Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

Zsombor Zrubka; Péter Vékás; Péter Németh; Ágota Dobos; Ottó Hajdu; Levente Kovács; László Gulácsi; Judith Hibbard; Márta Péntek

doi:10.1007/s10198-022-01434-0

Validation of the PAM-13 instrument in the Hungarian general population 40 years old and above

Eur J Health Econ. 2022 Nov;23(8):1341-1355. doi: 10.1007/s10198-022-01434-0. Epub 2022 Jan 31.

Authors

Zsombor Zrubka^{1

2}, Péter Vékás³, Péter Németh⁴, Ágota Dobos⁵, Ottó Hajdu⁶, Levente Kovács⁷, László Gulácsi^{7

8}, Judith Hibbard⁹, Márta Péntek⁷

Affiliations

¹ University Research and Innovation Center, Óbuda University, Bécsi út 96/b, Budapest, 1034, Hungary. zrubka.zsombor@uni-obuda.hu.
² Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary. zrubka.zsombor@uni-obuda.hu.
³ Institute of Mathematical Statistics and Modelling, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
⁴ Doctoral School of Economics, Business and Informatics, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
⁵ Centre for Foreign Language Education and Research, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
⁶ Institute of Business Economics, Eötvös Loránd University, Rákóczi út 7, Budapest, 1088, Hungary.
⁷ University Research and Innovation Center, Óbuda University, Bécsi út 96/b, Budapest, 1034, Hungary.
⁸ Corvinus Institute for Advanced Studies, Corvinus University of Budapest, Fővám tér 8, Budapest, 1093, Hungary.
⁹ Health Policy Research Group, University of Oregon, 1209 University of Oregon, Eugene, OR, 97403-1209, USA.

Abstract

Background: Patient activation comprises the skills, knowledge and motivation necessary for patients' effective contribution to their care. We adapted and validated the 13-item Patient Activation Measure (PAM-13) in the ≥ 40 years old Hungarian general population.

Methods: A cross-sectional web survey was conducted among 900 respondents selected from an online panel via quota sampling. After 10 days, the survey was repeated on 100 respondents. The distribution, internal consistency, test-retest reliability, factor structure, convergent, discriminant and known-groups validity of PAM-13 were assessed according to the COSMIN guidelines.

Results: The sample comprised 779 respondents. Mean (± SD) age was 60.4 ± 10.6 years, 54% were female and 67% had chronic illness. Mean (± SD) PAM-13 score was 60.6 ± 10.0. We found good internal consistency (Cronbach alpha: 0.77), moderate test-retest reliability (ICC: 0.62; n = 75), a single-factor structure and good content validity: PAM-13 showed moderate correlation with the eHealth Literacy Scale (r = 0.40), and no correlation with age (r = 0.02), education (r = 0.04) or income (ρ = 0.04). Higher PAM-13 scores were associated with fewer lifestyle risks (p < 0.001), more frequent health information seeking (p < 0.001), participation in patient education (p = 0.018) and various online health-related behaviours. When controlling for health literacy, sociodemographic factors and health status, the association of higher PAM-13 scores with overall fewer lifestyle risks, normal body mass index, physical activity and adequate diet remained significant. Similar properties were observed in the subgroup of participants with chronic morbidity, but not in the age group 65+.

Conclusion: PAM-13 demonstrated good validity in the general population. Its properties in clinical populations and the elderly as well as responsiveness to interventions warrant further research.

Keywords: Health literacy; I10; Lifestyle-related risks; Online survey; PAM-13; Patient activation; Psychometric validation; eHEALS.

MeSH terms

Adult
Aged
Cross-Sectional Studies
Female
Health Literacy*
Humans
Hungary
Male
Middle Aged
Psychometrics
Reproducibility of Results
Surveys and Questionnaires
Telemedicine*

Abstract

MeSH terms

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