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      Assessing Medicare Beneficiaries' Readiness to Make Informed Health Plan Choices

      research-article
      Author(s): , Ph.D., , Ph.D., , M.Ed., M.L.I.S., , Ph.D., , Ph.D.
      Publication date (Print):
      Journal: Health Care Financing Review
      Publisher: CENTERS for MEDICARE & MEDICAID SERVICES

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          Abstract

          The Transtheoretical Model (TTM, the “stage model”) can guide development of programs to increase Medicare beneficiaries' readiness to make informed health plan choices. In this study, TTM staging algorithms were developed to assess readiness to engage in three types of informed choice: (1) learning about the Medicare program; (2) learning about Medicare health maintenance organizations (HMOs); and (3) reviewing different plan options. Stage of change based on all three algorithms is related to knowledge about the Medicare program and information-seeking. Findings provide evidence for the construct validity of the stage measures and for the applicability of the TTM to informed choice among beneficiaries.

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          Most cited references28

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          Stages and processes of self-change of smoking: toward an integrative model of change.

          J Prochaska, C C DiClemente (1983)
          Article 0 comments Cited 553 times – based on 0 reviews     Review now
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            In search of how people change. Applications to addictive behaviors.

            J Prochaska, C C DiClemente, J Norcross (1992)
            How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.
            Article 0 comments Cited 455 times – based on 0 reviews     Review now
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              The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change.

              C C DiClemente, J Prochaska, S Fairhurst … (1991)
              Traditionally smoking cessation studies use smoker and nonsmoker categories almost exclusively to represent individuals quitting smoking. This study tested the transtheoretical model of change that posits a series of stages through which smokers move as they successfully change the smoking habit. Subjects in precontemplation (n = 166), contemplation (n = 794), and preparation (n = 506) stages of change were compared on smoking history, 10 processes of change, pretest self-efficacy, and decisional balance, as well as 1-month and 6-month cessation activity. Results strongly support the stages of change model. All groups were similar on smoking history but differed dramatically on current cessation activity. Stage differences predicted attempts to quit smoking and cessation success at 1- and 6-month follow-up. Implications for recruitment, intervention, and research are discussed.
              Article 0 comments Cited 169 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Health Care Financ Rev
                Journal ID (iso-abbrev): Health Care Financ Rev
                Journal ID (publisher-id): HCFR
                Title: Health Care Financing Review
                Publisher: CENTERS for MEDICARE & MEDICAID SERVICES
                ISSN (Print): 0195-8631
                ISSN (Electronic): 1554-9887
                Publication date (Print): Fall 2001
                Volume: 23
                Issue: 1
                Pages: 87-104
                Article
                Publisher ID: hcfr-23-1-087
                PMC ID: 4194730
                PubMed ID: 12500365
                SO-VID: a976de3b-89ea-45ab-bb25-5b4490f63d72
                Copyright statement: Copyright @ 2001
                History
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                Subject: Research Article

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