Date of Award

3-25-2026

Embargo Period

3-28-2028

Document Type

Dissertation

Degree Name

Doctor of Health Administration

College

College of Health Professions

First Advisor

Jami Jones

Second Advisor

Jillian Harvey

Third Advisor

Abel Guevara

Abstract

This mixed-methods study examined Medicare enrollment literacy and plan selection among first-time Black beneficiaries in Southeast Queens, New York. Using a convergent design, the study integrated quantitative survey data with qualitative focus group findings to examine how information systems, community supports, and structural factors influence the Medicare enrollment process. The survey instrument, adapted from validated measures including the Health Literacy Questionnaire (HLQ) and items from the Medicare Current Beneficiary Survey (MCBS), assessed participants' understanding of and access to Medicare information. Focus groups with community navigators and senior-service professionals provided additional insight into communication practices, coordination challenges, and outreach strategies within local systems. Quantitative and qualitative data were analyzed independently and integrated during interpretation. Findings indicated that many first-time beneficiaries experienced difficulty understanding Medicare terminology, comparing coverage options, and estimating out-of-pocket costs. Participants frequently relied on trusted community networks for assistance, and digital navigation challenges remained common. These findings suggest that both individual literacy challenges and structural factors within the Medicare information environment contribute to enrollment difficulties. Improving the clarity of Medicare materials and strengthening community-based outreach and navigation programs may support more informed Medicare decision-making among older adults.

Rights

Copyright is held by the author. All rights reserved.

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Available for download on Tuesday, March 28, 2028

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