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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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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 4,490
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×
“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
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
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
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
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
Best Test Design. Rasch Measurement.
Wright, B. D., & Stone, M. H. (1979) · Medical Entomology and Zoology · Cited by 1,975
Wright, B. D., & Masters, G. N. (1982) · ACEReSearch Repository (Australian Council for Educational Research) · Cited by 1,930
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
Research works printed but not linked: 6
- Bandura A., 1991, Adaption, Learning and Affect, 226
- Kahn D. A., 1997, Consensus Methods in Practice Guideline Development, Psychopharmacology Bulletin, 33, 631
- Linacre J. M., 2002, Winsteps Manual
- Smith R. M., 1996, Polytomous Mean‐Square Fit Statistics, Rasch Measurement Transactions, 10, 516
- Winsteps, 2002, Winsteps: Rasch Model Statistical Software
- Wright B. D., 1979, Best Test Design
Cited by
Sorted by citations
Items 101–200 of 1,008
Patient-Centered Digital Health Records and Their Effects on Health Outcomes: Systematic Review
Brands, M. R., Gouw, S. C., Beestrum, M., Cronin, R. M., Fijnvandraat, K., & Badawy, S. M. (2022) · Journal of Medical Internet Research · doi:10.2196/43086 · Cited by 150
“…how much they take action, and if patients are capable of staying on course under stress (eg, measured by the Patient Activation Measure PAM13) [33] • Patient involvement: patients’involvement and participation in treatment decisions, and patients’involvement in sharing information, preparing…”
Captieux, M., Pearce, G., Parke, H. L., Epiphaniou, E., Wild, S., Taylor, S. J. C., & Pinnock, H. (2018) · BMJ Open · doi:10.1136/bmjopen-2018-024262 · Cited by 132
Quality and Cost Analysis of Nurse Staffing, Discharge Preparation, and Postdischarge Utilization
Weiss, M., Yakusheva, O., & Bobay, K. L. (2011) · Health Services Research · doi:10.1111/j.1475-6773.2011.01267.x · Cited by 167
“Patient engagement in self-management is an important part of successful transition to home-based care (Glasgow et al. 2002; Hibbard et al. 2004; Ryan, Aloe, and Mason-Johnson 2009).”
BackgroundSocial support and self‐management behaviour among patients with Type 2 diabetes
Schiøtz, M. L., Bøgelund, M., Almdal, T., Jensen, B. B., & Willaing, I. (2011) · Diabetic Medicine · doi:10.1111/j.1464-5491.2011.03485.x · Cited by 147
Almutairi, N., Hosseinzadeh, H., & Gopaldasani, V. (2020) · Primary Care Diabetes · doi:10.1016/j.pcd.2019.08.009 · Cited by 144
Abernethy, A. P., Herndon, J. E., Wheeler, J. L., Patwardhan, M. B., Shaw, H., Lyerly, H. K., & Weinfurt, K. P. (2008) · Health Services Research · doi:10.1111/j.1475-6773.2008.00887.x · Cited by 141
“Patients today, through models such as consumer-directed health plans, are being asked to play an increasing role in medical decision making (Hibbard et al. 2004).”
BackgroundGreen, C. A., Polen, M. R., Janoff, S. L., Castleton, D. K., Wisdom, J. P., Vuckovic, N. H., Perrin, N., Paulson, R. I., & Oken, S. L. (2008) · Psychiatric Rehabilitation Journal · doi:10.2975/32.1.2008.9.22 · Cited by 139
An integrative collaborative care model for people with mental illness and physical comorbidities
Ee, C., Lake, J., Firth, J., Hargraves, F., de Manincor, M., Meade, T., Marx, W., & Sarris, J. J. (2020) · International Journal of Mental Health Systems · doi:10.1186/s13033-020-00410-6 · Cited by 173
Institute of Medicine (2013) · National Academies Press eBooks · doi:10.17226/13444 · Cited by 170
“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).”
BackgroundConcepts and measures of patient empowerment: a comprehensive review
Cerezo, P. G., Juvé‐Udina, M., & Delgado‐Hito, P. (2016) · Revista da Escola de Enfermagem da USP · doi:10.1590/s0080-623420160000500018 · Cited by 136
“RESULTS Seventeen definitions(7-23) (Chart 1) and seven dimensions(9,14,24-28) of empowerment (Chart 2), and 10 empowerment measures (9,13,24,29-35) (Chart 3) were selected.”
BackgroundGraffigna, G., & Barello, S. (2018) · Patient Preference and Adherence · doi:10.2147/ppa.s145646 · Cited by 139
“The most established definitions and models of engagement 1,15–18 point to the following factors as impacting on the ability of people to be engaged in their health care.”
EHealth Technologies in Inflammatory Bowel Disease: A Systematic Review.
Jackson, B. D., Gray, K., Knowles, S. R., & De Cruz, P. (2016) · Journal of Crohn's and Colitis · doi:10.1093/ecco-jcc/jjw059 · Cited by 126
Patient engagement in hospital health service planning and improvement: a scoping review
Liang, L., Cako, A., Urquhart, R., Straus, S. E., Wodchis, W. P., Baker, G. R., & Gagliardi, A. R. (2018) · BMJ Open · doi:10.1136/bmjopen-2017-018263 · Cited by 145
“Instruments exist to assess patient readiness for PE, for example, the patient activation measure; these could be employed to evaluate the impact of behavioural interventions used to prepare patients for PE.(36) One study only examined the impact of PE on participants and health services; none assessed the impact of P…”
MethodInfluentialEhde, D. M., Elzea, J. L., Verrall, A. M., Gibbons, L. E., Smith, A. E., & Amtmann, D. (2015) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2015.07.015 · Cited by 132
Empowerment of Cancer Survivors Through Information Technology: An Integrative Review
Groen, W. G., Kuijpers, W., Oldenburg, H. S., Wouters, M. W., Aaronson, N. K., & van Harten, W. H. (2015) · Journal of Medical Internet Research · doi:10.2196/jmir.4818 · Cited by 126
“Nine manuscripts described the development and/or psychometric evaluation of a questionnaire on patient empowerment [37-45] and six qualitative studies described patient empowerment of chronic patients [46-51].”
InfluentialDevelopment of the Patient Activation Measure for Mental Health
Green, C. A., Perrin, N., Polen, M. R., Leo, M. C., Hibbard, J. H., & Tusler, M. (2009) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-009-0239-6 · Cited by 133
“Studies also indicate that activation predicts a range of important health-related practices, including self-management (e.g., medication adherence/monitoring, diet, exercise), disease prevention practices (e.g., screenings or immunizations), and health-information seeking (Hibbard et al. 2004).”
Self-citationPatient activation and the use of information to support informed health decisions
Hibbard, J. H. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.07.006 · Cited by 133
Self-citationTranslating Primary Care Practice Climate into Patient Activation
Becker, E. R., & Roblin, D. W. (2008) · Medical Care · doi:10.1097/mlr.0b013e31817919c0 · Cited by 132
“More highly activated patients believe their role in managing their health is important, have the knowledge and confidence to act appropriately, will act to maintain or improve their health, and will adhere to recommended care even when under stress.(25) Supportive interactions between patients and their primary care…”
BackgroundPalmer, N. R., Kent, E. E., Forsythe, L. P., Arora, N. K., Rowland, J. H., Aziz, N. M., Blanch‐Hartigan, D., Oakley-Girvan, I. A., Hamilton, A. S., & Weaver, K. E. (2014) · Journal of Clinical Oncology · doi:10.1200/jco.2014.55.5060 · Cited by 131
Measuring patient empowerment – A systematic review
Pekonen, A., Eloranta, S., Stolt, M., Virolainen, P., & Leino‐Kilpi, H. (2019) · Patient Education and Counseling · doi:10.1016/j.pec.2019.10.019 · Cited by 134
Hibbard, J. H., & Tusler, M. (2007) · Journal of Ambulatory Care Management · doi:10.1097/00004479-200701000-00002 · Cited by 127
Self-citationHoffman, A. S., Volk, R. J., Saarimaki, A., Stirling, C., LI, L. C., Härter, M. C., Kamath, G. R., & Llewellyn‐Thomas, H. A. (2013) · BMC Medical Informatics and Decision Making · doi:10.1186/1472-6947-13-s2-s13 · Cited by 126
“Cognitive psychologists may investigate whether interactive PtDA websites can foster increased patient activation or increased communication with clinicians, surrogate decision makers, and long-distance family members [59,66,67].”
BackgroundShared Decision-Making and Patient Empowerment in Preventive Cardiology
Kambhampati, S., Ashvetiya, T., Stone, N. J., Blumenthal, R. S., & Martin, S. S. (2016) · Current Cardiology Reports · doi:10.1007/s11886-016-0729-6 · Cited by 127
The development and testing of a measure assessing clinician beliefs about patient self‐management
Hibbard, J. H., Collins, P. A., Mahoney, E. R., & Baker, L. H. (2009) · Health Expectations · doi:10.1111/j.1369-7625.2009.00571.x · Cited by 124
Self-citationHarvey, L., Fowles, J. B., Xi, M., & Terry, P. E. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.02.005 · Cited by 123
“Patient activation is defined as an individual’s ability and willingness to take on the role of managing his or her health and health care [3].”
BackgroundBlakemore, A., Hann, M., Howells, K., Panagioti, M., Sidaway, M., Reeves, D., & Bower, P. (2016) · BMC Health Services Research · doi:10.1186/s12913-016-1843-2 · Cited by 122
“Patient activation is defined as how well a patient understands their own role in the healthcare process; and their level of knowledge, skill, and confidence in managing their own health [11].”
BackgroundChinman, M., Oberman, R. S., Hanusa, B. H., Cohen, A. N., Salyers, M. P., Twamley, E. W., & Young, A. S. (2013) · The Journal of Behavioral Health Services & Research · doi:10.1007/s11414-013-9343-1 · Cited by 124
“Patient activation refers to the knowledge, skill, confidence, and attitudes for managing health and treatment.(7) Several studies in medical domains have found that individuals with higher activation are healthier, report a better quality of life, are more satisfied with treatment, and engage in more health care prac…”
BackgroundLiteracy-appropriate educational materials and brief counseling improve diabetes self-management
Wallace, A. S., Seligman, H. K., Davis, T. C., Schillinger, D., Arnold, C. L., Shilliday, B. B., Freburger, J. K., & DeWalt, D. A. (2009) · Patient Education and Counseling · doi:10.1016/j.pec.2008.12.017 · Cited by 129
“A high score on the PAM suggests respondents are aware of, and involved in, preventive actions related to their own care [11,14].”
BackgroundSocial Media in Health — What are the Safety Concerns for Health Consumers?
Lau, A. Y. S., Gabarrón, E., Fernández-Luque, L., & Armayones, M. (2012) · Health Information Management Journal · doi:10.1177/183335831204100204 · Cited by 118
“2006), and the Patient Activation Measure (PAM) (Hibbard et al. 2004), researchers can use these scales to systematically measure consumers’ level of influence (or activation) from accessing social media, and subsequently evaluate the impact on their health behaviours and outcomes (Greene & Hibbard 2011).”
BackgroundHendriks, M. C. P., & Rademakers, J. J. D. J. M. (2014) · BMC Health Services Research · doi:10.1186/1472-6963-14-393 · Cited by 118
“This makes sense given the definition of patient activation; those with a higher activation level report to have more knowledge, skills, confidence and behaviors needed for self-managing one’s condition or health [9,10].”
BackgroundThe Impact of Patient Participation in Health Decisions Within Medical Encounters
Clayman, M. L., Bylund, C. L., Chewning, B. A., & Makoul, G. T. (2015) · Medical Decision Making · doi:10.1177/0272989x15613530 · Cited by 127
Wilson, C. J., Mitchelson, A. J., Tzeng, T. H., El‐Othmani, M. M., Saleh, J., Vasdev, S., LaMontagne, H. J., & Saleh, K. J. (2015) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2015.03.023 · Cited by 120
For the Public's Health: the Role of Measurement in Action and Accountability
Mays, G. P. (2010) · Cited by 120
Can Patients Be Part of the Solution? Views on Their Role in Preventing Medical Errors
Hibbard, J. H., Peters, E. M., Slovic, P., & Tusler, M. (2005) · Medical Care Research and Review · doi:10.1177/1077558705279313 · Cited by 119
Self-citationMaindal, H. T., Sokolowski, I., & Vedsted, P. (2009) · BMC Public Health · doi:10.1186/1471-2458-9-209 · Cited by 119
“In 2004, Hibbard et al defined the concept of being "activated" and developed the Patient Activation Measure (PAM) 22 item and a 13 item short form (PAM13) [3,4].”
BackgroundMethodNurse-led vs. usual-care for atrial fibrillation
Wijtvliet, P., Tieleman, R. G., Gelder, I. C. V., Pluymaekers, N. A. H. A., Rienstra, M., Folkeringa, R., Bronzwaer, P. N. A., Elvan, A., Elders, J., Tukkie, R., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz666 · Cited by 118
Telehealth by an Interprofessional Team in Patients With CKD: A Randomized Controlled Trial
Ishani, A., Christopher, J., Palmer, D., Otterness, S., Clothier, B. A., Nugent, S. M., Nelson, D. B., Rosenberg, M. E., Atwood, M. A., Bangerter, A. K., et al. (2016) · American Journal of Kidney Diseases · doi:10.1053/j.ajkd.2016.01.018 · Cited by 124
Patient perceptions of receiving test results via online portals: a mixed-methods study
Giardina, T. D., Baldwin, J. L., Nystrom, D. T., Sittig, D. F., & Singh, H. (2017) · Journal of the American Medical Informatics Association · doi:10.1093/jamia/ocx140 · Cited by 117
van den Bemt, B. J. F., Gettings, L., Domańska, B., Bruggraber, R., Mountian, I., & Kristensen, L. E. (2019) · Drug Delivery · doi:10.1080/10717544.2019.1587043 · Cited by 117
“PAM is a measure of how ‘activated’ a patient is and is a reliable indicator of the level of patient knowledge and confidence regarding their own health and care (Hibbard et al., 2004).”
BackgroundAgarwal, R., Anderson, C. L., Zarate, J., & Ward, C. (2013) · Journal of Medical Internet Research · doi:10.2196/jmir.2243 · Cited by 116
“especially salient in the context of PHR adoption are patients’ satisfaction with their health care provider [32-35] and the extent to which patients believe they are in control of their own health care (ie, patient activation) [36-38].”
BackgroundInfluentialStepleman, L. M., Goodworth, M.-C. R., Hibbard, J. H., Johns, L., Wright, D. E., & Hughes, M. D. (2010) · Disability and Rehabilitation · doi:10.3109/09638280903567885 · Cited by 114
“The PAM was initially validated on a randomly selected national probability sample of 1515 participants 45 years or older [8], but has since been utilised with other populations, including persons with chronic illness (e.”
BackgroundMethodInfluentialSelf-citationGraffigna, G., Barello, S., Libreri, C., & Bosio, A. C. (2014) · BMC Public Health · doi:10.1186/1471-2458-14-648 · Cited by 112
“Additionally, other scholars define patient engagement in terms of level of “activation”, by defining an engaged patient as “an active agent in the management of his/her own health, including developmental stages “of 1) believing the patient role is important, 2) having the confidence and knowledge necessary to take a…”
BackgroundBegum, N., Donald, M., Ozolins, I., & Dower, J. (2011) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2011.05.031 · Cited by 112
“assesses a person’s beliefs about, motivation for, and action for self-care [21].”
BackgroundBarker, I., Steventon, A., Williamson, R., & Deeny, S. R. (2018) · BMJ Quality & Safety · doi:10.1136/bmjqs-2017-007635 · Cited by 112
Patient Activation and Improved Outcomes in HIV-Infected Patients
Marshall, R., Beach, M. C., Saha, S. S., Mori, T., Loveless, M. O., Hibbard, J. H., Cohn, J. A., Sharp, V., & Korthuis, P. T. (2013) · Journal of General Internal Medicine · doi:10.1007/s11606-012-2307-y · Cited by 121
“A patient’s stage of activation can be identified by their PAM score; each stage corresponds to a range of knowledge levels and health-related behaviors.(2) Patient activation can change;(3) moreover, evidence indicates that targeted behavior-change interventions can increase activation levels(4) and may improve healt…”
BackgroundInfluentialSelf-citationEvolving to a new service-dominant logic for health care
Joiner, K., & Lusch, R. F. (2016) · Innovation and Entrepreneurship in Health · doi:10.2147/ieh.s93473 · Cited by 125
Racial/Ethnic Disparities And Consumer Activation In Health
Hibbard, J. H., Greene, J., Becker, E. R., Roblin, D. W., Painter, M. W., Pérez, D. J., Burbank-Schmitt, E., & Tusler, M. (2008) · Health Affairs · doi:10.1377/hlthaff.27.5.1442 · Cited by 109
Self-citationAndrawis, J. P., Akhavan, S., Chan, V., Lehil, M. S., Pong, D., & Bozic, K. J. (2015) · Clinical Orthopaedics and Related Research · doi:10.1007/s11999-015-4247-4 · Cited by 109
“with key clinical indicators, such as overall health status and self-management behaviors [18].”
BackgroundMethodMultimorbidity and Decision-Making Preferences Among Older Adults
Chi, W. C., Wolff, J. L., Greer, R. C., & Dy, S. M. (2017) · The Annals of Family Medicine · doi:10.1370/afm.2106 · Cited by 108
KING, J. A. C., O'Neill, B. M., Ramsay, P., Linden, M., Medniuk, A. D., Outtrim, J. G., & Blackwood, B. (2019) · Critical Care · doi:10.1186/s13054-019-2441-6 · Cited by 112
“While there are various methods for assessing aspects of activation, such as self-efficacy [59], health locus of control [60] and readiness to change [61], they focus on predicting single behaviours rather than the broader elements such as knowledge, skills, beliefs and motivation that a patient needs to manage a chro…”
MethodZhao, Y. C., Zhao, M., & Song, S. (2022) · Journal of Medical Internet Research · doi:10.2196/42447 · Cited by 111
“Patients with chronic conditions have long-term health management demands; thus, many health experts call for patient activation, an ideal state wherein patients know how to manage their conditions, keep functioning, and prevent health declines [13].”
Patient activation, depression and quality of life
Magnezi, R., Glasser, S., Shalev, H., Sheiber, A., & Reuveni, H. (2014) · Patient Education and Counseling · doi:10.1016/j.pec.2013.10.015 · Cited by 107
“, knowledge, skill and confidence, in managing chronic health conditions which he/she may have [1,19].”
BackgroundMorgan, H. M., Entwistle, V. A., Cribb, A., Christmas, S., Owens, J., Skea, Z. C., & Watt, I. S. (2016) · Health Expectations · doi:10.1111/hex.12453 · Cited by 107
Carman, K. L., & Workman, T. A. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.07.009 · Cited by 107
Choudhry, N. K., Isaac, T., Lauffenburger, J. C., Gopalakrishnan, C., Lee, M., Vachon, A., Iliadis, T. L., Hollands, W., Elman, S., Kraft, J. M., et al. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.3189 · Cited by 107
Does patient activation level affect the cancer patient journey?
Hibbard, J. H., Mahoney, E. R., & Sonet, E. M. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.03.019 · Cited by 107
“Patients are categorized into four levels of activation which have been previously validated, representing progression from a passive care recipient (level one) to patients who are more proactive in managing their health (level four) [1,2].”
BackgroundSelf-citationSteffens, N. M., Tucholka, J. L., Nabozny, M. J., Schmick, A. E., Brasel, K. J., & Schwarze, M. L. (2016) · JAMA Surgery · doi:10.1001/jamasurg.2016.1308 · Cited by 104
A Framework for Describing Health Care Delivery Organizations and Systems
Piña, I. L., Cohen, P. D., Larson, D. B., Marion, L. N., Sills, M. R., Solberg, L. I., & Zerzan, J. T. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.301926 · Cited by 103
Beyond Reading and Understanding: Health Literacy as the Capacity to Act
Rademakers, J. J. D. J. M., & Heijmans, M. (2018) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph15081676 · Cited by 103
“Apart from the ‘official’ health literacy instruments, the Patient Activation Measure (PAM) also measures knowledge, skills, and self-confidence in dealing with one’s own health, (chronic) illness, and healthcare [6].”
BackgroundRobert, G., Locock, L., Williams, O., Cornwell, J., Donetto, S., & Goodrich, J. (2022) · Cambridge University Press eBooks · doi:10.1017/9781009237024 · Cited by 114
Innovation by patients with rare diseases and chronic needs
Oliveira, P., Zejnilović, L., Canhão, H. M., & von Hippel, E. (2015) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-015-0257-2 · Cited by 101
“An increasing stream of literature argues for a more prominent role of patients and caregivers in healthcare delivery [11-14].”
BackgroundMoljord, I. E. O., Lara‐Cabrera, M. L., Perestelo‐Pérez, L., Rivero‐Santana, A., Eriksen, L., & Linaker, O. M. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.06.009 · Cited by 100
“Patient activation specifies the level of patients’ engagement [1,2] and may contribute to better self-management [3], higher engagement in”
BackgroundMethodInfluentialPatient Engagement A Consumer-Centered Model to Innovate Healthcare
Graffigna, G., Barello, S., & Triberti, S. (2015) · doi:10.1515/9783110452440 · Cited by 102
Shortell, S. M., Poon, B. Y., Ramsay, P. P., Rodríguez, H. P., Ivey, S. L., Huber, T., Rich, J., & Summerfelt, T. (2017) · Journal of General Internal Medicine · doi:10.1007/s11606-016-3980-z · Cited by 107
Lubetkin, E. I., Lu, W.-H., & Gold, M. R. (2010) · Journal of Health Care for the Poor and Underserved · doi:10.1353/hpu.0.0350 · Cited by 99
Henselmans, I., Heijmans, M., Rademakers, J. J. D. J. M., & van Dulmen, S. (2014) · Health Expectations · doi:10.1111/hex.12206 · Cited by 99
Almalki, M., Gray, K. M., & Martin-Sanchez, F. J. (2015) · Health Information Science and Systems · doi:10.1186/2047-2501-3-s1-s1 · Cited by 100
“In this model, the self-activation activity refers to the concept of taking a more active role in managing one’s health through having three key components: beliefs, knowledge, and, skills [10].”
BackgroundImproving Confidence for Self Care in Patients with Depression and Chronic Illnesses
Ludman, E. J., Peterson, D., Katon, W. J., Lin, E. H. B., Korff, M. V., Ciechanowski, P. S., Young, B. A., & Gensichen, J. S. (2013) · Behavioral Medicine · doi:10.1080/08964289.2012.708682 · Cited by 111
Activating Seniors to Improve Chronic Disease Care: Results from a Pilot Intervention Study
Frosch, D. L., Rincon, D., Ochoa, S., & Mangione, C. M. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.02980.x · Cited by 97
Disparities in Electronic Health Record Patient Portal Use in Nephrology Clinics
Jhamb, M., Cavanaugh, K. L., Bian, A., Chen, G., Ikizler, T. A., Unruh, M. L., & Abdel-Kader, K. F. M. (2015) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01640215 · Cited by 102
Care Coordination for the Chronically Ill: Understanding the Patient's Perspective
Maeng, D. D., Martsolf, G. R., Scanlon, D. P., & Christianson, J. B. (2012) · Health Services Research · doi:10.1111/j.1475-6773.2012.01405.x · Cited by 97
“They know how to manage their condition and maintain functioning and prevent health declines; and they have the skills and behavioral repertoire to manage their condition, collaborate with their health providers, maintain their health functioning, and access appropriate and high-quality care” (Hibbard et al. 2004).”
BackgroundMethodInfluentialPatient-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) · Cited by 96
Does patient activation predict the course of type 2 diabetes? A longitudinal study
Sacks, R. M., Greene, J., Hibbard, J. H., Overton, V., & Parrotta, C. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.01.014 · Cited by 96
“Patients are then categorized into four levels of activation which have been previously validated, representing progression from a passive care recipient (level one) to a patient in great control of his or her own health (level four) [30].”
Self-citationBhise, V., Meyer, A. N. D., Menon, S., Singhal, G., Street, R. L., Giardina, T. D., & Singh, H. (2017) · International Journal for Quality in Health Care · doi:10.1093/intqhc/mzx170 · Cited by 96
“A PAM Score was calculated for each parent participant using the materials received from Insignia Health© regarding the use of parent PAM-10.”
MethodPeer support for people with schizophrenia or other serious mental illness
Chien, W. T., Clifton, A., Zhao, S., & Lui, S. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010880.pub2 · Cited by 95
Russo, S., Jongerius, C., Faccio, F., Pizzoli, S. F. M., Pinto, C. A., Veldwijk, J., Janssens, R., Simons, G., Falahee, M., de Bekker-Grob, E. W., et al. (2019) · Value in Health · doi:10.1016/j.jval.2018.12.007 · Cited by 98
Greene, J., Hibbard, J. H., Alvarez, C., & Overton, V. (2016) · The Annals of Family Medicine · doi:10.1370/afm.1904 · Cited by 95
Self-citationA Narrative Review of Patient and Family Engagement
Cené, C. W., Johnson, B., Wells, N., Baker, B., Davis, R., & Turchi, R. M. (2016) · Medical Care · doi:10.1097/mlr.0000000000000548 · Cited by 95
How do People with Different Levels of Activation Self-Manage their Chronic Conditions?
Dixon, A., Hibbard, J. H., & Tusler, M. (2009) · Patient · doi:10.2165/11313790-000000000-00000 · Cited by 93
Self-citationMultimorbidity in people with chronic kidney disease
Fraser, S. D., & Taal, M. W. (2016) · Current Opinion in Nephrology & Hypertension · doi:10.1097/mnh.0000000000000270 · Cited by 93
“Patient activation includes the patient-held belief that an active role is important, having the confidence and knowledge to take action, actually taking action and maintaining changes in the face of stress [32].”
BackgroundInpatient Portals for Hospitalized Patients and Caregivers: A Systematic Review
Kelly, M. M., Coller, R. J., & Hoonakker, P. (2017) · Journal of Hospital Medicine · doi:10.12788/jhm.2894 · Cited by 95
Impact of a Wellness Portal on the Delivery of Patient-Centered Preventive Care
Nagykaldi, Z. J., ASPY, C. B., Chou, A. F., & Mold, J. W. (2012) · The Journal of the American Board of Family Medicine · doi:10.3122/jabfm.2012.02.110130 · Cited by 93
“Patient activation was assessed using an adapted Patient Activation Measure (PAM) questionnaire.(10) The shorter form of the PAM instrument included 13 items in 3 subscales, measuring patient knowledge, confidence, and skills that demonstrate selfefficacy.”
MethodSkrepnik, N., Spitzer, A., Altman, R., Hoekstra, J., Stewart, J., & Toselli, R. (2017) · JMIR mHealth and uHealth · doi:10.2196/mhealth.7179 · Cited by 88
“As a result, the concept of activation can be useful for evaluating interventions and for tailoring care plans for individual patients in a clinical setting [30,31].”
The Role of Engagement in Teleneurorehabilitation: A Systematic Review
Matamala-Gomez, M., Maisto, M., Montana, J. I., Mavrodiev, P. A., Baglio, F., Rossetto, F., Mantovani, F., Riva, G., & Realdon, O. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00354 · Cited by 100
“created the patient activation measure (PAM) to assess patient activation (23).”
BackgroundInfluentialWhat Works Best to Engage Participants in Mobile App Interventions and e-Health: A Scoping Review
Oakley-Girvan, I., Yunis, R., Longmire, M., & Ouillon, J. S. (2022) · Telemedicine and e-Health · doi:10.1089/tmj.2021.0176 · Cited by 92
Using Systematic Measurement to Target Consumer Activation Strategies
Hibbard, J. H. (2008) · Medical Care Research and Review · doi:10.1177/1077558708326969 · Cited by 92
“While previous studies have shown that the PAM scores are predictive of a range of behaviors ( Hibbard et al., 2004, 2005 ), the mapping of behaviors into different levels of activation, as presented here, is a new approach to using the measure.”
BackgroundResultSelf-citationDevelopment and Validation of the Consumer Health Activation Index
Wolf, M. S., Smith, S. G., Pandit, A. U., Condon, D. M., Curtis, L. M., Griffith, J. W., O’Conor, R. M., Rush, S. R., Bailey, S. C., Kaplan, G. D., et al. (2018) · Medical Decision Making · doi:10.1177/0272989x17753392 · Cited by 91
Patient-Clinician Communication About Pain: A Conceptual Model and Narrative Review
Henry, S. G., & Matthias, M. S. (2018) · Pain Medicine · doi:10.1093/pm/pny003 · Cited by 90
Patient and Citizen Participation in Health: The Need for Improved Ethical Support
Williamson, L. (2014) · The American Journal of Bioethics · doi:10.1080/15265161.2014.900139 · Cited by 91
“Different terminology is used to describe participation efforts: patient and public involvement (PPI), lay participation, consumer activation, and citizen engagement (British Medical Association [BMA] 2011; Carpini, Cook, and Jacobs 2004; Charles and DeMaio 1993; Hibbard et al. 2004).”
BackgroundGoldberg, R. W., Dickerson, F., Lucksted, A. A., Brown, C. H., Weber, E., Tenhula, W. N., Kreyenbuhl, J. A., & Dixon, L. B. (2013) · Psychiatric Services · doi:10.1176/appi.ps.201200034 · Cited by 90
“The 13-item Patient Activation Scale (29) reflects an individual’s perceived ability to manage his or her illness and to act as an effective patient.”
BackgroundPeer Coaches to Improve Diabetes Outcomes in Rural Alabama: A Cluster Randomized Trial
Safford, M. M., Andreae, S., Cherrington, A., Martin, M. Y., Halanych, J. H., Lewis, M., Patel, A. J., Johnson, E., Clark, D. G., Gamboa, C. M., et al. (2015) · The Annals of Family Medicine · doi:10.1370/afm.1798 · Cited by 94
Grosberg, D., Fogel‐Grinvald, H., Reuveni, H., & Magnezi, R. (2016) · Journal of Medical Internet Research · doi:10.2196/jmir.5832 · Cited by 90
“This is consistent with the literature on patient activation and the assumption that consumers will make more prudent health and health care choices and will increase their “activation” when they are given relevant and quality information [9].”
Moore, S. M., Schiffman, R. F., Waldrop‐Valverde, D., Redeker, N. S., McCloskey, D. J., Kim, M. T., Heitkemper, M. M., Guthrie, B. J., Dorsey, S. G., Docherty, S. L., et al. (2016) · Journal of Nursing Scholarship · doi:10.1111/jnu.12233 · Cited by 89
“We recommend that activation be measured using the 10-item Patient Activation Measure® (PAM®; Hibbard et al., 2004), a self-report scale that predicts self-management behaviors, including selfmonitoring, goal setting, medication management, health information seeking, and healthy living behaviors (e.g., healthy diet a…”
MethodInfluentialParry, C., Kramer, H. M., & Coleman, E. A. (2006) · Home Health Care Services Quarterly · doi:10.1300/j027v25n03_03 · Cited by 89
“…believe in the notion that the patient is a critical component of the health care team, and who have the skills and knowledge to “manage their condition, collaborate with health providers, maintain their health functioning, and access appropriate and high-quality care” (Hibbard et al. 2004, 1010).”
BackgroundGreene, J., Hibbard, J. H., Sacks, R. M., & Overton, V. (2013) · Health Affairs · doi:10.1377/hlthaff.2012.1409 · Cited by 88
Self-citationOnline support group use and psychological health for individuals living with HIV/AIDS
Mo, P. K. H., & Coulson, N. (2013) · Patient Education and Counseling · doi:10.1016/j.pec.2013.04.004 · Cited by 93
“Empowered patients are considered to be more successful in managing their illness, collaborating with their health providers, and maintaining their health [18].”
BackgroundReliability and validity of the patient activation measure in hospitalized patients
Prey, J. E., Qian, M., Restaino, S. W., Hibbard, J. H., Henry, S. B., Schnall, R., Rothenberg, G., Vawdrey, D. K., & Creber, R. M. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.06.029 · Cited by 88
“The PAM-13 also describes the extent to which patients are informed and involved in their healthcare [6].”
BackgroundSelf-citationThomas, E. E., Spittal, M. J., Taxman, F. S., & Kinner, S. A. (2015) · Health & Justice · doi:10.1186/s40352-015-0022-6 · Cited by 88
“We measured health involvement using a patient activation scale (Hibbard et al. 2004) and two survey items indicating the importance to the participant of maintaining his/her physical or mental health after release.”
InfluentialGroene, O., Klazinga, N., Wagner, C., Arah, O. A., Thompson, A. G. H., Bruneau, C., & Suñol, R. (2010) · BMC Health Services Research · doi:10.1186/1472-6963-10-281 · Cited by 87
“Patient involvement will be assessed using a combination of existing patient surveys, drawing on existing measures of patient-centredness, shared-decision making and discharge preparation [42-46].”
Theiss, L. M., Wood, T. E., McLeod, M. C., Shao, C. C., Marques, I. C. D. S., Bajpai, S., Lopez, E., Duong, A. M., Hollis, R. H., Morris, M. S., et al. (2021) · The American Journal of Surgery · doi:10.1016/j.amjsurg.2021.10.024 · Cited by 87
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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