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This study examines the relationship between patient health status and the likelihood of missing appointments in a community health center serving low-income patients. Medical records of 465 adult patients scheduled to be seen during one week in February 1999 were audited for an 18-month period. Seventy-three percent of patients failed to keep one or more appointments; 43% missed one or two; 30% missed three or more. Health status measures significantly associated with missing appointments included depression (p = 0.03), anxiety/panic disorder (p = 0.03), and using tobacco (p = <0.001). Linear regression analysis indicated that the number of appointments scheduled and of diagnosed psychological conditions, as well as patient age were significant predictors of missed appointments. Patient appointment keeping is predictable; definable, measurable characteristics of patients can contribute to setting priorities for customizing interventions.

Community physicians described a variety of factors that contribute to their identity as teachers. Faculty development programs offer opportunities to strengthen teacher identity and foster relationships between teaching programs and community-based faculty.

Community health workers (CHWs) have gained prominence in health care, recognizing the influence of community and environment on health. This study evaluates CHWs' efforts to assess patients' readiness to change and facilitate self-management goal setting. Six pairs of community health centers were randomly assigned to employ CHWs on health care teams. Each team worked with a defined population of patients. We assessed changes in documented patient self-management goals and clinical measures from both control and intervention CHCs before and after deploying CHWs, finding a significant increase in self-management goal setting between the intervention and control health centers.