Firth, N. orcid.org/0000-0003-1984-6869, Bone, C. orcid.org/0000-0002-6000-7680 and Holt, R. (2020) Health psychology attendance: A multilevel analysis of patient-level predictors and therapist effects. Health Psychology, 39 (11). pp. 945-955. ISSN 0278-6133
Abstract
The study investigated adult outpatient Health Psychology Services appointment attendance, cancellation, and missed appointments (A/C/M). The first objective was to determine which demographic and process factors predicted the probability of A/C/M. The second objective was to determine whether there remained residual significant differences in A/C/M between therapists (i.e., a “therapist effect”), after controlling for explanatory variables. We conducted a practice-based retrospective 2-year cohort study. Three-level multilevel models were constructed and tested to analyze the probability of A/C/M at (1) assessment appointments (N = 1,175) and (2) follow-up appointments (N = 5,441). After controlling for predictor variables, significant therapist effects were found for attendance (10.0% to 13.0%) and cancellation (4.4%) at follow-up appointments (but not assessments), indicating significantly different attendance rates at follow-up between therapists. Predictors of attendance at follow-up included patient age, pretherapy symptom severity scores (including risk and symptom scores), and completion of intake questionnaires. Early morning follow-up appointments were least likely to be canceled, followed by late afternoon and finally midday appointments. Treatment intensity predicted attendance, but among qualified therapists, qualification type and pay level were nonsignificant. No significant predictors of attendance at assessment were detected. Attendance at Health Psychology Services outpatient appointments varies significantly according to patient, therapist, and appointment factors. Key routinely collected variables are predictive of attendance at follow-up. Clinical implications include the potential to identify patients at risk of nonattendance and target engagement interventions to these patients. Research directions include closer examination of variability in follow-up attendance between therapists.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2020 APA. This is an author-produced version of a paper subsequently published in Health Psychology. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Sheffield |
Academic Units: | The University of Sheffield > Faculty of Medicine, Dentistry and Health (Sheffield) > School of Health and Related Research (Sheffield) > ScHARR - Sheffield Centre for Health and Related Research The University of Sheffield > Faculty of Science (Sheffield) > Department of Psychology (Sheffield) |
Depositing User: | Symplectic Sheffield |
Date Deposited: | 23 Sep 2020 16:32 |
Last Modified: | 26 Jan 2022 14:51 |
Status: | Published |
Publisher: | American Psychological Association |
Refereed: | Yes |
Identification Number: | 10.1037/hea0001021 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:165871 |