Reducing Missed Appointments

NCT06915480 | Recruiting Phase 3

• 1 other identifier: IRB00455545
• Study Type: interventional
• Target: 5,000
• Locations: 1 country
• Sites: 1

Brief Summary

There are four goals of this project: (1) To examine the impact of different appointment reminder messages on appointment attendance; (2) to determine the added benefit of a patient navigator reaching out in advance of appointments to families at elevated risk of missing their appointment, and determine the most common barriers families face in appointment attendance; (3) to evaluate which patients are at highest risk of missing their appointment, and to determine the effectiveness of the intervention trial across different patient risk levels; and (4) to examine if the missing appointment interventions increase the socioeconomic diversity patients.

Conditions

Neurodevelopmental Disorders

Outcome Measures

Primary Outcomes (1)

• Patient appointment no-show

  Proportion of appointments that are neither kept nor cancelled

  6 months

Secondary Outcomes (1)

• Patient appointment cancel

  6 months

Study Arms (6)

Standard message, no navigator

ACTIVE COMPARATOR

This arm represents the standard operating procedures. It includes basic appointment information and no personal assistance with appointment navigation.

Behavioral: Reminder message and patient navigation

Standard message with navigator

EXPERIMENTAL

This arm represents the standard pre-appointment reminder message. This arm will include personal assistance with appointment navigation.

Behavioral: Reminder message and patient navigation

Enhanced message #1, no navigator

EXPERIMENTAL

This arm represents a novel pre-appointment reminder message based on existing scientific literature. This arm will not include personal assistance with appointment navigation.

Behavioral: Reminder message and patient navigation

Enhanced message #1 with navigator

EXPERIMENTAL

This arm represents a novel pre-appointment reminder message based on existing scientific literature. This arm will include personal assistance with appointment navigation.

Behavioral: Reminder message and patient navigation

Enhanced message #2, no navigator

EXPERIMENTAL

This arm represents a second novel pre-appointment reminder message based on existing scientific literature. This arm will not include personal assistance with appointment navigation.

Behavioral: Reminder message and patient navigation

Enhanced message #2 with navigator

EXPERIMENTAL

This arm represents a second novel pre-appointment reminder message based on existing scientific literature. This arm will include personal assistance with appointment navigation.

Behavioral: Reminder message and patient navigation

Interventions

Reminder message and patient navigation BEHAVIORAL

This study will evaluate the combination of pre-appointment messages and patient navigation services.

Enhanced message #1 with navigator; Enhanced message #1, no navigator; Enhanced message #2 with navigator; Enhanced message #2, no navigator; Standard message with navigator; Standard message, no navigator

Eligibility Criteria

• Age: 1 Month - 24 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64)

You may qualify if:

• All patients who are scheduled to be seen within the center for autism or the center for neuropsychological and psychological assessment for evaluation appointments will be automatically enrolled in the reminder message portion of the intervention trial.
• Patients who are at elevated risk within the center for neuropsychological and psychological assessment are automatically enrolled in the patient navigator portion of the intervention trial.

You may not qualify if:

• None for the messaging portion of the study
• For patient navigation, patients \>18 years of age will be excluded.

Sponsors & Collaborators

• Hugo W. Moser Research Institute at Kennedy Krieger, Inc.: lead

Study Sites (1)

Kennedy Krieger Institute

Baltimore, Maryland, 21211, United States

RECRUITING

Related Publications (3)

• Gornik AE, Northrup RA, Kalb LG, Jacobson LA, Lieb RW, Peterson RK, Wexler D, Ludwig NN, Ng R, Pritchard AE. To confirm your appointment, please press one: Examining demographic and health system interface factors that predict missed appointments in a pediatric outpatient neuropsychology clinic. Clin Neuropsychol. 2024 Feb;38(2):279-301. doi: 10.1080/13854046.2023.2219421. Epub 2023 Jun 8.

  PMID: 37291078 BACKGROUND

• Kalb LG, Freedman B, Foster C, Menon D, Landa R, Kishfy L, Law P. Determinants of appointment absenteeism at an outpatient pediatric autism clinic. J Dev Behav Pediatr. 2012 Nov-Dec;33(9):685-97. doi: 10.1097/DBP.0b013e31826c66ef.

  PMID: 23095496 BACKGROUND

• Berliner Senderey A, Kornitzer T, Lawrence G, Zysman H, Hallak Y, Ariely D, Balicer R. It's how you say it: Systematic A/B testing of digital messaging cut hospital no-show rates. PLoS One. 2020 Jun 23;15(6):e0234817. doi: 10.1371/journal.pone.0234817. eCollection 2020.

  PMID: 32574181 BACKGROUND

MeSH Terms

Conditions

Neurodevelopmental Disorders

Interventions

Patient Navigation

Condition Hierarchy (Ancestors)

Mental Disorders

Intervention Hierarchy (Ancestors)

Patient-Centered Care; Primary Health Care; Comprehensive Health Care; Patient Care Management; Health Services Administration

Study Officials

• luther G kalb, PhD

  Hugo W. Moser Research Institute at Kennedy Krieger, Inc.

  PRINCIPAL INVESTIGATOR

Central Study Contacts

luther G kalb, PhD

CONTACT

4439239439; kalb@kennedykrieger.org

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, CARE PROVIDER
• Masking Details: Families and providers will be fully masked to condition. The investigators will know about condition as they orchestrate the study.
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: FACTORIAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: All families will be randomized to one of three pre-appointment reminder messages. Additionally, families who are at high risk of experiencing a missed appointment will receive patient navigation services in one of the two departments.

Study Record Dates

• First Submitted: March 31, 2025
• First Posted: April 8, 2025
• Study Start: December 29, 2025
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 1, 2027
• Last Updated: March 18, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)