title: Stages of change and patient activation measure scores in the context of incentive-based health interventions.
abstract: OBJECTIVE
  To determine if two widely used behavioral change measures-Stages of Change (SoC) and Patient Activation Measure (PAM)-correlate with each other, are affected by financial incentives, or predict positive outcomes in the context of incentive-based health interventions.
  
  
  METHODS
  Secondary analysis of two randomized controlled trials of incentives for weight loss and for improved diabetes self-monitoring.
  
  
  METHODS
  Philadelphia, Pennsylvania; Newark, New Jersey.
  
  
  METHODS
  A total of 132 obese and 75 diabetic adults enrolled in one of two trials. MEASURES . SoC and PAM scores; weight loss and usage rate of diabetes self-monitoring equipment.
  
  
  METHODS
  Multiple regression; Kruskal-Wallis test.
  
  
  RESULTS
  We found no association between baseline SoC and PAM scores in either study (p = .30 and p = .89). Regression models showed no association between baseline PAM score and SoC and subsequent outcomes for either study (weight loss study: PAM: p = .14, SoC: p = .1; diabetes study: PAM: p = .45, SoC: p = .61). Change in PAM score and SoC among participants in the intervention groups did not differ by study arm or among participants with better outcomes. CONCLUSION . PAM score and SoC may not effectively predict success or monitor progress among individuals enrolled in incentive-based interventions.
authors.forename: Nora V
authors.initials: NV
authors.lastname: Becker
authors.forename: David A
authors.initials: DA
authors.lastname: Asch
authors.forename: Jeffrey T
authors.initials: JT
authors.lastname: Kullgren
authors.forename: Scarlett L
authors.initials: SL
authors.lastname: Bellamy
authors.forename: Aditi P
authors.initials: AP
authors.lastname: Sen
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp
mesh_terms: D000328:Adult; D001521:Behavior Therapy / Q000379:methods*; D015190:Blood Glucose Self-Monitoring; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D009042:Motivation; D009515:New Jersey; D010358:Patient Participation; D015143:Philadelphia; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Behavioral Economics, Health Incentives, Motivation, Stage of Change, Patient Activation, Prevention Research. Manuscript format: research; Health focus: medical self-care, weight control; Outcome measure: behavioral; Research purpose: intervention testing/program evaluation; Setting: local community; Strategy: incentives; Study design: randomized trial; Target population age: adults; Target population circumstances: geographic location