Levesque Deborah A, Cummins Carol O, Prochaska Janice M, Prochaska James O
Pro-Change Behavior Systems, Inc., W. Kingston, RI 02892, USA.
Health Care Financ Rev. 2006 Summer;27(4):25-40.
A randomized trial involving 1,351 new Medicare enrollees was conducted to assess the efficacy of a transtheoretical model (TTM) based manual and multimedia expert system program that delivered guidance and feedback matched to individual stage of readiness to compare Medicare health plans. At 6 months post-intervention, compared to enrollees in the control group, those receiving the manual plus expert system intervention or the manual alone exhibited greater increases in Medicare knowledge. The TTM-based interventions also increased use of and satisfaction with traditional Medicare education materials among most enrollees. The interventions' impact on stage of change for comparing plans was observed only among treatment group participants who had examined and evaluated the materials. The challenges to increasing informed choice and possible dissemination channels for stage-based materials are discussed.
一项涉及1351名新加入医疗保险的参保人的随机试验开展了，目的是评估基于跨理论模型（TTM）的手册及多媒体专家系统项目的效果，该项目提供与比较医疗保险健康计划的个体准备阶段相匹配的指导和反馈。在干预后6个月时，与对照组的参保人相比，接受手册加专家系统干预或仅接受手册干预的参保人在医疗保险知识方面有更大幅度的增长。基于TTM的干预措施还提高了大多数参保人对传统医疗保险教育材料的使用和满意度。干预措施对比较计划的改变阶段的影响仅在检查和评估了材料的治疗组参与者中观察到。文中讨论了增加明智选择的挑战以及基于阶段的材料可能的传播渠道。
