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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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Pyatak, E. A., Carandang, K. M., Collins, C. R., & Carlson, M. E. (2022) · American Journal of Occupational Therapy · doi:10.5014/ajot.2022.049269 · Cited by 53
“…[COPM]; Law et al., 2019), overall health status (e.g., 12-item Short-Form Health Survey [Jenkinson & Layte, 1997], EuroQol – 5D [Herdman et al., 2011]), and health management capability (e.g., Patient Activation Measure [Hibbard et al., 2004]; Pain Self-Efficacy Questionnaire [Nicholas, 2007]).”
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“Study participants voluntarily filled out the Patient Activation Measure (PAM) assessing four stages of “activation” as measured by whether patients (1) believe that their role is important; (2) have the confidence and knowledge necessary to take action; (3) are taking action to maintain and improve one’s health; and…”
MethodPsychometric Properties of the Hebrew Translation of the Patient Activation Measure (PAM-13)
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“Patient activation was assessed using six items, similar to the Patient Activation Measure by Hibbard et al. (2004).”
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Don't Blame Patients, Engage Them: Transforming Health Systems to Address Health Literacy
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“The Patient Activation Measure (PAM) assessed “activation,” which reflects a patient’s level of engagement and empowerment in their health care.(23) Clinical, surgical, and health care resource use outcomes were obtained through a review of electronic medical chart records.”
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“Scores on the Patient Activation Measure (PAM), developed to measure a patient’s knowledge, skills, and confidence for self-management (Hibbard et al., 2004; Hibbard et al., 2005), have been associated with better self-management behaviors, healthcare utilization, and outcomes.”
BackgroundEvangelista, L. S., Liao, S. S., Motie, M., Michelis, N. D., & Lombardo, D. M. (2014) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515114520766 · Cited by 48
Multilevel Research and the Challenges of Implementing Genomic Medicine
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“Patient–provider health communication and patient-centered health technologies can enhance productive encounters between activated patients (47) and proactive provider teams (48,49).”
BackgroundLara‐Cabrera, M. L., Salvesen, Ø. O., Nesset, M. B., Cuevas, C. D. L., Iversen, V. C., & Gråwe, R. W. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.028 · Cited by 48
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Edbrooke-Childs, J., Edridge, C., Averill, P., Delane, L., Hollis, C., Craven, M. P., Martin, K., Feltham, A., Jeremy, G., Deighton, J., et al. (2019) · JMIR mHealth and uHealth · doi:10.2196/11677 · Cited by 39
“Study measures included (1) the Patient Activation Measure [4] to assess young people’s empowerment and self-management of their mental health and well-being, (2) the CollaboRATE [38] and the Shared Decision Making Questionnaire 9 [39] to assess shared decision making, (3) the Youth Empowerment…”
InfluentialActivating people to partner in health and self‐care: use of the Patient Activation Measure
Janamian, T., Greco, M. J., Cosgriff, D., Baker, L., & Dawda, P. (2022) · The Medical Journal of Australia · doi:10.5694/mja2.51535 · Cited by 47
Munce, S., Fehlings, M. G., Straus, S. E., Nugaeva, N., Jang, E., Webster, F., & Jaglal, S. B. (2014) · BMC Neurology · doi:10.1186/s12883-014-0209-9 · Cited by 47
Survivorship navigation outcome measures
Pratt‐Chapman, M. L., Simon, M. A., Patterson, A. K., Risendal, B., & Patierno, S. R. (2011) · Cancer · doi:10.1002/cncr.26261 · Cited by 47
Battersby, M., Harris, M., Smith, D., Reed, R. L., & Woodman, R. J. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.06.003 · Cited by 47
“Other scales are available [47,48] but the advantage of the PIH is that it can serve as a self-management risk screening tool and an outcome measure of change over time.”
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Which consumers are ready for consumer-directed health plans?
Greene, J., Hibbard, J. H., Dixon, A., & Tusler, M. (2006) · Journal of Consumer Policy · doi:10.1007/s10603-006-9008-z · Cited by 46
“The first measure is the Patient Activation Measure, which was recently developed to assess the extent of an individual’s knowledge, skills, beliefs, and confidence in managing his or her health conditions (Hibbard, Mahoney, Stockard, & Tusler, 2005; Hibbard, Stockard, Mahoney, & Tusler, 2004 ).”
BackgroundSelf-citationReligiosity and Patient Activation Among Hospital Survivors of an Acute Coronary Syndrome
Abu, H. O., McManus, D. D., Kiefe, C. I., & Goldberg, R. J. (2019) · Journal of General Internal Medicine · doi:10.1007/s11606-019-05345-4 · Cited by 46
Alsadaan, N., Ramadan, O. M. E., & Alqahtani, M. (2024) · BMC Nursing · doi:10.1186/s12912-024-01996-9 · Cited by 51
“…managing their health but might require assistance; 56–72 signifying high activation, with patients being comfortable in taking an active role in managing their health; and 73–100 representing very high activation, wherein patients are highly confident and skilled in managing their health [65].”
BackgroundDevelopment and evaluation of a nurse-led, tailored stroke self-management intervention
Kidd, L., Lawrence, M., Booth, J., Rowat, A. M., & Russell, S. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-1021-y · Cited by 46
“The use of the concept of ‘patient activation’, as measured using the Patient Activation Measure (PAM) (described more in Table 1), developed by Judith Hibbard and colleagues [23] in this way is relatively new in the UK [20].”
BackgroundMethodCarta, M. G., Moro, M. F., Lorefice, L., Picardi, A., Trincas, G., Fenu, G., Cocco, E. E., Floris, F., Bessonov, D., Akiskal, H. S., et al. (2014) · Journal of Affective Disorders · doi:10.1016/j.jad.2014.05.024 · Cited by 47
“Activation has been described as a developmental process in which people move from a state of very little understanding of their condition and taking little or no active role in their own health-care management to a state of understanding the disease and taking an active role in their own care (Hibbard et al., 2004).”
BackgroundPalermo, T. M., Zempsky, W. T., Dampier, C., Lalloo, C., Hundert, A. S., Murphy, L. K., Bakshi, N., & Stinson, J. (2018) · Contemporary Clinical Trials · doi:10.1016/j.cct.2018.10.006 · Cited by 51
“—Process measures include iCanCope program usage; the Multidimensional Scale of Perceived Social Support (MSPSS) (36) to assess social support from family, friends, and significant others; the Patient Activation Measure (PAM) (37) to assess the ability to self-manage illness; the Sickle Cell Self-Efficacy Scale (SCES)…”
MethodKnudsen, M. V., Petersen, A. K., Angel, S., Hjortdal, V. E., Maindal, H. T., & Laustsen, S. (2019) · European Journal of Cardiovascular Nursing · doi:10.1177/1474515119885325 · Cited by 46
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“The outcome measures (SE Scale, heiQ, PAM, HAQ, pain, fatigue, and CES-D) were scored, and pre-and postintervention differences were calculated.”
BackgroundInfluentialEducational Inequalities in Health Behaviors at Midlife
Clouston, S., Richards, M., Cadar, D., & Hofer, S. M. (2015) · Journal of Health and Social Behavior · doi:10.1177/0022146515594188 · Cited by 48
“…perhaps suggesting that researchers examining “personal” resources focus more clearly on noncognitive capabilities, including the personal interest in confidently taking action to improve or maintain good health behaviors when self-managing health (e.g., “activation”; Hibbard et al. 2004).”
BackgroundFriedman, A. B., Asthana, A. K., Knowles, S. R., Robbins, A., & Gibson, P. R. (2021) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.16452 · Cited by 45
“Occasionally active, giving me symptoms 1– 2 days/month 11 (22) 20 (18) 3 (14) 12 (17)”
BackgroundRanjbaran, S., Shojaeizadeh, D., Dehdari, T., Yaseri, M., & Shakibazadeh, E. (2022) · Diabetology & Metabolic Syndrome · doi:10.1186/s13098-021-00773-x · Cited by 45
“Active patients are people who have the knowledge, skills and confidence to manage their health [15].”
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“In particular, we drew from three relevant tenets underlying Hibbard et al.’s Patient Activation Measure.38,39 First, we aim to enable patients’ awareness of their therapies to support their engagement in activities that maintain functioning.”
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Lindsay, A., Hibbard, J. H., Boothroyd, D. B., Glaseroff, A., & Asch, S. M. (2018) · Journal of General Internal Medicine · doi:10.1007/s11606-018-4657-6 · Cited by 52
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Engaged patients, engaged partnerships: singles and partners dealing with an acute cardiac event
Bertoni, A., Donato, S., Graffigna, G., Barello, S., & Parise, M. (2014) · Psychology Health & Medicine · doi:10.1080/13548506.2014.969746 · Cited by 44
Coffey, J. D., Christopherson, L. A., Williams, R. D., Gathje, S. R., Bell, S. J., Pahl, D. F., Manka, L., Blegen, R. N., Maniaci, M. J., Ommen, S. R., et al. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.1052408 · Cited by 44
“Patients also complete the Patient Activation Measure questionnaire (PAM) (64) at baseline, 30-, 90- and 180-days, as well as receive a patient experience survey after graduating from the program.”
MethodRefahi, H., Klein, M., & Feigerlová, E. (2022) · Telemedicine Journal and e-Health · doi:10.1089/tmj.2022.0115 · Cited by 44
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“Hibbard, Stockard, Mahoney, and Tusler (2004) have developed a conception of “ patient activation ” that involves four primary elements which can be viewed as markers for its development: “ beliefs about the importance of the patient role, ” “ confidence and knowledge, ” “ taking action, ” and “…”
BackgroundInfluentialDeterminants of patient activation in a community sample of breast and prostate cancer survivors
O’Malley, D. M., Dewan, A. A., Ohman‐Strickland, P., Gundersen, D. A., Miller, S. M., & Hudson, S. V. (2017) · Psycho-Oncology · doi:10.1002/pon.4387 · Cited by 45
Jo, S., & Nabatchi, T. (2018) · Public Management Review · doi:10.1080/14719037.2018.1487577 · Cited by 47
“The PAM assesses individuals’ ‘knowledge, skills and confidence for managing their own health’ (Hibbard et al. 2004).”
BackgroundInfluentialvan Vugt, H. A., Boels, A. M., de Weerdt, I., de Koning, E. J. P., & Rutten, G. E. H. M. (2018) · Patient Preference and Adherence · doi:10.2147/ppa.s188391 · Cited by 44
“…patient activation reflects a person’s internal motivation and ability to engage in health-promoting behavior, an external factor such as insulin therapy may not alter a person’s knowledge, motivation, skills and confidence; 7 insulin therapy and patient activation could therefore be unrelated.”
Self-management program improves participation in patients with neuromuscular disease
Veenhuizen, Y., Cup, E. H. C., Jonker, M. A., Voet, N. B. M., van Keulen, B. J., Maas, D. M., Heeren, A., Groothuis, J. T., van Engelen, B. G. M., & Geurts, A. C. H. (2019) · Neurology · doi:10.1212/wnl.0000000000008393 · Cited by 44
“As there is no cure for most NMD, interventions aim to influence fatigue-related factors to increase participation.(3) Research has demonstrated that aerobic exercise training (AET) alleviates chronic fatigue in facioscapulohumeral dystrophy (FSHD)(4) and mitochondrial myopathies (MM).”
Hosseinzadeh, H., Verma, I., & Gopaldasani, V. (2020) · Australian Journal of Primary Health · doi:10.1071/py19204 · Cited by 44
Ypinga, J. H. L., van Halteren, A. D., Henderson, E. J., Bloem, B. R., Smink, A. J., Tenison, E., Munneke, M., Ben‐Shlomo, Y., & Darweesh, S. K. L. (2021) · BMC Neurology · doi:10.1186/s12883-021-02308-3 · Cited by 45
“Hibbard, J.H., et al., Development of the Patient Activation Measure (PAM): conceptualizing and measuring activation in patients and consumers.”
InfluentialDanis, M., & Solomon, M. (2013) · Health Affairs · doi:10.1377/hlthaff.2012.1081 · Cited by 40
Loukanova, S., Molnar, R., & Bridges, J. F. P. (2007) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/14737167.7.3.281 · Cited by 44
Moreno‐Chico, C., Paz, L. G., Monforte‐Royo, C., Arrighi, E., Navarro-Rubio, M. D., & Fernández-Puebla, A. G. (2017) · Family Practice · doi:10.1093/fampra/cmx022 · Cited by 43
“A key concept is patient activation, which refers to people’s knowledge, skills and confidence for self-management of their health and health care (3).”
BackgroundUhrig, J. D., Lewis, M. A., Bann, C., Harris, J. L., Furberg, R., Coomes, C. M., & Kuhns, L. M. (2012) · Journal of Health Communication · doi:10.1080/10810730.2011.649156 · Cited by 45
“, 2000; Tang & Pillay, 2004), patient involvement or activation (Greenfield et al., 1988; Hibbard et al., 2004; Lerman et al., 1990), reduction of risk behaviors (Coleman et al.”
BackgroundThe Internet Diabetes Self-Management Workshop for American Indians and Alaska Natives
Jernigan, V. B. B., & Lorig, K. R. (2010) · Health Promotion Practice · doi:10.1177/1524839909335178 · Cited by 45
“The Patient Activation Measure (PAM) is an assessment tool that measures the broad range of elements involved in patient activation, including knowledge, skills, beliefs, and behaviors that a patient needs to manage a chronic illness (Hibbard et al., 2004).”
BackgroundHorowitz, C. R., Abul‐Husn, N. S., Ellis, S., Ramos, M. A., Negron, R., Suprun, M., Zinberg, R. E., Sabin, T., Hauser, D., Calman, N., et al. (2015) · Contemporary Clinical Trials · doi:10.1016/j.cct.2015.12.020 · Cited by 43
“We also ask about perceived racism [25], patient activation [26], knowledge about genetics [27,28], depression [29], general anxiety [30], perceived stress [31], life chaos [32], social support [33], health literacy [34], access to health care [35], diet and physical activity [36], health care utilization [37], and de…”
Gammon, D., Strand, M., Eng, L. S., Børøsund, E., Varsi, C., & Ruland, C. M. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7524 · Cited by 46
“The score can range between 0 to100, and 100 indicates the best possible patient activation [31,32].”
Marsilio, M., Fusco, F., Gheduzzi, E., & Guglielmetti, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18073336 · Cited by 45
Greyson, D. L., & Johnson, J. L. (2015) · Journal of the Association for Information Science and Technology · doi:10.1002/asi.23392 · Cited by 51
Evaluating recovery colleges: a co-created scoping review
Lin, E. H. B., Harris, H., Black, G., Bellissimo, G., Giandomenico, A. D., Rodak, T., Costa-Dookhan, K. A., Shier, R., Rovet, J., Gruszecki, S., et al. (2022) · Journal of Mental Health · doi:10.1080/09638237.2022.2140788 · Cited by 43
Empowering patients through eHealth: a case report of a pan-European project
Lettieri, E., Fumagalli, L. P., Radaelli, G., Bertele, P., Vogt, J., Hammerschmidt, R., Lara, J. L., Carriazo, A., & Masella, C. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0983-0 · Cited by 42
“activation” [14] to operationalise “patient empowerment” and to position the expected results within the ongoing international debate.”
BackgroundInfluentialUsing mediation analysis to identify causal mechanisms in disease management interventions
Linden, A., & Karlson, K. B. (2013) · Health Services and Outcomes Research Methodology · doi:10.1007/s10742-013-0106-5 · Cited by 45
Cancer patients’ experiences with and perceived outcomes of yoga: results from focus groups
van Uden‐Kraan, C. F., Chinapaw, M. J. M., Drossaert, C. H. C., Leeuw, I. M. V., & Buffart, L. M. (2013) · Supportive Care in Cancer · doi:10.1007/s00520-013-1728-4 · Cited by 41
“Empowered patients are considered to be successful in managing their condition, maintaining their health functioning and accessing appropriate and high-quality care [37].”
BackgroundCramm, J. M., & Nieboer, A. P. (2014) · BMJ Open · doi:10.1136/bmjopen-2014-005914 · Cited by 46
“The model of high-quality chronic care delivery seeks to promote a fuller understanding of each patient’s life and preferences, tailoring care to his or her needs and empowering him or her as a proactive participant in care delivery.(11) 12 These concepts are often associated with the term ‘patient-centered care.”
The Influence of Health Literacy and Patient Activation on Patient Information Seeking and Sharing
Ledford, C. J. W., Cafferty, L. A., & Russell, T. C. (2015) · Journal of Health Communication · doi:10.1080/10810730.2015.1066466 · Cited by 42
Roberts, N., Kidd, L., Dougall, N. J., Patel, I. S., McNarry, S., & Nixon, C. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.05.006 · Cited by 42
Wicks, P. J., Thorley, E. M., Simacek, K. F., Curran, C. J., & Emmas, C. (2018) · Journal of Medical Internet Research · doi:10.2196/jmir.9909 · Cited by 42
“The PAM scores were calculated according to recommended scoring guidelines from the scale developers, including the four levels of activation [25].”
InfluentialEvaluating Patient-Centered Mobile Health Technologies: Definitions, Methodologies, and Outcomes
Bruce, C. R., Harrison, P., Giammattei, C., Desai, S.-N., Sol, J. R., Jones, S. L., & Schwartz, R. L. (2020) · JMIR mhealth and uhealth · doi:10.2196/17577 · Cited by 42
“Patient biosensor monitoring devices (eg, glucose monitoring kits) Patient Activation Measure (PAM) [58,59] Focus groups, semistructured interviews Willingness and ability to take independent actions to manage their health”
BackgroundMethodInfluentialConceptualisation of self-management intervention for people with early stage dementia
Martin, F., Turner, A., WALLACE, L. M., & Bradbury, N. (2012) · European Journal of Ageing · doi:10.1007/s10433-012-0253-5 · Cited by 41
“2007) with secondary outcome measuring Patient Activation Measure (Hibbard et al. 2004), Hospital Anxiety and Depression Scale (Zigmond and Snaith 1983) and Memory Controllability”
MethodChubak, J., Anderson, M. L., Saunders, K. W., Hubbard, R. A., Tuzzio, L., Liss, D. T., Morales, L. S., & Reid, R. J. (2012) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2012.04008.x · Cited by 41
“With the knowledge, skills, beliefs, and behaviors necessary to manage their illness over time, “activated” patients are engaged, effective members of their own healthcare team.(3,5) Various interventions have been shown to increase patient activation and possibly improve outcomes, but little is known about the natura…”
BackgroundMethodNissen, M. J., Tsai, M. L., Blaes, A. H., Swenson, K. K., & Koering, S. M. (2013) · Journal of Cancer Survivorship · doi:10.1007/s11764-012-0261-7 · Cited by 41
“In this study, treatment summaries were sent only to individuals who requested them, presumably a relatively “activated” subgroup [29], so one might wonder why the improvements in accuracy were not even greater than they were.”
BackgroundMunson, G. W., Wallston, K. A., Dittus, R. S., Speroff, T., & Roumie, C. L. (2009) · Journal of General Internal Medicine · doi:10.1007/s11606-009-1002-0 · Cited by 41
Kidney transplant patients’ attitudes towards self-management support: A Q-methodological study
Grijpma, J. W., Tielen, M., van Staa, A. L., Maasdam, L., van Gelder, T., Berger, S. P., Busschbach, J. J. V., Betjes, M. G. H., Weimar, W. W., & Massey, E. K. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.11.018 · Cited by 41
Racial/Ethnic Disparities in Influenza Vaccination of Chronically Ill US Adults
Bleser, W. K., Miranda, P. Y., & Jean‐Jacques, M. (2016) · Medical Care · doi:10.1097/mlr.0000000000000544 · Cited by 43
Effect of TELEmedicine for Inflammatory Bowel Disease on Patient Activation and Self-Efficacy
Bilgrami, Z., Abutaleb, A., Chudy‐Onwugaje, K., LANGENBERG, P. W., Regueiro, M. D., Schwartz, D. A., Tracy, J. K., Ghazi, L. J., Patil, S. A., Quezada, S. M., et al. (2019) · Digestive Diseases and Sciences · doi:10.1007/s10620-018-5433-5 · Cited by 41
Crooks, M. G., Elkes, J., Storrar, W., Roy, K. C., North, M., Blythin, A. M., Watson, A., Cornelius, V. R., & Wilkinson, T. M. A. (2020) · ERJ Open Research · doi:10.1183/23120541.00460-2020 · Cited by 41
Dumitra, T. C., Ganescu, O., Hu, R. W., Fiore, J. F., Kaneva, P. A., Mayo, N. E., Lee, L., Liberman, A. S., Chaudhury, P. K., Ferri, L. E., et al. (2020) · JAMA Surgery · doi:10.1001/jamasurg.2020.5002 · Cited by 41
The Major Extremity Trauma Rehabilitation Consortium (METRC) (2019) · Journal of Orthopaedic Trauma · doi:10.1097/bot.0000000000001581 · Cited by 41
Fotheringham, J., Barnes, T., Dunn, L., Lee, S., Ariss, S., Young, T. A., Walters, S. J., Laboi, P., Henwood, A., Gair, R., et al. (2017) · BMC Nephrology · doi:10.1186/s12882-017-0748-6 · Cited by 40
“Think Kidneys questionnaire 6 monthly POS-S Renal symptom score [16], quality of life (EQ-5D-5L [15]), patient activation measure [14]”
BackgroundMethodUçar, G. C., Dönmez, A. A., Kapucu, S., & Borman, P. (2021) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2021.102081 · Cited by 40
McInnes, D. K., Solomon, J., Shimada, S. L., Petrakis, B. A., Bokhour, B. G., Asch, S. M., Nazi, K. M., Houston, T. K., & Gifford, A. L. (2013) · Medical Care · doi:10.1097/mlr.0b013e31827808bf · Cited by 40
Laugesen, J., & Hassanein, K. (2016) · Computers in Human Behavior · doi:10.1016/j.chb.2016.09.054 · Cited by 40
Eliacin, J., Coffing, J., Matthias, M. S., Burgess, D. J., Bair, M. J., & Rollins, A. L. (2016) · Administration and Policy in Mental Health and Mental Health Services Research · doi:10.1007/s10488-016-0779-5 · Cited by 40
Buono, E. W., Vrijens, B., Bosworth, H. B., Liu, L. Z., Zullig, L. L., & Granger, B. B. (2017) · Patient Preference and Adherence · doi:10.2147/ppa.s127131 · Cited by 42
Banerjee, A., Hendrick, P. A., Bhattacharjee, P., & Blake, H. (2017) · Patient Education and Counseling · doi:10.1016/j.pec.2017.12.002 · Cited by 40
“Different scales are commonly employed to measure SM for example, Arthritis Self-Efficacy Scale (ASES) [11], Patient Activation Measure (PAM) [15] and the Health Education Impact Questionnaire (heiQ) [16]; however, there is currently no standardised way of measuring SM. National clinical practice guidelines do not rec…”
Bulck, L. V., Claes, K. J., Dierickx, K., Hellemans, A., Jamar, S., Smets, S., & Pottelbergh, G. V. (2018) · BMC Nephrology · doi:10.1186/s12882-018-0917-2 · Cited by 40
“Driven by the person-centered approach, patient activation specifies the level of patients’ involvement with their health care and refers to the extent to which they have the knowledge, belief, motivation, confidence, and skills to manage a chronic disease [5].”
BackgroundAcute Care Patient Portal Intervention: Portal Use and Patient Activation
Schnock, K. O., Snyder, J. E., Fuller, T. E., Duckworth, M., Grant, M., Yoon, C. S., Lipsitz, S. R., Dalal, A. K., Bates, D. W., & Dykes, P. C. (2019) · Journal of Medical Internet Research · doi:10.2196/13336 · Cited by 40
“It refers to a patient’s knowledge, skills, and confidence in managing their health condition [15].”
Hellström, A., Tessma, M. K., Flink, M., Dahlgren, A., Schildmeijer, K. G. I., & Ekstedt, M. (2019) · BMC Public Health · doi:10.1186/s12889-019-8025-1 · Cited by 40
“The first version, developed in 2004, comprised 22 items [8], and in 2005, a shorter version of 13 items was developed to enhance the feasibility of measuring activation [9].”
BackgroundGimbel, R. W., Rennert, L., Crawford, P. F., Little, J. R., Truong, K. D., Williams, J. E., Griffin, S. F., Shi, L., Chen, L., Zhang, L., et al. (2020) · Journal of Medical Internet Research · doi:10.2196/17968 · Cited by 40
“In addition, in phase II, we sought to recruit a maximum of 120 participants (per PCMH), with a proportional distribution of patients with PAM levels 1 through 4; a primer on PAM levels is included elsewhere [21,43].”
BackgroundImplementing recovery resources in trauma care: impact and implications
Simske, N. M., Breslin, M. A., Hendrickson, S. B., York, K. P., & Vallier, H. A. (2019) · OTA International The Open Access Journal of Orthopaedic Trauma · doi:10.1097/oi9.0000000000000045 · Cited by 39
Fotheringham, J., Barnes, T., Dunn, L., Lee, S., Ariss, S., Young, T. A., Walters, S. J., Laboi, P., Henwood, A., Gair, R., et al. (2021) · PLoS ONE · doi:10.1371/journal.pone.0253966 · Cited by 39
“The secondary endpoints of change in patient activation; [4,19] quality of life (EQ-5D-5L) [20] and POS-S Renal symptom score components (anxiety, depression and pain) [21] were measured six-monthly at pre-defined timepoints.”
MethodThe impact of different modalities for activating patients in a community health center setting
Deen, D., Lu, W.-H., Weintraub, M. R., Maranda, M. J., Elshafey, S., & Gold, M. R. (2012) · Patient Education and Counseling · doi:10.1016/j.pec.2012.04.012 · Cited by 39
Crouch, P.-C., PhD, C., Johnson, M. O., & Janson, S. L. (2015) · PeerJ · doi:10.7717/peerj.852 · Cited by 39
Activation for Health Management in Colorectal Cancer Survivors and Their Family Caregivers
Mazanec, S. R., Sattar, A., Delaney, C. P., & Daly, B. J. (2015) · Western Journal of Nursing Research · doi:10.1177/0193945915604055 · Cited by 39
Development of Health Equity Indicators in Primary Health Care Organizations Using a Modified Delphi
Wong, S. T., Browne, A. J., Varcoe, C., Lavoie, J. G., Fridkin, A., Smye, V. L., Godwin, O., & Tu, D. (2014) · PLoS ONE · doi:10.1371/journal.pone.0114563 · Cited by 39
“Given past work in this area [9, 24–27] and our analysis of the Table 1.”
ResultWeiss, J. B., Berner, E. S., Johnson, K. B., Giuse, D. A., Murphy, B. A., & Lorenzi, N. M. (2013) · Journal of Biomedical Informatics · doi:10.1016/j.jbi.2013.04.004 · Cited by 39
“In addition to interpersonal measures of support and measures of individual characteristics [35], research in online social support will be better informed by including measures of some of the components of support structures such as social capital.”
Background
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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