There is interest in using predictive models to address non-attendance of healthcare appointments without prior notification. Although several National Health Service (NHS) hospital trusts have piloted predictive models for non-attendance, there is a lack of published evidence in clinical settings.

This mixed-methods evaluation of the pilot of a predictive model intervention in outpatient services aimed to examine (1) the effect of the intervention on patient non-attendance and (2) staff engagement in the delivery of the intervention.

A mixed-methods study across two pilot phases. Quantitative data explored the use and impact of the predictive model on non-attendance. Z-tests were conducted to assess changes to non-attendance rates prepilot and in the two phases. Qualitative ethnographic work included 30 periods of observation and interviews with staff.

Nine outpatient services in an NHS Foundation Trust that volunteered to pilot the predictive model intervention. Qualitative participants were NHS clerical and administrative staff delivering the intervention and service managers.

An off-the-shelf predictive model, consisting of a cloud-based, random forest algorithm, produced a risk score of non-attendance by drawing on information from patients’ electronic health records. Staff in the pilot sites attempted to phone patients with a risk score to remind them of upcoming appointments.

Quantitative analysis showed that in phase 1, there were low volumes of intervention calls made across services, but three of nine outpatient services significantly reduced their non-attendance rate. There was a lower overall call rate in phase 2 among the four remaining participating services. One significantly reduced its non-attendance rate from 20.4% to 19.1% (p

The predictive model intervention was positioned as a simple solution to address a complex problem; however, there were challenges inherent in deployment within a dynamic healthcare setting. The sustainability of the intervention and its impact on patient experience warrants further exploration.

Many adolescent girls experience body dissatisfaction and have low levels of physical activity. Secondary school physical education (PE) offers opportunities for girls to build self-confidence and stay active; however, PE uniforms can be a barrier to participation.

To explore how secondary school PE uniform policies influence body image attitudes and PE engagement (participation and enjoyment) among adolescent girls, and how these policies could be co-developed in future.

A qualitative study involving focus groups and interviews.

Forty-four 12–13 year-old girls and six PE staff members from six mixed-sex secondary schools in England.

Using topic guides and participatory activities to aid discussions, we explored PE uniform preferences and the influence on body image attitudes and PE engagement with adolescent girls, as well as the PE uniform policy development process with PE staff. Data were analysed using reflexive thematic analysis, supported by NVivo V.14.

Three themes were generated. Theme 1, ‘Striking the right balance between choice, comfort and uniformity’, describes the challenges of developing PE uniform policies that offer pupils choice to maximise comfort, while maintaining uniformity to ensure smartness, and to reduce social comparison. Theme 2, ‘PE uniforms are "made for boys"’ reflects that current policies can often provide unisex uniforms that do not fit the female body, or gendered options that limit girls’ choices over style and fit. Theme 3, ‘Self-confidence influences comfort in wearing PE uniform, and in turn PE engagement’ suggests girls with high self-confidence may be less concerned about others’ opinions and how they look, leading to greater PE enjoyment, whereas girls with lower self-confidence described feeling self-conscious, especially in communal changing rooms, which could impact their comfort and PE engagement.

Our findings suggest that developing PE uniform policies, which allow pupils to choose their own bottoms, wear additional layers and wear PE uniform all day may improve comfort and inclusivity among girls, facilitating better PE engagement.