REFERENCE: Frankel, B. S., Hoevell, M. F. (1978). Health service appointment keeping: A behavioral view and critical review. Behavior Modification, 2, 435-464.

Appointment keeping was described as a chain of behavior which results in a health service client attending an appointment. The environmental cues and consequences, both aversive and reinforcing, which might impact each behavior in this chain were illustrated and described as either strengthening or weakening appointment keeping. Appointment keeping surveys and experimental research were reviewed in the context of this behavior profile, as well as methodological soundness. Survey studies broadened our understanding of appointment keeping by pinpointing populations in special need, but few changeable variables (e.g., behavior of health care team or delivery system, physical environment, and so on) were found to be related to appointment keeping. A number of intervention studies showed increased appointment adherence coincidental with the use of reminders and reinforcing consequences. Thus, it was concluded that a behavioral profile could focus investigators' attention on potentially changeable variables which might improve adherence to health service appointments. Suggestions for future research are made.


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