The CAHPS 1.0 survey instrument appears to have excellent psychometric properties.

Intrinsic satisfaction and extrinsic job factors amenable to change appear central to NAs' overall satisfaction and intention to leave. A facility may be able to improve extrinsic job factors that improve NAs' job-related affects, including intrinsic satisfaction.

This article assesses the presumption that consumer choice in health care is based on a rational weighing of alternatives--that information consumers about plan or provider performance, when coupled with information on cost plus service scope and limitation, will lead consumers to select high-quality, low-priced plans or providers. The authors review research on what health care consumers know, what they want to know, and what others think they should know. They also consider how people use information in making decisions and what this implies for what consumers really need to know to make effective decisions. The article concludes that assuming a rational consumer does not account for choice among options in the increasingly complex health care context facing consumers today. Based on this review, the article identifies gaps in the knowledge and sketches out a prospective research agenda in the area of consumer health care decision making.

This survey can be used to understand CNA workforce issues and challenges and to plan for sustainable solutions to stabilize this workforce. The NNAS can be linked to other existing data sets to examine more comprehensive and complex relationships among CNA, facility, resident, and community characteristics, thereby expanding its usefulness.

Infection prevalence in HHC, hospice, and NH populations is similar. Although these infections may be community acquired or acquired during earlier healthcare exposures, these findings fill an important gap in understanding the national infection burden and may help inform future research on infection epidemiology and prevention strategies in long-term care populations.

Cognitive testing was integral in the development and refinement of the CAHPS instrument. The cognitive testing findings contributed to an improved instrument that should capture consumers' health care and plan experiences with less response error than one not subjected to such testing. The cognitive testing process and findings can be useful to other researchers with similar survey development goals.

Most plan report cards that compare the performance of health plans have framed the decision about plan choice as an opportunity to get better-quality care. This study uses a controlled experimental design to examine the effect of reframing the health plan choice decision to one that emphasizes protecting oneself from possible risk. The findings show that framing the health plan decision using a risk message has a consistent and significant positive impact on how consumers comprehend, value, and weight comparative performance information.

In this paper we examine how the presence and visibility of outdoor and indoor physical activity resources (e.g., walking path/ trail, outdoor tennis courts, gardens, etc.) influences participation in physical activity among elderly residents in non-profit continuing care retirement communities and other senior housing communities. This paAnjali Joseph, PhD, is per reports findings from a survey of 800 such communities. A social ecological model was used to study the relationships between the environment and physical activity behavior. A fifty-two percent response rate (n = 398) was obtained. Campuses with more attractive outdoor and indoor physical activity facilities had more residents participating in different types of physical activity.