Measuring self-management of patients' and employees' health: further validation of the Patient Activation Measure (PAM) based on its relation to employee characteristics

Patient Educ Couns. 2009 Oct;77(1):116-22. doi: 10.1016/j.pec.2009.02.018. Epub 2009 Apr 7.


Objective: Evaluate the Patient Activation Measure (PAM) in relation to personal characteristics in employed populations. Further validate the PAM for use in improving clinical or employer-based health-intervention programs.

Methods: Data for analysis were taken from baseline survey information and health screenings collected during a randomized, controlled trial testing two different health promotion programs. Study population included 625 employees (predominantly white collar) from two companies in the northern Midwest of the United States: a large, integrated health care system and a national airline.

Results: PAM's psychometric properties are robust in two employed populations. Activation is directly related not only to health status, but also to job performance measures. The strong positive relationship of PAM to measures of healthy behavior, health information-seeking and readiness-to-change further validate the measure. Commonly, a difference of 5 points on the PAM separated healthy from less healthy behaviors.

Conclusion: Activation can be understood in a broader population health context and need not be restricted to people with chronic illnesses. The study provides guidance on how to interpret PAM scores.

Practice implications: The PAM can be used as part of any health-intervention program designed to improve patients' or employees' self-management skills, whether the program is clinic-based or employer-based.

Publication types

  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Body Mass Index
  • Data Collection
  • Female
  • Health Behavior
  • Health Promotion
  • Health Status
  • Health Status Indicators
  • Humans
  • Linear Models
  • Male
  • Mass Screening
  • Middle Aged
  • Multivariate Analysis
  • Occupational Health*
  • Program Development*
  • Program Evaluation
  • Psychometrics
  • Self Care*
  • Surveys and Questionnaires