Between 20% and 57% of patients at community mental health centers miss their first mental health appointment, resulting in wasted resources and longer wait times for other patients. To date, only one peer-reviewed quantitative study examined the relationship between appointment reminder practices and children's and adolescents' first appointment attendance rates for community mental health centers. The purpose of this quantitative study was to examine the relationship between first appointment wait times, electronic appointment reminders, phone appointment reminders, and first appointment attendance for U.S. community mental health centers, along with the potential moderating effects of age, ethnicity, and gender. Blumer's symbolic interaction theory served as the theoretical framework. Secondary data on was collected from 12 Texas-based community mental health centers covering 5,260 patients. Binary logistic regression uncovered the following key study findings: (a) wait time and message type significantly predicted appointment attendance; (b) e-mail appointment and text reminders were significantly more effective than were phone reminders; and (c) age, gender, and ethnicity moderated the relationship between wait time and message type, and first appointment attendance. The implications for positive social change include improving our understanding of the optimal appointment reminder tactics that increase children's and adolescents' mental health appointment attendance rates, improve operating efficiency of community health centers, and increase the likelihood that children and adolescents will receive needed mental health services.

tLess than half of all adults meet the federal exercise recommendations (CDC, 2010) and college-aged adults may be more vulnerable to the consequences of physical inactivity with about two-thirds of college students leading sedentary lifestyles (Harvey-Berino, Pope, Gold, et al., 2012; Tully & Cupples, 2011). Mobile apps provide an efficient way to track physical activity and electronic prompts can enhance mobile apps by reminding individuals to participate. Therefore, the purpose of this study was to examine the effectiveness of a mobile app and electronic prompts sent via Twitter for promoting exercise motivation and adherence in sedentary university students. The hypotheses tested were: (a) a significantly greater percentage of participants in the treatment group would progress through the stages-of-change (SOC) from pre- to post-program compared to the control group, and (b) the treatment group would demonstrate significantly greater exercise adherence than the control group. Thirteen participants followed an 8-week running program on a mobile app. The control group (n = 8) followed the running program while the treatment group (n = 5) also received electronic prompts sent via Twitter to remind participants to exercise. The SOC modified four stage algorithm was used pre- and post-program to assess exercise motivation. Exercise adherence was measured by total number of completed workouts out of the 24 prescribed. A significantly greater number of participants in the control group progressed at least one stage from pre- to post-program compared to participants in the treatment group, χ2 = 6.9, p = 0.008. Additionally, participants in the control group reported a greater number of completed workouts (M = 12.5, SD = 7.6) compared to the participants in the treatment group (M = 3.6, SD = 4.0). These findings suggest that while the mobile app may be beneficial for promoting exercise motivation and adherence, the electronic prompts sent via Twitter appeared to have no effect. Further studies are needed to determine the most effective way to use Twitter to increase exercise motivation and adherence of sedentary university students.