Levels and correlates of patient activation in health center settings: building strategies for improving health outcomes

J Health Care Poor Underserved. 2010 Aug;21(3):796-808. doi: 10.1353/hpu.0.0350.


Patient activation refers to people's ability to engage in self-management of their health and health care. We assessed the performance of the Patient Activation Measure (PAM) for patients attending three inner-city health centers and compared resultant scores with those of the general U.S. adult population. We approached 801 patients and 527 (65.8%) participated; the majority were Latino(a) or African American/Black. No differences in activation were seen according to age. Males and more educated patients were more activated (p<.05) and patients with better self-rated health and adequate health literacy were more activated than their counterparts (p<.001). Patterns of scores resembled those of the U.S. general population for educational attainment and self-rated health but not for gender and age. Compared with the general population, more patients were characterized as level 1 (least activated). Developing strategies that enhance patient activation is critical to improving health outcomes, particularly in less advantaged populations.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • African Americans / statistics & numerical data
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Literacy
  • Health Status
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • New York City
  • Patient Participation / methods
  • Patient Participation / statistics & numerical data*
  • Patient-Centered Care / organization & administration*
  • Self Care*
  • Sex Factors
  • Surveys and Questionnaires
  • United States
  • Urban Health Services*
  • Young Adult