{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T02:57:01Z","timestamp":1792119421580,"version":"4.4.0"},"reference-count":36,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T00:00:00Z","timestamp":1736380800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["The Cleft Palate Craniofacial Journal"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:sec>\n                    <jats:title>\n                      <jats:italic>Objective<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Evaluate predictors for attendance and adherence to speech evaluations and determine factors that influence longitudinal care for patients with cleft palate and craniofacial differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Design<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Retrospective, observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Setting<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Tertiary children\u2019s hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Participants<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Eight hundred and eighty newborns receiving care between 2014 and 2022 were included in the study sample for longitudinal assessment of appointment adherence. Participants were included if they had a cleft-related diagnosis, were scheduled for an initial speech evaluation between 1 and 3 years old, were scheduled for follow-up speech evaluations between 3 and 6 years old, and had demographic, diagnostic, and clinical data in their charts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Main Outcome Measures:<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>\n                      Variables of interest included demographic data, diagnostic criteria, insurance data, distance to clinic, speech\/resonance characteristics, hard\/soft palate integrity, and surgical data. Chi-square analyses, independent sample\n                      <jats:italic>t<\/jats:italic>\n                      -tests, and descriptive statistics were conducted to identify characteristics of those who attended appointments and those who did not. Logistic regression analyses were conducted to examine factors predictive of appointment adherence over time.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Results<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>\n                      A total of 66.9% of patients attended the initial speech evaluation. A total of 50.6% of participants adhered to follow-up appointments. Distance to clinic (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.018), insurance type (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001), and cleft type (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) influenced initial speech evaluation attendance. For follow-up appointment adherence, cleft type (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001) was the strongest predictor pre-pandemic, while severity of velopharyngeal function (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.037) strongly predicted adherence during the pandemic.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>\n                      <jats:italic>Conclusion<\/jats:italic>\n                    <\/jats:title>\n                    <jats:p>Appointment adherence is multifactorial and driven by geographic, demographic, and clinical variables. Identifying barriers to care may improve appointment adherence for those with speech\/resonance needs and prevent patients from being lost to follow-up.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10556656241310203","type":"journal-article","created":{"date-parts":[[2025,1,9]],"date-time":"2025-01-09T06:15:00Z","timestamp":1736403300000},"page":"201-213","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Understanding Access to Care: Factors Influencing Patient Attendance at Craniofacial Speech Evaluations"],"prefix":"10.1177","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-6678-4952","authenticated-orcid":false,"given":"Camryn","family":"Heister","sequence":"first","affiliation":[{"name":"Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA"},{"name":"Lancaster Cleft Palate Clinic, Lancaster, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Dillon","sequence":"additional","affiliation":[{"name":"Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Brady","sequence":"additional","affiliation":[{"name":"Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Magdalena","family":"Soldanska","sequence":"additional","affiliation":[{"name":"Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph K.","family":"Williams","sequence":"additional","affiliation":[{"name":"Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6839-9116","authenticated-orcid":false,"given":"Kazlin","family":"Mason","sequence":"additional","affiliation":[{"name":"Center for Craniofacial Disorders, Children's Healthcare of Atlanta, Atlanta, GA, USA"},{"name":"Department of Human Services, University of Virginia, Charlottesville, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,1,9]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.4103\/2231-0746.101342"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1597\/08-250.1"},{"issue":"1","key":"e_1_3_3_4_2","first-page":"143","article-title":"Parameters for the evaluation and treatment of patients with cleft lip\/palate or other craniofacial anomalies","volume":"30","author":"American Cleft Palate-Craniofacial Association","year":"1993","unstructured":"American Cleft Palate-Craniofacial Association. Parameters for the evaluation and treatment of patients with cleft lip\/palate or other craniofacial anomalies. Cleft Palate- Craniofac J. 1993;30(Suppl 1):143-153.","journal-title":"Cleft Palate- Craniofac J"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/SAP.0000000000003443"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618767421"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211026488"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1597\/02-119.5.1"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2021.02.043"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211042162"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/0036933014564133"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2024-084737"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665618764739"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/1055665619856245"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11113-016-9416-y"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/107755870005700302"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1002\/bdra.23173"},{"key":"e_1_3_3_18_2","volume-title":"Health-care utilization as a proxy in disability determination","author":"National Academies of Sciences, Engineering, and Medicine. Factors that affect health-care utilization","year":"2018","unstructured":"National Academies of Sciences, Engineering, and Medicine. Factors that affect health-care utilization. Health-care utilization as a proxy in disability determination. The National Academies Press; 2018. Accessed October 10, 2024. https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK500097\/"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1597\/05-162"},{"key":"e_1_3_3_20_2","first-page":"1","article-title":"A geospatial analysis of barriers to cleft lip and palate care in the United States","author":"Heron MJ","year":"2024","unstructured":"Heron MJ, Rezwan SK, Zhu KJ, Gornitsky J, Redett RJ, Yang R. A geospatial analysis of barriers to cleft lip and palate care in the United States. Cleft Palate Craniofac J. 2024:1-11. doi:https:\/\/doi.org\/10.1177\/10556656241259883","journal-title":"Cleft Palate Craniofac J"},{"issue":"9","key":"e_1_3_3_21_2","first-page":"736","article-title":"Enhanced milieu teaching with phonological emphasis: A pilot telepractice parent training study for toddlers with clefts","volume":"8","author":"Philp J","year":"2021","unstructured":"Philp J, Ellis PK, Scherer NJ, Lien KM. Enhanced milieu teaching with phonological emphasis: A pilot telepractice parent training study for toddlers with clefts. Children (Basel). 2021;8(9):736. doi:https:\/\/doi.org\/10.3390\/children8090736","journal-title":"Children (Basel)."},{"issue":"5","key":"e_1_3_3_22_2","first-page":"965","article-title":"Parent experiences of undertaking therapy for cleft palate speech disorders following in-depth training","volume":"8","author":"Sell D","year":"2023","unstructured":"Sell D, O\u2019Rourke C, Sweeney T. Parent experiences of undertaking therapy for cleft palate speech disorders following in-depth training. Perspect ASHA Spec Interest Groups. 2023;8(5):965-985. doi:https:\/\/doi.org\/10.1044\/2023_persp-22-00253","journal-title":"Perspect ASHA Spec Interest Groups"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211069828"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2019.01394"},{"issue":"29","key":"e_1_3_3_25_2","first-page":"1","article-title":"Race\/ethnicity, insurance, income and access to care: The influence of health status","volume":"12","author":"Wang TF","year":"2013","unstructured":"Wang TF, Shi L, Nie X, Zhu J. Race\/ethnicity, insurance, income and access to care: The influence of health status. Int J Equity Health. 2013;12(29):1-7. doi:https:\/\/doi.org\/10.1186\/1475-9276-12-29","journal-title":"Int J Equity Health."},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656211055006"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/22799036231160624"},{"issue":"1411","key":"e_1_3_3_28_2","first-page":"1","article-title":"The effect of health insurance on the utilization of health services: A systematic review and meta-analysis","volume":"8","author":"Shami E","year":"2019","unstructured":"Shami E, Tabrizi JS, Nosratnejad S. The effect of health insurance on the utilization of health services: A systematic review and meta-analysis. Galen Med J. 2019;8(e1411):1-8. doi:https:\/\/doi.org\/10.31661\/gmj.v8i0.1411","journal-title":"Galen Med J"},{"key":"e_1_3_3_29_2","first-page":"1","article-title":"The uninsured and the ACA: A primer\u2014Key facts about health insurance and the uninsured amidst changes to the Affordable Care Act","author":"Garfield R","year":"2019","unstructured":"Garfield R, Orgera K, Published AD. The uninsured and the ACA: A primer\u2014Key facts about health insurance and the uninsured amidst changes to the Affordable Care Act. KFF. 2019. 1-18. https:\/\/www.kff.org\/affordable-care-act\/report\/the-uninsured-and-the-aca-a-primer-key-facts-about-health-insurance-and-the-uninsured-amidst-changes-to-the-affordable-care-act\/.","journal-title":"KFF"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1177\/10556656221150291"},{"issue":"5","key":"e_1_3_3_31_2","article-title":"A questionnaire study to assess patients with cleft lip and palate for their oral health-related quality of life","volume":"15","author":"Sahoo AR","year":"2023","unstructured":"Sahoo AR, Singh Dheer S, Mahesh PC, Goyal P, Sidhu R, Deepalakshmi S. A questionnaire study to assess patients with cleft lip and palate for their oral health-related quality of life. Cureus. 2023;15(5):e38712. doi:https:\/\/doi.org\/10.7759\/cureus.38712","journal-title":"Cureus"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813486081"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph110404280"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31822b6a67"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2011.11.004"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1590\/S1983-51752011000400017"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1597\/13-104"}],"container-title":["The Cleft Palate Craniofacial Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656241310203","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10556656241310203","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10556656241310203","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:21:29Z","timestamp":1777393289000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10556656241310203"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,9]]},"references-count":36,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2025,2]]}},"alternative-id":["10.1177\/10556656241310203"],"URL":"https:\/\/doi.org\/10.1177\/10556656241310203","relation":{},"ISSN":["1055-6656","1545-1569"],"issn-type":[{"value":"1055-6656","type":"print"},{"value":"1545-1569","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,9]]}}}