The Use of Implementation Intentions to Increase the Appointment Attendance of OEF/OIF Veterans

The purpose of the current pilot study will be to utilize implementation intentions to
increase patient compliance with appointment attendance. It is anticipated that participants
who take an active role in their plan and utilize the implementation intention procedures
will be more likely to make and attend the appointments suggested by their treating
clinician. Sixty participants will be recruited to participate in the research project.
Participants in the current study will be individuals referred for a secondary Traumatic
Brain Injury (TBI) screen. This appointment serves to develop the plan of care that will be
used for determination of the treatments that would be beneficial to the Veteran and as such
the appointments necessary for further assessment or treatment in affiliated clinics (i.e.
mental health, physical therapy, neuropsychology). Twenty participants will serve as controls
who will receive treatment planning as usual. Twenty participants will receive treatment as
usual but will be asked to contact the clinics directly to make their appointments. Twenty
participants will be provided with a simple implementation intention induction. The simple
induction will consist of the creation of "what/when/where" statements surrounding their
intention to call to schedule and to attend medical appointments associated with their care.
Research staff will then monitor the participants' appointment schedule daily to determine if
they made the appropriate appointments and subsequently attended those appointments. Primary
data for the examination will be these yes/no data points as to whether the participant
successfully adhered to their initial intention to schedule the prescribed appointments.
Additionally, for those who schedule the prescribed appointments, the latency in days from
the time they indicated they intended to make their appointments will serve as a measure of
their compliance. Across all groups, attendance at those appointments will be recorded to
determine if the procedures lead to an increase in their attendance at their appointments
compared to the treatment as usual group. This pilot project will provide valuable initial
data as to the potential effectiveness of a simple, cost-effective means of increasing
appointment attendance. If successful, it could lead to cost savings to the VA system and a
decrease in the appointment wait time for Veterans by increasing the utilization of available
appointments.

Inclusion Criteria:

- Completed appointment for secondary TBI screen

- English speaker

Exclusion Criteria:

- Neurological injury leading to dementia

- In ability to consent owing to cognitive barriers

- Non-English speaker

- Unable to schedule appointments the next working day after their secondary screen