may not have accessed healthcare services during coronavirus disease 2019 (COVID-19) lockdown.MethodsThis case control study aimed to understand changes in characteristics and diagnosis of patients attending a large UK Emergency Department (ED) during the first wave of the COVID-19 pandemic (March–May 2020) compared with equivalent weeks in 2019.ResultsWe found a 50.7% drop in first attendances to the ED in 2020. Likelihood of attendance and admission decreased for paediatric patients and increased for patients ≥ 46 years, and for men. Likelihood of admission increased for all Black ethnic groups and for patients from the most deprived index of multiple deprivation quintiles. This shift to an older, male, more deprived patient population with greater representation of ethnic minority groups was amplified in the ‘Infections’ diagnostic category.ConclusionsCOVID-19 has dramatically impacted ED usage. Our analysis contributes to local resource planning and understanding of changes in healthcare-seeking behaviour during the pandemic. Future research to identify positive behaviour changes could help sustain a reduction in non-urgent visits in the longer term.

Adherence to a follow-up program after gestational diabetes.

The aim of this study was to examine attendance for early postpartum follow-up among women with gestational diabetes mellitus (GDM), and to identify factors that influenced their likelihood of attending. One thousand eight hundred and nineteen women with GDM were retrospectively analyzed. During pregnancy, the following data were collected: age, family history of diabetes, ethnicity, prepregnancy BMI, fasting plasma glucose, glycated hemoglobin, gestational week of GDM diagnosis, timing and mode of delivery, newborn's birth weight and length. Glycemia and insulinemia during OGTT, lipid profile and postpartum BMI were assessed at follow-up. Based on the OGTT, women were classified as having normal glucose tolerance (NGT) or abnormal glucose tolerance (AGT), which included impaired fasting glucose (IFG), impaired glucose tolerance (IGT), IFG + IGT, and DM2. Factors predicting postpartum attendance for follow-up and onset of AGT were considered. Of the 889 (48.9%) who attended the scheduled postpartum OGTT, 741 (83.4%) had NGT, while 148 (16.6%) had AGT (IFG 6.7%, IGT 7.7%, IFG + IGT 0.8%, DM2 1.5%). The predictors of adherence to follow-up were: not belonging to an immigrant group; family history of DM2; and insulin therapy in pregnancy. The same factors were also predictive of AGT. Our data suggest a role of ethnicity in both attendance for postpartum follow-up and its outcome. Despite efforts to provide care for women with GDM, postpartum screening rates are still low among Italian women, and especially among immigrants. Hence, the need to improve these patients' awareness of the severe risk of developing diabetes after pregnancy, concentrating efforts especially on women belonging to the most at risk ethnic groups.

Careers guidance provisions and progression to post-16 education: An empirical analysis for Wales

Careers guidance is widely regarded as important in supporting young people in making appropriate decisions following school. However, there is very little empirical evidence as to its effectiveness. This paper examines whether the services provided by Careers Wales have encouraged progression to post-compulsory education in Wales. The paper uses administrative education data for 2 cohorts of school pupils who completed their final year of compulsory education in Wales 2012/13 and 2013/14. Through linkage to individual level client records held by Careers Wales, those pupils who had received careers guidance during their final 2 years of school are identified. Further linkage to records regarding participation in either school based sixth-forms or colleges of Further Education provides a complete picture of participation in post-compulsory education among Welsh pupils and how rates of transition vary among different groups of pupils, including whether or not pupils had had some form of contact with Careers Wales. Multivariate statistical analysis was undertaken to examine whether or not, after controlling for other characteristics, accessing the services of Careers Wales was associated with the likelihood of attending post-compulsory education. The results based on multivariate logistic regression analysis reveal that receiving careers guidance through the medium of group sessions increases the likelihood of overall participation in post-compulsory education. The effect of this is enhanced when pupils also received a one to once careers interview during the last 2 years of school. In general, careers interventions are associated with a reduced likelihood of attendance at Sixth Form but encourages student transition to Further Education. The study offers important insights for policy makers and career practitioners in terms of the contributions of careers guidance in supporting post-16 educational landscape in Wales.

669-P: Factors to Improve Attendance at Diabetes Self-Management Education Classes

Formal diabetes self-management education (DSME) improves glycemic control. Yet, many patients referred to DSME do not attend. This study examined differences between patients referred to DSME who attended class (PA) and those who did not (PN) to assess factors that might be associated with attendance. Methods: The study was conducted at an urban safety net hospital over two months. Phone interviews (128) were conducted with a convenience sample of patients after the scheduled DSME class (43 PA and 85 PN) to assess reason for attendance or not. Medical records supplied data on demographics, insurance status, and co-morbidities. Results: DSME overall attendance was 32% of 197. While obesity was associated with increased likelihood of attendance (OR 2.67, P < .05), overall disease burden was not. Attendance did not differ by age, sex, diabetes duration, insurance status, or A1c. PA and PN reported similar reasons for planning to attend (general knowledge, 36%; “told to”, 32%; dietary information, 24%). Primary reasons for not attending were time conflicts (31%), poor health (24%), lack of perceived need (24%), and transportation (22%). Excluding those PN who denied perceived need for DSME, 64% of PN wanted to reschedule. Thus, lack of attendance may be related more to barriers than lack of interest. PN wanting knowledge were more likely (OR 6.7 p< 0.001) to want to reschedule and those just “told to” go (OR 0.24 p< 0.05) or felt no need (OR 0.15 p< 0.05) were less likely to reschedule. Conclusions: Addressing both external and internal factors should improve DSME attendance. Flexible/negotiated scheduling, greater variety of class times/locations, ease of rescheduling, and access to alternative transportation options may address external barriers. To address perception of a lack of need for DSME, additional strategies such as clear communication of DSME benefits by clinical providers are needed to enhance attendance. Disclosure R. Wolf: None. C.S. Barnes: None. J. Caudle: None. S.G. Krishnapura: None. J.L. Dupont: None. R.J. Crawford: None. P.L. Dickerson: None. D.C. Ziemer: None.

I've booked you a place, good luck: Applying behavioral science to improve attendance at high-impact job recruitment events

Finding a job, especially in a recovering or uncertain economy, is challenging. Jobseekers Allowance (JSA) welfare benefit claimants in the United Kingdom have many competing options available to them in terms of how they direct their efforts in looking for work. Jobcentres, the organizations that support job seekers, have very strong links to the labor market and often run recruitment events in direct partnership with large employers seeking to hire in bulk. Attendance at these events, or any other specific job search activity, is typically low. This article reports the results of a randomized control trial designed to test the effectiveness of mobile phone text messaging in compelling jobseekers to attend such events. Tailored text messages are found to significantly increase the likelihood of attendance. We find text messages to be particularly effective when they seek to induce reciprocity and address low morale in the recipient.

Randomised controlled trial comparing uptake of NHS Health Check in response to standard letters, risk-personalised letters and telephone invitations

BackgroundNHS Health Check is a primary prevention programme offering cardiovascular disease (CVD) risk assessment to adults in England aged 40–74. Uptake remains a challenge and invitation method is a strong predictor of uptake. There is evidence of low uptake when using invitation letters. Telephone invitations might increase uptake, but are not widely used. We explored the potential to improve uptake through personalising letters to patient’s CVD risk, and to compare this with generic letters and telephone invitations.MethodsHEalth Check TRial (HECTR) was a three-arm randomised controlled trial in nine general practices in Staffordshire (UK). Eligible patients were randomised to be invited to a NHS Health Check using one of three methods: standard letter (control); telephone invitation; letter personalised to the patient’s CVD risk. The primary outcome was attendance/non-attendance. Data were collected on a range of patient- and practice-level factors (e.g., patient socio-demographics, CVD risk, practice size, Health Checks outside usual working hours). Multi-level logistic regression estimated the marginal effects to explore whether invitation method predicted attendance. Invitation costs were collated from practices to estimate cost benefit.ResultsIn total, 4614 patients were included in analysis (mean age 50.2 ± 8.0 yr.; 52.4% female). Compared with patients invited by standard letter (30.9%), uptake was significantly higher in those invited by telephone (47.6%, P < .001), but not personalised letter (31.3%, p = .812). In multi-level analysis, compared with the standard letter arm, likelihood of attendance was 18 percentage points higher in the telephone arm and 4 percentage points higher in the personalised letter arm. The effect of telephone calls appeared strongest in patients who were younger and had lower CVD risk. We estimated per 1000 patients invited, risk-personalised letters could result in 40 additional attended Health Checks (at no extra cost) and telephone invitations could result in 180 additional Health Checks at an additional cost of £240.ConclusionsTelephone invitations should be advocated to address the substantial deficit between current and required levels of NHS uptake, and could be targeted at younger and lower CVD risk adults. Risk-personalised letters should be explored further in a larger sample of high risk individuals.Trial registrationRegistration number: ISRCTN15840751 date of registration: 24/10/2017.

Patient-Reported Barriers and Limitations to Attending Diabetes Group Visits

Through this exploratory study, we sought to understand why group visit participation is low among adult patients with type 2 diabetes. Eligible study participants included adult patients with type 2 diabetes. After a pilot survey was sent to a random sample of 48 patients, the remaining 187 eligible patients were invited to complete a revised version of the survey. Most frequently cited reasons for not attending group visits included diabetes under control, work and/or other responsibilities, and time barriers. There was variability in the desired time for the visits, though the majority of patients preferred evening visits. While some patients reported copays as a challenge, the likelihood of attending did not decrease for this subgroup. Most patients surveyed (54%) indicated interest in diabetes group visits. Implementing strategies to address the patient-identified system barriers (eg, time, transportation, and copays) may increase participation in diabetes group visits.

Follow-up care instructions, treatment summaries, and cancer survivors' receipt of follow-up health care and late/long term effects.

Cancer survivors need follow-up care. Survivorship care plans (SCP), including follow-up care instructions (FCI) and treatment summaries (TS), were designed to improve cancer survivors' receipt of follow-up care after cancer treatment. However, there is a paucity of evidence regarding the relationship between survivors' receipt of FCI and TS and their receipt of follow-up care and late/long term effects. This study used data from the 2010 LIVESTRONG online survey of people affected by cancer, including 3541 cancer survivors who had completed treatment. Receipt of FCI was associated with greater likelihood of attendance at all regular medical appointments (aOR 2.28, 95% CI 1.60-3.23), receipt of cancer surveillance (aOR 1.64, 95% CI 1.28-2.09), being up to date on preventive cancer screening (aOR 2.63, 95% CI 2.00-3.47), and with fewer late/long term effects (IRR 0.77, 95% CI 0.69-0.85). Receipt of TS was associated with greater likelihood of attendance at all regular medical appointments (aOR 1.79, 95% CI 1.31-2.44) and being up to date on preventive cancer screening (aOR 1.43, 95% CI 1.14-1.78), but not cancer surveillance or late/long term effects. This study is among the first to document the associations between SCP and survivors' attendance at regular medical appointments, cancer surveillance, preventive cancer screenings, and late/long term effects. The findings suggest that SCP may facilitate follow-up care needed by cancer survivors after cancer treatment is completed.

Is it the unexpected experience that keeps them coming back? Group climate and session attendance examined between groups, between members, and between sessions.

Attending group therapy sessions is necessary for a group member to have a chance at receiving benefit from the intervention. Group members' perceptions of their group's climate has been linked with important group member outcomes, including session attendance. On the basis of the writings of Curran and Bauer (2011), the current study examined group members' longitudinal ratings of session engagement and decomposed them into between-groups, between-members, and between-sessions components. These components were then used to examine the relationship between group members' ratings of an engaged group climate in the previous session and their attendance the following session. Session attendance in 573 group sessions for 91 group members in 14 Taiwanese counseling groups was modeled in a 3-level hierarchical model (sessions within group members, within groups). Contrary to our hypotheses, between-groups, between-members, and between-sessions components of engagement were not related to session attendance. However, there was a significant interaction between the between-members and between-sessions components of session engagement and group size in predicting session attendance. The likelihood of attendance increased when group members who, on average, rated sessions as being low in engagement uncharacteristically rated a previous session as high in engagement. The likelihood of attendance also increased when group members who, on average, rated sessions as high in engagement uncharacteristically rated the previous session as low in engagement. Larger group sizes amplified these effects. Expectancy (dis)confirmation theory is used to explain these results. Theoretical, research, and clinical implications are discussed.

Stereotype Threat Reduces Motivation to Improve

According to stereotype threat theory, negative stereotypes impair performance and can lead to reduced motivation. In the present study, we examined whether the female-mathematics stereotype not only impairs women’s performance but also buffers their self-esteem from negative feedback and reduces their motivation to improve. Before completing a mathematics test, 80 (54 female) participants were informed either that men outperform women on the test (stereotype threat condition) or that men and women perform equally well (no-stereotype condition). Following the test, participants received positive or negative feedback prior to rating their self-esteem. Finally, participants were invited to attend free mathematics tutorials and asked to indicate their likelihood of attending. Women under stereotype threat performed worse and were less motivated than non-stereotyped women to attend mathematics tutorials after receiving negative feedback. Furthermore, although men’s self-esteem was higher if they received positive rather than negative feedback, feedback valence had no effect on women’s self-esteem. These results suggest that the effect of stereotype threat on women’s mathematical performance is potentially compounded by its capacity to reduce motivation to improve. Practical implications are discussed, with a particular focus on the need for interventions that produce an identity-safe environment, foster an incremental view of mathematical ability, and provide information about successful role models.

Acceptance of repeat worksite HIV voluntary counselling and testing in a rural South African factory

In response to the human immunodeficiency virus (HIV) pandemic, many employers in sub-Saharan Africa have introduced voluntary counselling and testing (VCT) for HIV. To assess the factors that predict repeat VCT attendance at 12-month follow-up we analysed data from a nurse-administered questionnaire that was distributed to factory workers in a rural South African factory. Employees were offered VCT for HIV in 2009 and again 12 months later. Odds ratios examined factors associated with attendance at follow-up. Totally, 2138 employees accepted VCT at initial assessment and 406 attended at follow-up. After controlling for socio-demographic factors (age, gender, marital status and education), elevated blood glucose was associated with increased likelihood of attendance at follow-up; positive HIV status was a key risk factor for non-attendance at follow-up. This study underscores the importance of determining those groups at risk of non-attendance at employer-provided repeat VCT clinics; differences between employee groups might usefully inform targeted promotional activities to encourage attendance.

Early childhood care and education attendance in Central Asia

Abstract Drawing on a set of recent nationally-representative surveys, this study examines Early Childhood Care and Education attendance in Central Asia. Between 12% and 22% of children attended ECCE, while the number of attendance hours was irregular and varied greatly. Having a mother with lower education and being from a poorer household reduced the likelihood of attendance in all countries. Living in a rural area reduced the likelihood of attendance in all countries except Kazakhstan. Other factors associated with lower likelihood of attendance varied across countries and included having an additional child under 5 in the household, an increase in child age, and residing in a non-Russian speaking household. In terms of frequency of attendance, living in capital cities was associated with an increase in attendance frequency in Kazakhstan and Kyrgyzstan, while residing in a wealthier household was associated with an increase in frequency in Tajikistan and Kyrgyzstan. Measures to improve ECCE attendance are discussed.

Factors associated with non-attendance, opportunistic attendance and reminded attendance to cervical screening in an organized screening program: a cross-sectional study of 12,058 Norwegian women.

BackgroundCervical cancer incidence and mortality may be reduced by organized screening. Participant compliance with the attendance recommendations of the screening program is necessary to achieve this. Knowledge about the predictors of compliance is needed in order to enhance screening attendance.MethodsThe Norwegian Co-ordinated Cervical Cancer Screening Program (NCCSP) registers all cervix cytology diagnoses in Norway and individually reminds women who have no registered smear for the past three years to make an appointment for screening. In the present study, a questionnaire on lifestyle and health was administered to a random sample of Norwegian women. The response rate was 68%. To address the predictors of screening attendance for the 12,058 women aged 25-45 who were eligible for this study, individual questionnaire data was linked to the cytology registry of the NCCSP. We distinguished between non-attendees, opportunistic attendees and reminded attendees to screening for a period of four years. Predictors of non-attendance versus attendance and reminded versus opportunistic attendance were established by multivariate logistic regression.ResultsWomen who attended screening were more likely than non-attendees to report that they were aware of the recommended screening interval, a history of sexually transmitted infections and a history of hormonal contraceptive and condom use. Attendance was also positively associated with being married/cohabiting, being a non-smoker and giving birth. Women who attended after being reminded were more likely than opportunistic attendees to be aware of cervical cancer and the recommended screening interval, but less likely to report a history of sexually transmitted infections and hormonal contraceptive use. Moreover, the likelihood of reminded attendance increased with age. Educational level did not significantly affect the women's attendance status in the fully adjusted models.ConclusionsThe likelihood of attendance in an organized screening program was higher among women who were aware of cervical screening, which suggests a potential for a higher attendance rate through improving the public knowledge of screening. Further, the lower awareness among opportunistic than reminded attendees suggests that physicians may inform their patients better when smears are taken at the physician's initiative.

The use of basic life support skills by hospital staff; what skills should be taught?

To assess the frequency of use of basic life support (BLS) skills among hospital staff of all disciplines. Postal survey of 9600 teaching hospital staff. 3807 respondents from all disciplines. Frequency of attendance, and the use of BLS skills, at patients with cardiopulmonary arrest. Most respondents reported having attended BLS training previously: 27.9% in the prior 6 months; 24.5% 6-12 months previously; 17.1% over 1 year ago; and 11.5% over 2 years ago. 17.1% reported never having received BLS training. 1.9% gave no valid response. Nearly half of all respondents had never attended a cardiopulmonary arrest. Among those most likely to have attended, i.e. qualified nursing and medical staff, the median frequency of attendance was less than once per year. Ventilation delivered using a pocket mask or bag-valve-mask was reported by 9.4 and 29.2% of respondents, respectively. Less than 7% reported the use of mouth-to-mouth ventilation. Only among qualified nursing (8.8%) and medical (24.7%) staff did this proportion exceed 5%. The vast majority of non-qualified nursing staff (84.9%), allied health professionals (86%) and administrative and clerical staff (98%) had used neither chest compressions nor mouth-to-mouth ventilation. Some skills taught during BLS training are used infrequently in the in-hospital situation. The likelihood of attendance at arrest events and of the use of BLS skills is extremely low among some identified professional groups. BLS skills teaching should be targeted at those groups most likely to actually use them in order to make best use of the resources available.

Relocation of a static breast screening unit: a study of factors affecting attendance.

To assess the effect of relocation of an urban static breast screening unit on the attendance rates (uptake) in different parts of the catchment area. The Bolton Breast Screening Programme. The attendance rates for screening for patients in each of the seven Bolton postcode districts were obtained from the breast screening computer system for the 29 months prior to and 38 months following the relocation of the screening unit. The overall attendance rate for screening in Bolton fell by 1%. The fall was most marked in BL1 (2.0%), the location of the original screening unit. BL4, the district housing the new unit, showed an increase in attendance of 1.1%. The other districts showed a similar trend with smaller reductions in attendances from districts that were closer to the screening unit than before, and vice versa. The direct distance between the centre of the women's home postcode district and the screening unit had a significant effect on the attendance rate (p = 0.045). For each kilometre further from the screening unit, the attendance decreased by approximately 2%. However, there was a 6.4% difference between the highest and lowest district attendance rates, the highest rates being in the less deprived areas. There is a significant inverse relationship between the distance a woman must travel for screening and her likelihood of attending. However, this has a relatively minor effect on attendance rates compared to that of socioeconomic factors.

Influence of mailing strategies on response to questionnaires

Aims and methodA prospective study was undertaken to evaluate the effect of a stamped addressed envelope, as compared to a non-stamped but addressed envelope or no envelope, on response to a mailed questionnaire. The correlation between questionnaire response and subsequent attendance at the first appointment was also studied.ResultsThe overall response rate was 26% of 176 families offered first appointments at a local child psychiatry service. Families provided with a stamped addressed envelope were more likely to return their questionnaire and those families who returned the questionnaire were more likely to attend their first appointment.Clinical implicationsThe return of patient questionnaires has significant clinical and resource implications. Only essential questionnaires should be sent out to referred families as nearly three-quarters will not be returned. The return rate can be enhanced by providing a stamped addressed envelope but, if questionnaires are not returned within 10 days, the likelihood of return is minimal. As more than half of the families who failed to return the questionnaire also failed to attend their first appointment, questionnaires can be used as a measure of motivation and likelihood of attendance as well as a source of clinical information.