This study develops a model of the adaptive behavior of hospital administrators to the mandate to implement consumer participation. The model consists of three variable sets: Contextual variables describing the economic and social milieu of the hospitals; implementation variables which describe structural aspects of the advisory boards; and outcome variables related to the study program objective of facilitating both delivery and community utilization of ambulatory services. Specific findings are that a consumer chairman promotes consumer input and that in a setting where voluntary organizations are observed, consumer representatives that arc a mixed group of recipients of care and community group representatives are most effective. It was found that contextual variablcs predict outcome through a mediating set of implementation variables but that contextual variables and implementation variables arc also independent predictors of outcome. The study generated four hypotheses; that the attitude of the administrator toward consumer participation is directly related to the level of consumer input observed; that training is inversely related to outcome; that smaller programs arc more responsive to the mandate to implement consumer participation than larger programs; and that if the hospital needs community legitimation of its goals, higher consumer participation is observed.