The DOI matches its Crossref record; 36 of the 36 references it cites were found in a registry or an index.
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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“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]
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Beiwinkel, T., Hey, S., Bock, O., & Rössler, W. (2017) · Frontiers in Public Health · doi:10.3389/fpubh.2017.00249 · Cited by 15
“The PAM rates the agreement to 13 items on a 4-point scale (89).”
BackgroundRathert, C., Mittler, J. N., Vogus, T. J., & Lee, Y. S. H. (2023) · Social Science & Medicine · doi:10.1016/j.socscimed.2023.116290 · Cited by 12
Skott, M., Durbeej, N., Smitmanis-Lyle, M., Hellner, C., Allenius, E., Salomonsson, S., Lundgren, T., Jayaram-Lindström, N., & Rozental, A. (2021) · BMC Health Services Research · doi:10.1186/s12913-021-06617-8 · Cited by 12
“, knowledge, skill, and confidence in self-management [23], the Recovery Assessment Scale, i.”
Backgroundde Leon, E. B., Campos, H. L. M., Santos, N. B., Brito, F. A., & Almeida, F. A. (2024) · BMC Health Services Research · doi:10.1186/s12913-023-10529-0 · Cited by 8
“Patient activation refers to one’s internal readiness and capabilities to undertake health-promoting actions [9].”
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Arnautovska, U., Ritchie, G., Soole, R., Menon, A., Korman, N., Milton, A., Varnfield, M., Kelly, J., Jansen, P., Baker, A., et al. (2025) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s513272 · Cited by 7
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Lipsett, M., & Berkman, E. (2025) · Health Psychology · doi:10.1037/hea0001434 · Cited by 3
“self-management activation was evaluated using the modi fi ed four-item Brief Patient Activation Measure, assessing patient-reported knowledge for self-managing health or chronic conditions (Hibbard et al., 2004).”
Metadata
- 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
- Health Sciences › Nursing › Research and Theory › 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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