title: Psychometric properties of the patient activation measure among multimorbid older adults.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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.
authors.affiliation: Department of Orthopaedic Surgery, The Johns Hopkins University School of Medicine, 601 North Caroline Street/JHOC 5244, Baltimore, MD 21287, USA. rskolas1@jhmi.edu
authors.forename: Richard L
authors.initials: RL
authors.lastname: Skolasky
authors.forename: Ariel Frank
authors.initials: AF
authors.lastname: Green
authors.forename: Daniel
authors.initials: D
authors.lastname: Scharfstein
authors.forename: Chad
authors.initials: C
authors.lastname: Boult
authors.forename: Lisa
authors.initials: L
authors.lastname: Reider
authors.forename: Stephen T
authors.initials: ST
authors.lastname: Wegener
mesh_terms: D000368:Aged / Q000523:psychology; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D015438:Health Behavior; D006801:Humans; D008297:Male; D010358:Patient Participation / Q000523:psychology* / Q000706:statistics & numerical data; D011594:Psychometrics; D011787:Quality of Health Care; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards