Psychometric Properties of the Patient Activation Measure among Multimorbid Older Adults
Richard L. Skolasky
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street/JHOC 5244, Baltimore, MD 21287
Address correspondence to Richard L. Skolasky, Sc.D., Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street/JHOC 5244, Baltimore, MD 21287; e-mail: [email protected]. Ariel Frank Green, M.D., M.P.H., is with the Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD. Daniel Scharfstein, Sc.D., is with the Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Chad Boult, M.D., M.P.H., M.B.A., and Lisa Reider, M.H.S., are with the Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Stephen T. Wegener, Ph.D., is with the Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD.
Search for more papers by this authorAriel Frank Green
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
Search for more papers by this authorDaniel Scharfstein
Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Search for more papers by this authorChad Boult
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Search for more papers by this authorLisa Reider
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Search for more papers by this authorStephen T. Wegener
Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD.
Search for more papers by this authorRichard L. Skolasky
Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street/JHOC 5244, Baltimore, MD 21287
Address correspondence to Richard L. Skolasky, Sc.D., Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street/JHOC 5244, Baltimore, MD 21287; e-mail: [email protected]. Ariel Frank Green, M.D., M.P.H., is with the Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD. Daniel Scharfstein, Sc.D., is with the Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Chad Boult, M.D., M.P.H., M.B.A., and Lisa Reider, M.H.S., are with the Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD. Stephen T. Wegener, Ph.D., is with the Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD.
Search for more papers by this authorAriel Frank Green
Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD
Search for more papers by this authorDaniel Scharfstein
Department of Biostatistics, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Search for more papers by this authorChad Boult
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Search for more papers by this authorLisa Reider
Department of Health Policy and Management, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD
Search for more papers by this authorStephen T. Wegener
Department of Physical Medicine and Rehabilitation, The Johns Hopkins University School of Medicine, Baltimore, MD.
Search for more papers by this authorAbstract
Objectives. The Patient Activation Measure (PAM) quantifies the extent to which people are informed about and involved in their health care. Objectives were to determine the psychometric properties of PAM among multimorbid older adults and evaluate a theoretical, four-stage model of patient activation.
Methods. A cross-sectional analysis was used to assess the psychometric properties of PAM. Internal consistency was assessed using Cronbach α. Construct validity was evaluated using general linear modeling to compute associations between PAM scores and health-related behaviors, functional status, and health care quality. Latent class analysis was used to evaluate the theoretical four-stage structure of patient activation.
Study Setting. Participants in a randomized trial of Guided Care (N=855), a model of comprehensive health care for older adults with chronic conditions that put them at risk of using health services heavily during the coming year.
Principal Findings. Higher PAM activation scores and stage were positively associated with higher functional status, health care quality, and adherence to some health behaviors. Latent class analysis supported the multistage theory of patient activation.
Conclusions. The PAM is a reliable, valid, and potentially clinically useful measure of patient activation for multimorbid older adults.
Supporting Information
Appendix SA1: Author Matrix.
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