Stages of change and patient activation measure scores in the context of incentive-based health interventions

Am J Health Promot. Nov-Dec 2015;30(2):133-5. doi: 10.4278/ajhp.141001-QUAN-489.


Purpose: 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.

Design: Secondary analysis of two randomized controlled trials of incentives for weight loss and for improved diabetes self-monitoring.

Setting: Philadelphia, Pennsylvania; Newark, New Jersey.

Subjects: 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.

Analysis: 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.

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.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Behavior Therapy / methods*
  • Blood Glucose Self-Monitoring*
  • Female
  • Health Behavior*
  • Humans
  • Male
  • Motivation*
  • New Jersey
  • Patient Participation*
  • Philadelphia
  • Randomized Controlled Trials as Topic
  • Treatment Outcome
  • Weight Loss*