Address correspondence to Deborah A. Levesque, Ph.D., Director of Health Behavior Change Programs, Pro-Change Behavior Systems Inc., P.O. Box 755, West Kingston, RI 02892. Carol O. Cummins, M.Ed., MLIS, Project Director, and Janice M. Prochaska, Ph.D., President and CEO, are with the Pro-Change Behavior Systems Inc., West Kingston, RI. James O. Prochaska, Ph.D., Professor, is with the Department of Psychology, University of Rhode Island, Kingston, RI.
Stage of Change for Making an Informed Decision about Medicare Health Plans
Article first published online: 21 APR 2006
Health Services Research
Volume 41, Issue 4p1, pages 1372–1391, August 2006
How to Cite
Levesque, D. A., Cummins, C. O., Prochaska, J. M. and Prochaska, J. O. (2006), Stage of Change for Making an Informed Decision about Medicare Health Plans. Health Services Research, 41: 1372–1391. doi: 10.1111/j.1475-6773.2006.00547.x
- Issue published online: 21 APR 2006
- Article first published online: 21 APR 2006
- health insurance;
- informed decision making;
- transtheoretical model of change (TTM)
Objective. To assess the applicability of the transtheoretical model of change (TTM) to informed choice in the Medicare population.
Data Sources/Study Setting. Two hundred and thirty-nine new Medicare enrollees randomly selected from the Center for Medicare and Medicaid Services' October 2001 Initial Enrollee File, a repository of data for persons who are going to turn 65 and become entitled to enroll in Medicare in the next 3 months.
Study Design. Study participants completed TTM measures of stage of change, decisional balance, and self-efficacy for informed choice, as well as measures of Medicare knowledge, perceived knowledge, and information seeking. Model testing was conducted to determine whether well-established relationships between stage of change, decisional balance, and self-efficacy replicate for informed choice in the Medicare population, and whether Medicare knowledge and information-seeking increase across the stages.
Data Collection/Extraction Methods. Survey data were collected using mail surveys with telephone follow-up for nonresponders.
Principal Findings. Predicted relationships were established between stage of change for informed choice and decisional balance, self-efficacy, Medicare knowledge, and information seeking. The amount of variance accounted for by stage of change for informed choice was larger than that found for smoking cessation, where the TTM has had its greatest successes.
Conclusions. The methods and findings lay the groundwork for development of TTM-based interventions for Medicare beneficiaries, and provide a prototype for the application of the TTM to informed decision making among other types of consumers who are being asked to take more responsibility for their health care.