Optimizing Interventions by Baseline Motivation to Close Care Gaps

Preventive care (e.g., cancer screenings, diabetes tests) and disease management (e.g., taking recommended medications) are important, especially among aging adults that are at increased risk for many detectable diseases. Finding cost-effective interventions to close care gaps in preventive care and disease management is valuable not only for optimizing the well-being of aging individuals but also for improving population health at the societal level. This proposal builds on the premise that changing behavior requires two stages: 1) establish some intentions to act and 2) turn such intentions into action (Heckhausen & Gollwitzer, 1987). Capitalizing on this intention-action framework, this proposal classifies interventions into intention-oriented interventions and action-oriented interventions, depending to the stage of behavior change they target. We theorize that the efficacy of these two classes of interventions depends on the stage individuals are at along the path to behavior change (i.e., their baseline motivation), with intention-oriented intervention being effective among individuals with low baseline motivation and action-based interventions being effective among individuals with higher baseline motivation. This proposal aims to test the impact of intention- and action-oriented interventions on closing care gaps, understanding whether their effectiveness depends on individuals’ baseline motivation (i.e., the stage individuals are at in the path to behavior change), and examine their separate and joint impact.