Q&A: Measuring patient activation

Q: What's a tool my staff can use to measure patient activation?

A: The Patient Activation Measure (PAM) is a licensed quantitative tool designed to measure a patient’s level of activation to engage in his or her healthcare. The PAM is a 13-question instrument developed to measure a patient’s knowledge, skill, and confidence for self-management. PAM measures each patient’s developmental progress in these areas. It has strong psychometric properties using Rasch methodology. 

The researcher developing items of a test or questionnaire who intends to sum the scores on the items can use a Rasch model analysis to check the degree to which this scoring and summing is defensible in the data collected. For example, if two groups are to be compared on the variable of interest (i.e., males and females), it is important to demonstrate that the workings of the items are the same in the two groups. Working in the same way permits interpreting the total score as meaning the same in the two groups.

Researcher Judith Hibbard developed the questionnaire. Hibbard intended to sum the scores on the PAM questionnaire. She tested the PAM as a research instrument using Rasch methodology so the scores would have meaning on an interval or ratio level. This is important in data analysis, because the scores could be used to calculate the mean and standard deviation. Therefore, the PAM scores have statistical meaning, superior to a survey response. The PAM provides a baseline activation level, and the case manager and interprofessional team can use it again to measure the patient’s progress with the benefit of coaching, education, or other interventions.

For more information, see Case Management Guide to Population Health: Management Across the Continuum of Care.

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