Psychometric properties of the patient activation measure among multimorbid older adults

Health Serv Res. 2011 Apr;46(2):457-78. doi: 10.1111/j.1475-6773.2010.01210.x. Epub 2010 Nov 19.


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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged / psychology
  • Chronic Disease
  • Cross-Sectional Studies
  • Educational Status
  • Female
  • Health Behavior
  • Humans
  • Male
  • Patient Participation / psychology*
  • Patient Participation / statistics & numerical data
  • Psychometrics
  • Quality of Health Care
  • Reproducibility of Results
  • Surveys and Questionnaires / standards