Development of the Patient Activation Measure (PAM): Conceptualizing and Measuring Activation in Patients and Consumers
Open accessAbstract
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.
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The Patient Activation Measure (PAM) is a validated measure of patient activation that includes a person's beliefs, motivation, and actions for self-care.
“Participants also completed the 10-question Patient Activation Measure (PAM), a validated measure of patient activation that includes person’s beliefs, motivation, and actions for self-care at these visits [9,23,24].”
From Effectiveness of Digital Medicines to Improve Clinical Outcomes in Patients with Uncontrolled Hypertension and Type 2 Diabetes: Prospective, Open-Label, Cluster-Randomized Pilot Clinical Trial (2017) · cites this paper as [23]
The Conclusions describe PAM as a valid measure of activation encompassing beliefs, confidence, and action to manage health. However, the Methods report validation of a 22-item PAM, not the 10-question version participants completed; this source does not establish that version’s validity. The indexed passages do not provide page numbers. (LLM, conf=0.87)
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Cites
Applying the Rasch Model: Fundamental Measurement in the Human Sciences
Bond, T. G., & Fox, C. M. (2003) · Journal of Educational Measurement · doi:10.1111/j.1745-3984.2003.tb01103.x · Cited by 4,503 · see citing works
Patient Self-management of Chronic Disease in Primary Care
Bodenheimer, T. (2002) · JAMA · doi:10.1001/jama.288.19.2469 · Cited by 3,598 · cited 2× · see citing works
“The review findings indicated that being an engaged and active participant in one’s own care is linked to better health outcomes (Von Korff et al. 1997; Lorig et al. 1999; Von Korff et al. 1998; Bodenheimer et al. 2002) and measurable cost savings (Glasgow et al. 2002).”
A Rating Formulation for Ordered Response Categories
Andrich, D. (1978) · Psychometrika · doi:10.1007/bf02293814 · Cited by 2,984 · see citing works
DiClemente, C. C., Prochaska, J. O., Fairhurst, S., Velicer, W. F., Velasquez, M. M., & Rossi, J. S. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.59.2.295 · Cited by 2,402 · see citing works
Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Bandura, A., Ritter, P., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (1999) · Medical Care · doi:10.1097/00005650-199901000-00003 · Cited by 2,261 · see citing works
Assessing the Effects of Physician-Patient Interactions on the Outcomes of Chronic Disease
Kaplan, S. H., Greenfield, S., & Ware, J. E. (1989) · Medical Care · doi:10.1097/00005650-198903001-00010 · Cited by 2,043 · see citing works
Probabilistic Models for some Intelligence and Attainment Tests.
Wolins, L., Wright, B. D., & Rasch, G. (1982) · Journal of the American Statistical Association · doi:10.2307/2287805 · Cited by 2,009 · see citing works
Best Test Design. Rasch Measurement.
Wright, B. D., & Stone, M. H. (1979) · Medical Entomology and Zoology · Cited by 1,975 · see citing works
Wright, B. D., & Masters, G. N. (1982) · ACEReSearch Repository (Australian Council for Educational Research) · Cited by 1,930 · see citing works
DiClemente, C. C., Prochaska, J. O., Fairhurst, S., et al. (1991) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.59.2.295 · Cited by 1,838 · see citing works
Expanding Patient Involvement in Care
Greenfield, S., Kaplan, S. H., & Ware, J. E. (1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-102-4-520 · Cited by 1,459 · see citing works
Bond, T. G., & Fox, C. M. (2001) · Psychology Press eBooks · doi:10.4324/9781410600127 · Cited by 1,351 · see citing works
The transtheoretical model and stages of change
Prochaska, J. O., Redding, C. A., & Evers, K. E. (1996) · Cited by 1,328 · see citing works
Collaborative Management of Chronic Illness
Von Korff, M., Gruman, J., Schaefer, J., Curry, S. J., & Wagner, E. H. (1997) · Annals of Internal Medicine · doi:10.7326/0003-4819-127-12-199712150-00008 · Cited by 1,269 · cited 3× · see citing works
“Collaborating on care and engaging in shared clinical decision making are also linked with better health outcomes (Von Korff et al. 1997; Kaplan, Greenfield, and Ware 1989; Glasgow 2002).”
BackgroundMeasurement and Evaluation in Psychology and Education.
S., R., Thorndike, R. L., & Hagen, E. P. (1961) · Journal of the American Statistical Association · doi:10.2307/2282039 · Cited by 1,235 · see citing works
Outcome Measures for Health Education and Other Health Care Interventions
Lorig, K., Stewart, A., Ritter, P., González, V., Laurent>, D., & Lynch, J. (1996) · doi:10.4135/9781452232966 · Cited by 1,132 · see citing works
Patients’ participation in medical care
Greenfield, S., Kaplan, S. H., Ware, J. E., Yano, E. M., & Frank, H. J. L. (1988) · Journal of General Internal Medicine · doi:10.1007/bf02595921 · Cited by 1,117 · see citing works
O’Leary, A. (1985) · Behaviour Research and Therapy · doi:10.1016/0005-7967(85)90172-x · Cited by 802 · see citing works
Measurement and Evaluation in Psychology and Education.
Jarrett, R. F., Thorndike, R. L., & Hagen, E. (1956) · Journal of the American Statistical Association · doi:10.2307/2281462 · Cited by 572 · see citing works
Form C of the MHLC Scales: A Condition-Specific Measure of Locus of Control
Wallston, K. A., Stein, M. J., & Smith, C. A. (1994) · Journal of Personality Assessment · doi:10.1207/s15327752jpa6303_10 · Cited by 557 · see citing works
Self-Efficacy and Health Behavior Among Older Adults
Grembowski, D. E., Patrick, D. L., Diehr, P. K., Durham, M., Beresford, S. A. A., Kay, E., & Hecht, J. A. (1993) · Journal of Health and Social Behavior · doi:10.2307/2137237 · Cited by 408 · see citing works
Health Behavior and Health Education
&NA; (1991) · Medical Care · doi:10.1097/00005650-199106000-00006 · Cited by 407 · see citing works
Glasgow, R. E., Funnell, M. M., Bonomi, A. E., Davis, C., Beckham, V., & Wagner, E. H. (2002) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2402_04 · Cited by 376 · see citing works
Treatment Costs, Cost Offset, and Cost-Effectiveness of Collaborative Management of Depression
Korff, M. V., Katon, W. J., Bush, T. M., Lin, E. H. B., Simon, G. E., Saunders, K. W., Ludman, E. J., Walker, E. A., & Unützer, J. (1998) · Psychosomatic Medicine · doi:10.1097/00006842-199803000-00005 · Cited by 271 · see citing works
Von Korff, M., Moore, J. E., Lorig, K., Cherkin, D. C., Saunders, K., González, V. M., Laurent, D., Rutter, C., & Comite, F. (1998) · Spine · doi:10.1097/00007632-199812010-00016 · Cited by 257 · see citing works
The Measurement of Vision Disability
Massof, R. W. (2002) · Optometry and Vision Science · doi:10.1097/00006324-200208000-00015 · Cited by 202 · see citing works
Davidson, R. (1998) · Springer eBooks · doi:10.1007/978-1-4899-1934-2_2 · Cited by 178 · see citing works
Can Medicare Beneficiaries Make Informed Choices?
Hibbard, J. H., Jewett, J. J., Engelmann, S., & Tusler, M. (1998) · Health Affairs · doi:10.1377/hlthaff.17.6.181 · Cited by 126 · see citing works
Self-citationA randomized trial of the use of patient self-assessment data to improve community practices.
Wasson, J. H., Stukel, T. A., Weiss, J. E., Hays, R. D., Jette, A. M., & Nelson, E. C. (1999) · PubMed · Cited by 119 · see citing works
Consumers' Information Needs: Results of a National Survey
Isaacs, S. L. (1996) · Health Affairs · doi:10.1377/hlthaff.15.4.31 · Cited by 99 · see citing works
Consensus methods in practice guideline development: a review and description of a new method.
Kahn, D. A., Docherty, J. P., Carpenter, D., & Frances, A. (1997) · PubMed · Cited by 55 · see citing works
Use of a Secure Internet Web Site for Collaborative Medical Research
Marshall, W. W. (2000) · JAMA · doi:10.1001/jama.284.14.1843 · Cited by 52 · see citing works
Consumer-Driven Health Plans: Are They More Than Talk Now?
Gabel, J. R., Sasso, A. T. L., & Rice, T. (2002) · Health Affairs · doi:10.1377/hlthaff.w2.395 · Cited by 44 · see citing works
Hibbard, J. H., Greenlick, M. R., Jimison, H. B., Capizzi, J. A., & Kunkel, L. E. (2001) · Evaluation & the Health Professions · doi:10.1177/01632780122034984 · Cited by 20 · see citing works
Self-citationUse of performance data to change physician behavior
Marshall, M., Shekelle, P., Brook, R., & Leatherman, S. T. (2000) · PubMed · Cited by 10 · see citing works
Flagged first, then by citations
Research works printed but not linked: 6
- Bandura A. Self-efficacy Mechanism in Physiological Activation and Health-Promoting Behavior. In: Madden J, Matthysse S, Barchas J, editors. Adaption, Learning and Affect. New York: Raven Press; 1991. pp. 226–69. [Google Scholar]
- Glasgow RE. Seattle, Washington: Paper present at the Congress on Improving Chronic Care: Innovations in Research and Practice; 2002. Technology and Chronic Care; pp. 8–10. September. [Google Scholar]
- Linacre JM. Winsteps Manual. Chicago: Winsteps; 2002. [Google Scholar]
- Smith RM. Polytomous Mean-Square Fit Statistics. Rasch Measurement Transactions. 1996;10(3):516–7. [Google Scholar]
- Winsteps. Winsteps: Rasch Model Statistical Software. Chicago: Winsteps; 2002. [Google Scholar]
- Wright BD, Stone MH. Best Test Design. Chicago: Mesa Press; 1979. [Google Scholar]
Cited by
Sorted by citations
Achieving integration in mixed methods designs-principles and practices
Fetters, M. D., Curry, L. A., & Creswell, J. W. (2013) · Health Services Research · doi:10.1111/1475-6773.12117 · Cited by 5,772 · see citing works
Development and Testing of a Short Form of the Patient Activation Measure
Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005) · Health Services Research · doi:10.1111/j.1475-6773.2005.00438.x · Cited by 1,944 · see citing works
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BackgroundMethodSelf-citationHibbard, J. H., & Greene, J. (2013) · Health Affairs · doi:10.1377/hlthaff.2012.1061 · Cited by 1,787 · see citing works
Bakitas, M., Lyons, K. D., Hegel, M. T., Balan, S., Brokaw, F. C., Seville, J., Hull, J. G., Li, Z., Tosteson, T. D., Byock, I. R., et al. (2009) · JAMA · doi:10.1001/jama.2009.1198 · Cited by 1,726 · see citing works
Best Care at Lower Cost: The Path to Continuously Learning Health Care in America
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“Metrics have been developed for quantifying a patient’s activation, defined as the capability to participate in the care process (Hibbard, 2004; Hibbard et al., 2004).”
BackgroundHolden, R. J., Carayon, P., Gurses, A. P., Hoonakker, P., Hundt, A. S., Ozok, A. A., & Rivera-Rodriguez, A. J. (2013) · Ergonomics · doi:10.1080/00140139.2013.838643 · Cited by 1,221 · see citing works
Coproduction of healthcare service
Batalden, M., Batalden, P., Margolis, P., Seid, M., Armstrong, G., Opipari-Arrigan, L., & Hartung, H. (2016) · BMJ Quality & Safety · doi:10.1136/bmjqs-2015-004315 · Cited by 1,078 · see citing works
How Can We Increase Translation of Research into Practice? Types of Evidence Needed
Glasgow, R. E., & Emmons, K. M. (2007) · Annual Review of Public Health · doi:10.1146/annurev.publhealth.28.021406.144145 · Cited by 1,050 · see citing works
“patients (52) and families who collaborate in their care with providers who have resources and expertise.”
BackgroundGreene, J., & Hibbard, J. H. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1931-2 · Cited by 1,028 · see citing works
“We first conducted descriptive analyses of the total sample, and the sample stratified by tercile of the patients’ zip code per capita income, our measure of SES.(12) Then we examined the bivariate relationships between patient activation and the dependent measures.”
MethodInfluentialSelf-citationFeldstein, A. C., & Glasgow, R. E. (2008) · The Joint Commission Journal on Quality and Patient Safety · doi:10.1016/s1553-7250(08)34030-6 · Cited by 987 · see citing works
Castro, E. M., Regenmortel, T. V., Vanhaecht, K., Sermeus, W., & Hecke, A. V. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.07.026 · Cited by 955 · see citing works
Do increases in patient activation result in improved self-management behaviors?
Hibbard, J. H., Mahoney, E. R., Stock, R., & Tusler, M. (2007) · Health Services Research · doi:10.1111/j.1475-6773.2006.00669.x · Cited by 906 · see citing works
“These initial findings indicate the PAM predicts a range of behaviors, including: healthy behaviors (e.g., exercise, diet); disease-specific self-management behaviors; and consumeristic type behaviors (e.g., reading about risks with a new drug); (Hibbard et al. 2004, 2005).”
BackgroundSelf-citationDevelopment and Validation of the Patient Assessment of Chronic Illness Care (PACIC)
Glasgow, R. E., Wagner, E. H., Schaefer, J. K., Mahoney, L. D., Reid, R. J., & Greene, S. M. (2005) · Medical Care · doi:10.1097/01.mlr.0000160375.47920.8c · Cited by 863 · see citing works
Angst, C. M., & Agarwal, R. (2009) · MIS Quarterly · doi:10.2307/20650295 · Cited by 1,043 · see citing works
“Recent research suggests that those who feel empowered and are " activated " with respect to their care will be more willing to try health alternatives (Hibbard et al. 2004).”
BackgroundInterventions for increasing the use of shared decision making by healthcare professionals
Légaré, F., Adekpedjou, R., Stacey, D., Turcotte, S., Kryworuchko, J., Graham, I. D., Lyddiatt, A., Politi, M. C., Thomson, R., Elwyn, G., et al. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd006732.pub4 · Cited by 698 · see citing works
“Effect of interventions on primary outcome: interventions targeting patients compared to other interventions targeting patients (Continued) Study Interven- tion Interven- tion Outcome Direct quote No study Patient reported outcome measure - Continous data Meta-analysis Study Interven- tion Interven- tion Outcome N SMD…”
BackgroundMethodInfluentialAdherence and health care costs
McGuire, M., & Iuga, A. O. (2014) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s19801 · Cited by 736 · see citing works
The Unintended Consequences of Publicly Reporting Quality Information
Werner, R. M. (2005) · JAMA · doi:10.1001/jama.293.10.1239 · Cited by 599 · see citing works
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O’Connor, M., & Casey, L. (2015) · Psychiatry Research · doi:10.1016/j.psychres.2015.05.064 · Cited by 605 · see citing works
Personalised care planning for adults with chronic or long-term health conditions
Coulter, A., Entwistle, V. A., Eccles, A., Ryan, S., Shepperd, S., & Perera, R. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010523.pub2 · Cited by 592 · see citing works
When Patient Activation Levels Change, Health Outcomes And Costs Change, Too
Greene, J., Hibbard, J. H., Sacks, R. M., Overton, V., & Parrotta, C. (2015) · Health Affairs · doi:10.1377/hlthaff.2014.0452 · Cited by 577 · see citing works
Self-citationvan Uden‐Kraan, C. F., Drossaert, C. H. C., Taal, E., Shaw, B. R., Seydel, E. R., & van de Laar, M. A. F. J. (2008) · Qualitative Health Research · doi:10.1177/1049732307313429 · Cited by 465 · see citing works
Brandsen, T., Steen, T. P. S., & Verschuere, B. (2018) · Routledge eBooks · doi:10.4324/9781315204956 · Cited by 505 · see citing works
Finding Common Ground: Patient-Centeredness and Evidence-Based Chronic Illness Care
Wagner, E. H., Bennett, S. M., Austin, B. T., Greene, S. M., Schaefer, J. K., & Vonkorff, M. (2005) · The Journal of Alternative and Complementary Medicine · doi:10.1089/acm.2005.11.s-7 · Cited by 452 · see citing works
“5 The paradigm for high-quality chronic illness care now seeks to promote a fuller understanding of the patient’s life and preferences, “activation” 6 or “empowerment” 7 of patients, and tailoring of management to patient preferences.”
Secondary Prevention After Coronary Artery Bypass Graft Surgery
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“As healthcare experiences a paradigm shift from physician-centered to patient-centered care, CR programs play an integral role in education and transitioning patients to adopt health-related behaviors.(342) CR personnel can act as health coaches, providing self-management support, collaborating with patients to establ…”
BackgroundeHealth for Patient Engagement: A Systematic Review
Barello, S., Triberti, S., Graffigna, G., Libreri, C., Serino, S., Hibbard, J., & Riva, G. (2016) · Frontiers in Psychology · doi:10.3389/fpsyg.2015.02013 · Cited by 411 · see citing works
“Within this field, the healthcare debate is currently focusing on the concept of “patient engagement”—called also “patient activation” (Hibbard et al., 2004; Gruman et al., 2010; Carman et al., 2013; Graffigna et al., 2013a, 2014a, 2015a).”
BackgroundMethodInfluentialSelf-citationHibbard, J. H., Greene, J., & Overton, V. (2013) · Health Affairs · doi:10.1377/hlthaff.2012.1064 · Cited by 398 · see citing works
Self-citationParticipation in online patient support groups endorses patients’ empowerment
van Uden‐Kraan, C. F., Drossaert, C. H. C., Taal, E., Seydel, E. R., & van de Laar, M. A. F. J. (2008) · Patient Education and Counseling · doi:10.1016/j.pec.2008.07.044 · Cited by 380 · see citing works
“Empowered patients are considered to be successful in managing their condition, collaborating with their health providers, maintaining their health functioning and accessing appropriate and high quality care [4].”
BackgroundImproving health outcomes with better patient understanding and education
Adams, R. (2010) · Risk Management and Healthcare Policy · doi:10.2147/rmhp.s7500 · Cited by 384 · see citing works
From patient education to patient engagement: Implications for the field of patient education
Gruman, J., Rovner, M. H., French, M. E., Jeffress, D., Sofaer, S., Shaller, D., & Prager, D. J. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.02.002 · Cited by 362 · see citing works
“in 2004 [32].”
Druss, B. G., Zhao, L., von Esenwein, S. A., Bona, J. R., Fricks, L., Jenkins-Tucker, S., Sterling, E., DiClemente, R., & Lorig, K. (2010) · Schizophrenia Research · doi:10.1016/j.schres.2010.01.026 · Cited by 363 · see citing works
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Levy, H. G., & Janke, A. T. (2016) · Journal of Health Communication · doi:10.1080/10810730.2015.1131776 · Cited by 356 · see citing works
White, S. J., Foster, R., Marks, J., Morshead, R., Goldsmith, L. P., Barlow, S. H., Sin, J., & Gillard, S. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02923-3 · Cited by 357 · see citing works
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MethodPatient Engagement as an Emerging Challenge for Healthcare Services: Mapping the Literature
Barello, S., Graffigna, G., & Vegni, E. A. M. (2012) · Nursing Research and Practice · doi:10.1155/2012/905934 · Cited by 323 · see citing works
“Medicine 3 4 5 6 8 12 14 13 24 39 [29] 128 [150]”
BackgroundImproving the outcomes of disease management by tailoring care to the patient's level of activation.
Hibbard, J. H., Greene, J., & Tusler, M. (2009) · PubMed · Cited by 312 · see citing works
Self-citationPatient-Reported Outcomes In Performance Measurement
Cella, D. F., Hahn, E. A., Jensen, S. E., Butt, Z. A., Nowinski, C. J., Rothrock, N. E., & Lohr, K. N. (2015) · doi:10.3768/rtipress.2015.bk.0014.1509 · Cited by 326 · see citing works
Wisdom, J. P., Cavaleri, M. A., Onwuegbuzie, A. J., & Green, C. A. (2011) · Health Services Research · doi:10.1111/j.1475-6773.2011.01344.x · Cited by 302 · see citing works
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Domains, B. (2015) · Cited by 299 · see citing works
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“Hibbard, Stockard, Mahoney, Tusler [85] developed a Patient Activation Measure (PAM) to determine the levels of patient activation.”
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Self-citationLee, K., Hoti, K., Hughes, J. D., & Emmerton, L. (2014) · Journal of Medical Internet Research · doi:10.2196/jmir.3706 · Cited by 284 · see citing works
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MethodKangovi, S., Mitra, N., Norton, L., Harte, R., Zhao, X., Carter, T., Grande, D., & Long, J. A. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.4630 · Cited by 272 · see citing works
Kangovi, S., Mitra, N., Grande, D., White, M. L., McCollum, S., Sellman, J., Shannon, R. P., & Long, J. A. (2014) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.14327 · Cited by 274 · see citing works
Noah, B., Keller, M. S., Mosadeghi, S., Stein, L., Johl, S., Delshad, S., Tashjian, V. C., Lew, D., Kwan, J. T., Jusufagic, A., et al. (2018) · npj Digital Medicine · doi:10.1038/s41746-017-0002-4 · Cited by 273 · see citing works
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Prey, J. E., Woollen, J., Wilcox, L. G., Sackeim, A., Hripcsak, G. M., Henry, S. B., Restaino, S. W., Feiner, S., & Vawdrey, D. K. (2013) · Journal of the American Medical Informatics Association · doi:10.1136/amiajnl-2013-002141 · Cited by 265 · see citing works
Kangovi, S., Mitra, N., Grande, D., Huo, H., Smith, R. A., & Long, J. A. (2017) · American Journal of Public Health · doi:10.2105/ajph.2017.303985 · Cited by 258 · see citing works
Evaluation of a Patient Activation and Empowerment Intervention in Mental Health Care
Alegría, M., Polo, A. J., Gao, S., Santana, L., Rothstein, D., Jiménez, A., Hunter, M. L., Mendieta, F., Oddo, V., & Normand, S. (2008) · Medical Care · doi:10.1097/mlr.0b013e318158af52 · Cited by 255 · see citing works
“This definition of patient activation relates closely to Hibbard and colleagues’ initial stage of activation.(11) It focuses on patients being able to tell their concerns to health care providers; to manage symptoms (emotional or mental health); to get information to make decisions about treatment; to take an active r…”
BackgroundSupporting social prescribing in primary care by linking people to local assets: a realist review
Tierney, S., Wong, G., Roberts, N., Boylan, A., Park, S., Abrams, R., Reeve, J., Williams, V., & Mahtani, K. (2020) · BMC Medicine · doi:10.1186/s12916-020-1510-7 · Cited by 206 · see citing works
Patient empowerment in long-term conditions: development and preliminary testing of a new measure
Small, N., Bower, P., Chew-Graham, C. A., Whalley, D., & Protheroe, J. (2013) · BMC Health Services Research · doi:10.1186/1472-6963-13-263 · Cited by 244 · see citing works
“The Patient Activation Measure [96] has stronger psychometric properties than the current measure and was developed from the Rasch Rating Scale Model [97], an alternative statistical method to factor analysis, used to test scale structure.”
InfluentialRemmers, C., Hibbard, J., Mosen, D. M., Wagenfield, M., Hoye, R. E., & Jones, C. (2009) · Journal of Ambulatory Care Management · doi:10.1097/jac.0b013e3181ba6e77 · Cited by 242 · see citing works
“It was scaled and tested using the Rasch methodology, which yielded a 22-item instrument measured on a theoretical 0–100 scale where 100 represents the highest activation level (Hibbard et al., 2004).”
BackgroundMethodInfluentialSelf-citationMichie, S., Jochelson, K., Markham, W. A., & Bridle, C. (2009) · Journal of Epidemiology and Community Health · doi:10.1136/jech.2008.078725 · Cited by 238 · see citing works
Nursing Care Coordination for Patients with Complex Needs in Primary Healthcare: A Scoping Review
Karam, M., Chouinard, M., Poitras, M.-È., Couturier, Y., Vedel, I., Grgurevic, N., & Hudon, C. (2021) · International Journal of Integrated Care · doi:10.5334/ijic.5518 · Cited by 240 · see citing works
Fowles, J. B., Terry, P., Xi, M., Hibbard, J., Bloom, C. T., & Harvey, L. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2009.02.018 · Cited by 221 · see citing works
Self-citationHowell, D., Mayer, D. K., Fielding, R., Eicher, M., Leeuw, I. M. V., Johansen, C., Soto‐Pérez‐de‐Celis, E., Foster, C. N., Chan, R. J., Alfano, C. M., et al. (2020) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/djaa083 · Cited by 240 · see citing works
Bos-Touwen, I. D., Schuurmans, M. J., Monninkhof, E. M., Korpershoek, Y., Spruit-Bentvelzen, L., der Graaf, I. E.-V., de Wit, N. J., & Trappenburg, J. C. A. (2015) · PLoS ONE · doi:10.1371/journal.pone.0126400 · Cited by 232 · see citing works
“exercising and disease specific behaviors) [16,17].”
Rademakers, J. J. D. J. M., Nijman, J., van der Hoek, L., Heijmans, M., & Rijken, M. (2012) · BMC Public Health · doi:10.1186/1471-2458-12-577 · Cited by 230 · see citing works
“Though the concept of patient activation has a high face validity and was carefully constructed using experts consensus and patient focus groups [1], an important question remains what construct the instrument is actually measuring.”
BackgroundMethodMaximizing the Impact of e-Therapy and Serious Gaming: Time for a Paradigm Shift
Fleming, T. M., de Beurs, D., Khazaal, Y., Gaggioli, A., Riva, G., Botella, C., Baños, R. M., Aschieri, F., Bavin, L. M., Kleiboer, A., et al. (2016) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2016.00065 · Cited by 212 · see citing works
“Measure (PAM) (56) An interval-level, unidimensional Guttman-like measure”
BackgroundAssessment of Patient Empowerment - A Systematic Review of Measures
Barr, P. J., Scholl, I., Bravo, P., Faber, M. J., Elwyn, G. J., & McAllister, M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0126553 · Cited by 220 · see citing works
“The Patient Activation Measure (PAM) [58] is based on a developmental model, capturing patient development across 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…”
Engagement in a Diabetes Self-management Website: Usage Patterns and Generalizability of Program Use
Glasgow, R. E., Christiansen, S. M., Kurz, D., King, D. K., Woolley, T., Faber, A. J., Estabrooks, P. A., Strycker, L., Toobert, D., & Dickman, J. (2011) · Journal of Medical Internet Research · doi:10.2196/jmir.1391 · Cited by 219 · see citing works
“Interventions The interventions were guided by a behavioral systems approach to diabetes self- management [20-23] that applies validated behavior change principles at patient, health care provider, and social-environmental levels.”
Santana, M., & Feeny, D. H. (2013) · Quality of Life Research · doi:10.1007/s11136-013-0596-1 · Cited by 224 · see citing works
“activation can predict health utilization and health outcomes [46].”
BackgroundHealth literacy of Dutch adults: a cross sectional survey
van der Heide, I., Rademakers, J. J. D. J. M., Schipper, M., Droomers, M., Sørensen, K., & Uiters, E. (2013) · BMC Public Health · doi:10.1186/1471-2458-13-179 · Cited by 216 · see citing works
“This could influence information processing and decisionmaking and therefore seems relevant for the identification of those at risk of perceived difficulties with health information [41,42].”
Patient-physician role relationships and patient activation among individuals with chronic illness
Alexander, J. A., Hearld, L. R., Mittler, J. N., & Harvey, J. (2012) · Health Services Research · doi:10.1111/j.1475-6773.2011.01354.x · Cited by 206 · see citing works
“The measure has been psychometrically validated in several chronically ill adult populations (Hibbard et al. 2004, 2005).”
BackgroundMethodFrias, J., Virdi, N., Raja, P., Kim, Y., Savage, G., & Osterberg, L. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7833 · Cited by 211 · see citing works
“Participants also completed the 10-question Patient Activation Measure (PAM), a validated measure of patient activation that includes person’s beliefs, motivation, and actions for self-care at these visits [9,23,24].”
MethodPreparing Adolescents With Chronic Disease for Transition to Adult Care: A Technology Program
Huang, J. S., Terrones, L., Tompane, T., Dillon, L. W., Pian, M. S., Gottschalk, M. E., Norman, G. J., & Bartholomew, L. K. (2014) · PEDIATRICS · doi:10.1542/peds.2013-2830 · Cited by 211 · see citing works
Consumer Use of “Dr Google”: A Survey on Health Information-Seeking Behaviors and Navigational Needs
Lee, K., Hoti, K., Hughes, J., & Emmerton, L. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4345 · Cited by 199 · see citing works
“While self-perceived eHealth literacy refers to individuals’ self-perceived abilities to obtain and utilize Web-based health information for the purpose of self-management [52], patient activation refers to individuals’ self-belief in their behavioral repertoires, abilities, and knowledge pertaining to self-management…”
BackgroundInfluentialPsychometric properties of the patient activation measure among multimorbid older adults.
Skolasky, R., Green, A., Scharfstein, D. O., Boult, C., Reider, L., & Wegener, S. (2011) · Health Services Research · doi:10.1111/j.1475-6773.2010.01210.x · Cited by 201 · see citing works
Skill Set or Mind Set? Associations between Health Literacy, Patient Activation and Health
Smith, S. G., Curtis, L. M., Wardle, J., von Wagner, C., & Wolf, M. S. (2013) · PLoS ONE · doi:10.1371/journal.pone.0074373 · Cited by 196 · see citing works
“Statistical Analyses One-way Analysis of Variance (ANOVA) was used to compare mean performance on the TOFHLA and PAM by participant characteristics.”
BackgroundInfluentialEvaluating Patient Empowerment in Association With eHealth Technology: Scoping Review
Risling, T., Martinez, J., Young, J., & Thorp-Froslie, N. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7809 · Cited by 191 · see citing works
“The widespread uptake of the Patient Activation Measure (PAM) by Hibbard Stockard [33] as a standard in this area has provided some conceptual stability for patient activation.”
BackgroundSchmittdiel, J. A., Mosen, D. M., Glasgow, R. E., Hibbard, J. H., Remmers, C., & Bellows, J. (2007) · Journal of General Internal Medicine · doi:10.1007/s11606-007-0452-5 · Cited by 191 · see citing works
“We adapted 4 self-management behavioral items from Hibbard et al.12 and asked patients to rate these using a 4-point Likert scale (1=strongly disagree, 2=disagree, 3=agree, 4=strongly agree): (1) consuming 5 servings of fruits and vegetables, (2) doing tasks needed to manage their chronic condition, (3) following a re…”
MethodSelf-citationMobile-Web App to Self-Manage Low Back Pain: Randomized Controlled Trial
Irvine, A. B., Russell, H., Manocchia, M., Mino, D. E., Glassen, T. C., Morgan, R. L., Gau, J. M., Birney, A. J., & Ary, D. V. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.3130 · Cited by 190 · see citing works
“Other Constructs Patient Activation Measure The Patient Activation Measure (PAM) is a reliable probabilistic scale that assesses activation of patients to take responsibility for their own health [58,59].”
Promise of and potential for patient-facing technologies to enable meaningful use
Ahern, D. K., Woods, S. S., Lightowler, M. C., Finley, S. W., & Houston, T. K. (2011) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2011.01.005 · Cited by 189 · see citing works
eHealth for improving quality of life in breast cancer patients: A systematic review
Triberti, S., Savioni, L., Sebri, V., & Pravettoni, G. (2019) · Cancer Treatment Reviews · doi:10.1016/j.ctrv.2019.01.003 · Cited by 184 · see citing works
Kim, J. Y., Wineinger, N. E., & Steinhubl, S. R. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5429 · Cited by 180 · see citing works
“The Patient Activation Measure (PAM) is one of the tools for measuring an individual’s skills, confidence, and knowledge in managing his or her own health [8,9].”
The Care Transitions Intervention
Voss, R. (2011) · Archives of Internal Medicine · doi:10.1001/archinternmed.2011.278 · Cited by 181 · see citing works
Patient Activation and Adherence to Physical Therapy in Persons Undergoing Spine Surgery
Skolasky, R. L., MacKenzie, E. J., Wegener, S. T., & Riley, L. H. (2008) · Spine · doi:10.1097/brs.0b013e31818027f1 · Cited by 178 · see citing works
“easily changed (immutable) and those that could be changed (mutable).(6) Immutable psychological factors in-”
BackgroundMethodInfluentialSimmons, L. A., Wolever, R. Q., Bechard, E. M., & D, R. S. M. (2014) · Genome Medicine · doi:10.1186/gm533 · Cited by 177 · see citing works
“0%) measured the knowledge, confidence, and skills components of patient engagement using the Patient Activation Measure (PAM) [41], a well-validated instrument.”
BackgroundMethodInfluentialPilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD
Nguyen, H. (2009) · International Journal of Chronic Obstructive Pulmonary Disease · doi:10.2147/copd.s6643 · Cited by 165 · see citing works
Motivational interviewing‐based health coaching as a chronic care intervention
Linden, A., Butterworth, S. W., & Prochaska, J. O. (2010) · Journal of Evaluation in Clinical Practice · doi:10.1111/j.1365-2753.2009.01300.x · Cited by 174 · see citing works
“The non-participant group showed a non-statistically significant increase of 1.17 points on their PAM scores (scored from 0 to 100, with a higher score indicating better patient activation), while the participant group improved by 4.57 points (P = 0.02).”
InfluentialSolomon, M. P., Wagner, S. L., & Goes, J. B. (2012) · Journal of Medical Internet Research · doi:10.2196/jmir.1924 · Cited by 171 · see citing works
“Activated patients strive to understand their conditions, viewing problems as challenges with the confidence that they can be solved [8,19].”
Consumer Competencies and the Use of Comparative Quality Information
Hibbard, J. H., Peters, E. M., Dixon, A., & Tusler, M. (2007) · Medical Care Research and Review · doi:10.1177/1077558707301630 · Cited by 166 · see citing works
“The 13-item measure was created using Rasch methodology (Smith 1996), and it is a unidimensional, interval level, Guttman-like measure (Hibbard et al. 2004, 2005).”
BackgroundMethodInfluentialSelf-citationEneriz-Wiemer, M., Sanders, L., Barr, D. A., & Mendoza, F. (2014) · Academic Pediatrics · doi:10.1016/j.acap.2013.10.003 · Cited by 167 · see citing works
Brenk-Franz, K., Hibbard, J. H., Herrmann, W., Freund, T., Szécsényi, J., Djalali, S., Steurer-Stey, C. A., Sönnichsen, A. C., Tiesler, F., Storch, M., et al. (2013) · PLoS ONE · doi:10.1371/journal.pone.0074786 · Cited by 164 · see citing works
“The Patient Activation Measure (PAM) is a reliable and valid questionnaire that measures patient activation [8].”
BackgroundSelf-citationChronic disease self-management: A hybrid concept analysis
Miller, W. R., Lasiter, S., Ellis, R. J. B., & Buelow, J. M. (2014) · Nursing Outlook · doi:10.1016/j.outlook.2014.07.005 · Cited by 169 · see citing works
Breckenridge, K., Bekker, H. L., Gibbons, E., van der Veer, S. N., Abbott, D., Briançon, S., Cullen, R., Garneata, L., Jager, K., Lønning, K., et al. (2015) · Nephrology, Dialysis and Transplantation · doi:10.1093/ndt/gfv209 · Cited by 150 · see citing works
“• Measures reflecting aspects of patient involvement in their health care, including patient activation [11] and informed and shared decision-making [12].”
BackgroundKumar, P. S., Dwivedi, Y. K., & Anand, A. (2021) · Information Systems Frontiers · doi:10.1007/s10796-021-10136-6 · Cited by 178 · see citing works
Rivet Amico, K. (2011) · Journal of Health Psychology · doi:10.1177/1359105311398727 · Cited by 149 · see citing works
“Focused inquiries on global patient engagement in care, operationalized as timely enrollment, ongoing clinic attendance, frequency of service use, and/or adherence to other aspects of treatment such as medication, diet, and exercise, contribute to a growing recognition that supporting and promoting patient engagement…”
BackgroundGeng, E. H., Odeny, T., Lyamuya, R., Nakiwogga-Muwanga, A., Diero, L. O., Bwana, M., Braitstein, P. K. A., Somi, G. R., Kambugu, A. D., Bukusi, E. A., et al. (2015) · Clinical Infectious Diseases · doi:10.1093/cid/civ1004 · Cited by 162 · see citing works
“Such interventions may also promote potential critical mediators of retention such as treatment literacy and “patient activation” [34, 35].”
BackgroundThe Situation-Specific Theory of Heart Failure Self-care
Riegel, B. J., Dickson, V. V., & Vellone, E. (2022) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000919 · Cited by 176 · see citing works
“98 When studies on patient activation were synthesized in a systematic review of randomized controlled trials, interventions that improved patient activation significantly improved self-care in a variety of other chronic conditions 99 and for a variety of intermediate outcomes such as depression,…”
Public health literacy in America
Gazmararian, J. A., Curran, J. W., Parker, R. M., Bernhardt, J. M., & DeBuono, B. A. (2005) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2004.11.004 · Cited by 160 · see citing works
Alegría, M., Sribney, W., Pérez, D., Laderman, M., & Keefe, K. (2009) · Journal of general internal medicine · doi:10.1007/s11606-009-1074-x · Cited by 167 · see citing works
Patient Activation and 30-Day Post-Discharge Hospital Utilization
Mitchell, S. E., Gardiner, P. M., Sadikova, E., Martin, J. M., Jack, B. W., Hibbard, J. H., & Paasche‐Orlow, M. K. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-013-2647-2 · Cited by 158 · see citing works
“02 Retired 12 (18) 12 (10) 23 (12) 43 (14) 90 (13) Unemployed 17 (26) 36 (30) 54 (29) 70 (23) 177 (26) Employed (Part or Full Time) 11 (17) 35 (29) 58 (31) 122 (39) 226 (33) Been homeless Yes 14 (21) 17 (14) 30 (16) 33 (11) 94 (14) 0.”
Self-citationPatient centered primary care is associated with patient hypertension medication adherence
Roumie, C. L., Greevy, R. A., Wallston, K. A., Elasy, T. A., Kaltenbach, L. A., Kotter, K., Dittus, R. S., & Speroff, T. (2010) · Journal of Behavioral Medicine · doi:10.1007/s10865-010-9304-6 · Cited by 157 · see citing works
“The PAM has high reliability estimates (Cronbach’s a = 0.91) which are stable across health status, gender and age.”
BackgroundMethodInfluentialIrizarry, T., Shoemake, J. D., Nilsen, M. L., Czaja, S. J., Beach, S. R., & Dabbs, A. D. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7099 · Cited by 157 · see citing works
“The raw score is then converted to an overall score ranging from 0-100 using the table provided in PAM licensing materials [25].”
Graffigna, G., Barello, S., & Bonanomi, A. G. (2017) · PLoS ONE · doi:10.1371/journal.pone.0179865 · Cited by 156 · see citing works
Engaging patients through open notes: an evaluation using mixed methods
Esch, T., Mejilla, R., Anselmo, M. K., Podtschaske, B. V., Delbanco, T., & Walker, J. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010034 · Cited by 155 · see citing works
“on engagement and self-care, and each patient completed the patient activation measure (PAM-13) survey.(68) 69 All interviews were conducted in 2014 (February–March) in Greater Boston and were recorded and transcribed verbatim using a transcription service.”
MethodDeen, D., Lu, W.-H., Rothstein, D., Santana, L., & Gold, M. R. (2010) · Patient Education and Counseling · doi:10.1016/j.pec.2010.07.026 · Cited by 152 · see citing works
Kinney, R. L., Lemon, S. C., Person, S. D., Pagoto, S., & Saczynski, J. S. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.02.005 · Cited by 152 · see citing works
“Currently, the Patient Activation Measure (PAM) is the only validated instrument that comprehensively measures the degree to which patients are activated to manage their own health care [22] The PAM, which was developed and refined by Hibbard et al.”
BackgroundHealthcare Task Difficulty Among Older Adults With Multimorbidity
Boyd, C. M., Wolff, J. L., Giovannetti, E. R., Reider, L. M., Weiss, C., Xue, Q., Leff, B. A., Boult, C., Hughes, T. B., & Rand, C. (2014) · Medical Care · doi:10.1097/mlr.0b013e3182a977da · Cited by 150 · see citing works
“HCTD may be addressed in part through targeting patient activation, defined as patients’ knowledge, skills, and confidence for self-management.(13,14) As described in the Chronic Care Model, patient-centered chronic illness care is particularly important when considering complex treatment plans in older adults with mu…”
BackgroundMethod
- Authors
- Hibbard, J. H., Stockard, J., Mahoney, E. R., & Tusler, M.
- Affiliations
- University of Oregon (US)
- Corresponding author
- Hibbard, Judith H.
- Venue
- Health Services Research
- Publisher
- Wiley
- Published
- 2004-06-28
- Volume
- 39
- Issue
- 4p1
- Pages
- 1005-1026
- ISSN
- 0017-9124 (ISSN-L)
- 1475-6773
- PMC
- PMC1361049
- OpenAlex
- W1926404136
- Cited by
- 2,748
- References
- 36
- Citations by year
- 2026: 136 · 2025: 217 · 2024: 227 · 2023: 203 · 2022: 233 · 2021: 235 · 2020: 184 · 2019: 182 · 2018: 186 · 2017: 172 · 2016: 172 · 2015: 147 · 2014: 114 · 2013: 88 · 2012: 65
- FWCI
- 18.98
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Health Services Research (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Scholars' Bank (University of Oregon) (submittedVersion)
- Topics
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Social Sciences › Education › Health Education and Validation
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- Patient Activation Measure, patient activation, psychometric validation, Rasch analysis, scale development, chronic disease, health behavior change, healthcare quality improvement
- MeSH terms
- Adult, Aged, Aged, 80 and over, Chronic Disease, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Outcome and Process Assessment, Health Care, Patient Education as Topic, Patient Participation, Pilot Projects, Primary Prevention, Psychometrics, Surveys and Questionnaires, Time Factors, United States, Reproducibility of Results
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