<p> Medicare Part B is one of the federal health insurance programs available to senior citizens in the United States. Unlike Medicare Part A, Part B enrollment is not automatic, and those missing their initial enrollment period are assessed a 10% or more penalty in addition to their monthly premium rate for the rest of their lives. This problematic enrollment policy has impacted senior citizens who have missed Part B enrollment windows, creating for them an added financial burden when many are transitioning to fixed incomes. Guided by social construction theory and using a nonprobability, convenience sampling approach, the likelihood coefficient values associated with Medicare Part B enrollee awareness, stress, and income of 112 residents of a suburban city in a northeastern state who were 65 years and older were examined. Sequential <i>Forward: LR</i> methodology yielded a significant, negative (<i>b</i> = &ndash;1.21, Wald <i>_X</i>²(1) = 7.56, <i>OR</i> = .298, <i>p</i> = .006, CI [.126, .707]) and a significant, positive (<i>b</i> = 2.16, Wald <i>_X</i>²(1) = 6.29, <i>OR</i> = 8.678, <i>p</i> = .012, CI [1.60, 46.99]) likelihood of predicting Medicare Part B late enrollment penalties for awareness and stress; income was not a significant model predictor. Participants who reported higher stress levels were 8.7 times more likely to be classified in the Medicare Part B late enrollment penalty than those reporting lower stress. Participants who were aware of enrollment needs were 3.4 times more likely to have no late enrollment penalties than those who were unaware. Positive social change centers on increasing Medicare Part B consumer awareness, reducing stress of enrollment deadlines, and providing information to federal policy makers to simplify enrollment policies to reduce or end late enrollment penalties.</p><p>

<p> The low HIV prevalence in Maldives coupled with low HIV comprehensive knowledge presents a challenge to the consistency of the hypothesized HIV knowledge-prevention paradigm. Researchers had not explained why HIV prevalence in Maldives is low despite the low levels of HIV knowledge. The purpose of this qualitative case study was to investigate factors beyond HIV knowledge that contribute to the low HIV prevalence among Maldivian male youth. The research questions focused on the risk-reduction factors in the nonmarital sexual behavior of young Maldivian males that contribute to protecting them from contracting HIV and the predictors of safe and unsafe nonmarital sexual behaviors among this target group. The reasoned action approach (RAA) and the theories embedded in the RRA (i.e., the integrated behavioral model, the theory of reasoned action, and the theory of planned behavior) provided the theoretical foundation for this research. A purposeful sample of 18 male university students participated in open-ended interviews. Data were coded and analyzed to identify themes and subthemes. The results indicated that the low HIV prevalence in Maldives can be attributed to long-standing social values and norms that discourage nonmarital sexual engagement; however, these social values and norms are currently fading away, putting the low HIV prevalence status of Maldives at risk. The implications for social change include providing practitioners with specific risk factors they should address to prevent the spread of HIV that would result in the loss of lives and deterioration in the quality of life among young Maldivian men.</p><p>