Caregiver-Reported Barriers and Predictors of Appointment Attendance in Pediatric Craniofacial Team Care

ObjectiveTo identify caregiver-reported barriers influencing appointment attendance and evaluate demographic, clinical, and logistical predictors of missed pediatric craniofacial team visits.DesignProspective, multimethod study.SettingQuaternary pediatric craniofacial outpatient clinic.ParticipantsTwo hundred thirteen caregivers of patients scheduled for craniofacial team visits completed a 10-item questionnaire assessing factors that influence appointment attendance.Main Outcome MeasuresThe primary outcome was appointment attendance (attended vs. missed/canceled). Demographic and clinical variables were extracted from the medical record. Descriptive statistics were calculated. Chi-square or Fisher's exact tests assessed bivariate associations. A multivariable logistic regression model was used to identify predictors of attendance. Open-ended responses on missed visit reasons were analyzed thematically.ResultsFamilies managing a higher monthly healthcare burden were significantly more likely to attend scheduled appointments. Those with 4 or more health-related appointments (OR = 0.008, <i>P</i> < .001) had markedly lower odds of nonattendance. Similarly, families with other same-day appointments had significantly lower odds of nonattendance (OR = 0.154, <i>P</i> < .001). Children with syndromic diagnoses were also more likely to attend than their nonsyndromic peers (OR = 0.336, <i>P</i> = .045). Attendance was lower among families who reported receiving their preferred appointment time (OR = 0.11, <i>P</i> = .027). Demographic variables, including race, ethnicity, and insurance status, were not significant predictors of attendance.ConclusionsAppointment attendance appears to be more strongly influenced by logistical demands and care coordination than by demographic or clinical characteristics. Addressing these modifiable barriers through targeted supports may offer a more effective strategy for improving consistent attendance in craniofacial care.