Stage of change for making an informed decision about Medicare health plans.
OBJECTIVE
To assess the applicability of the transtheoretical model of change (TTM) to informed choice in the Medicare population.


METHODS
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.


METHODS
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.


METHODS
Survey data were collected using mail surveys with telephone follow-up for nonresponders.


RESULTS
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.
Levesque
Deborah A
DA
Director of Health Behavior Change Programs, Pro-Change Behavior Systems Inc., P.O. Box 755, West Kingston, RI 02892, USA.
Cummins
Carol O
CO
Prochaska
Janice M
JM
Prochaska
James O
JO
D005260:Female; D019538:Health Care Surveys; D006801:Humans; D033181:Information Dissemination; D007407:Interviews as Topic; D008297:Male; D006278:Medicare; D008962:Models, Theoretical; D010358:Patient Participation; D020377:Self Efficacy