Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers
Loading...
Date
2004-06-28
Authors
Hibbard, Judith H.
Stockard, Jean
Mahoney, Eldon R.
Tusler, Martin
Journal Title
Journal ISSN
Volume Title
Publisher
Wiley
Abstract
Background: Controlling costs and achieving health care quality improvements
require the participation of activated and informed consumers and patients.
Objectives: We describe a process for conceptualizing and operationalizing what it
means to be "activated" and delineate the process we used to develop a measure for
assessing "activation," and the psychometric properties of that measure.
Methods: We used the convergence of the findings from a national expert consensus
panel and patient focus groups to define the concept and identify the domains of
activation. These domains were operationalized by constructing a large item pool. Items
were pilot-tested and initial psychometric analysis performed using Rasch methodology.
The third stage refined and extended the measure. The fourth stage used a national
probability sample to assess the measure's psychometric performance overall and
within different subpopulations.
Study Sample: Convenience samples of patients with and without chronic illness, and
a national probability sample (N = 1,515) are included at different stages in the research.
Conclusions: The Patient Activation Measure is a valid, highly reliable, unidimensional,
probabilistic Guttman-like scale that reflects a developmental model of
activation. Activation appears to involve four stages: (1) believing the patient role is
important, (2) having the confidence and knowledge necessary to take action, (3)
actually taking action to maintain and improve one's health, and (4) staying the course
even under stress. The measure has good psychometric properties indicating that it can
be used at the individual patient level to tailor intervention and assess changes.
Description
22 pages
Keywords
Patient Activation, Self-management, Consumer Roles in Health Care
Citation
Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M. (2004). Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers. Health Services Research, 39, 1005- 1026. https://doi.org/10.1111/j.1475-6773.2004.00269.x