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Kateeb E, McKernan SC, Askelson N, et al. Applying "Stages of Readiness to Change" Model to Dentists' Decisions to Participate in Medicaid: An Exploratory Study. Risk Manag Healthc Policy. 2021;14:3311-3322doi: 10.2147/RMHP.S318357.
Kateeb, E., McKernan, S. C., Askelson, N., Momany, E., & Damiano, P. (2021). Applying "Stages of Readiness to Change" Model to Dentists' Decisions to Participate in Medicaid: An Exploratory Study. Risk management and healthcare policy, 143311-3322. https://doi.org/10.2147/RMHP.S318357
Kateeb, Elham, et al. "Applying "Stages of Readiness to Change" Model to Dentists' Decisions to Participate in Medicaid: An Exploratory Study." Risk management and healthcare policy vol. 14 (2021): 3311-3322. doi: https://doi.org/10.2147/RMHP.S318357
Kateeb E, McKernan SC, Askelson N, Momany E, Damiano P. Applying "Stages of Readiness to Change" Model to Dentists' Decisions to Participate in Medicaid: An Exploratory Study. Risk Manag Healthc Policy. 2021 Aug 11;14:3311-3322. doi: 10.2147/RMHP.S318357. eCollection 2021. PMID: 34413688; PMCID: PMC8369810.
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Risk Manag Healthc Policy. 2021 Aug 11;14:3311-3322. doi: 10.2147/RMHP.S318357. eCollection 2021.

Applying "Stages of Readiness to Change" Model to Dentists' Decisions to Participate in Medicaid: An Exploratory Study.

Risk management and healthcare policy

Elham Kateeb, Susan C McKernan, Natoshia Askelson, Elizabeth Momany, Peter Damiano

Affiliations

  1. Oral Health Research and Promotion Unit, Al-Quds University, Jerusalem, Palestine.
  2. Public Policy Center, University of Iowa, Iowa City, Iowa, USA.
  3. Department of Preventive and Community Dentistry, College of Dentistry, University of Iowa, Iowa City, Iowa, USA.
  4. Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa, USA.

PMID: 34413688 PMCID: PMC8369810 DOI: 10.2147/RMHP.S318357

Abstract

BACKGROUND: The Stages of Readiness to Change (SOC) behavioral model describes behavior change as a process and distinguishes individuals based on their current behavior and readiness to change that behavior. SOC can be used to improve dentists' participation in a state public dental benefit program (Medicaid) by targeting them at different SOC with interventions, strategies, and tools tailored to those stages. Therefore, this study assessed the usefulness of using SOC to describe dentists' attitudes towards and participation in Medicaid. Dentists' participation in Medicaid is of interest to policymakers, and this study demonstrates a method to identify potential opportunities for intervention.

METHODS: A modified SOC algorithm used data from a periodic survey of Iowa Dentists to categorize dentists (N=514) into: 1) pre-contemplation, 2) considering participation (SOC contemplation and preparation), 3) acting (SOC action and maintenance), and 4) risk of relapse (at risk for discontinuing participation). The four SOC stages were compared using ANOVA and post hoc Tukey's test among: practice characteristics, Dentists Altruism scale, Attitude about Program Administration scale, Attitude about Medicaid patients scale and Perception of Importance of Medicaid Problems scale.

RESULTS: Among survey respondents, 36% were categorized as pre-contemplation, 6% were considering Medicaid participation, 12% were acting as Medicaid providers with minimal risk of relapse, and 46% were participating and at risk of discontinuing. Dentists' attitudes towards program administration, Medicaid patients, and access to care varied across the SOC cycle.

CONCLUSION: Nearly, 46% dentists in this analysis were identified as at risk of discontinuing participation - a much larger proportion than dentists considering Medicaid participation. Categorizing dentists using this approach has important implications for programmatic interventions. For example, policymakers targeting our study population could focus their efforts on reducing the likelihood of dentists dropping out of the program, with less emphasis targeting dentists in the precontemplation stage.

© 2021 Kateeb et al.

Keywords: Medicaid; dentists; stages of change; surveys and questionnaires; transtheoretical model

Conflict of interest statement

The authors declare that they have no competing interests in this work.

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