Quality of Life Research

, Volume 22, Issue 3, pp 521–529 | Cite as

Psychometric assessment of the patient activation measure short form (PAM-13) in rural settings

  • Man Hung
  • Marjorie Carter
  • Candace Hayden
  • Rhonda Dzierzon
  • Jose Morales
  • Laverne Snow
  • Jorie Butler
  • Kim Bateman
  • Matthew Samore
Brief Communication



The patient activation measure short form (PAM-13) assesses patients’ self-reported health management skills, knowledge, confidence, and motivation. We used item response theory to evaluate the psychometric properties of the PAM-13 utilized in rural settings.


A Rasch partial credit model analysis was conducted on the PAM-13 instrument using a sample of 812 rural patients recruited by providers and our research staff. Specially, we examined dimensionality, item fit, and quality of measures, category response curves, and item differential functioning. Convergent and divergent validities were also examined.


The PAM-13 instrument has excellent convergent and divergent validities. It is fairly unidimensional, and all items fit the Rasch model well. It has relatively high person and item reliability indices. Majority of the items were free of item differential functioning. There were, however, some issues with ceiling effects. Additionally, there was a lack of responses for category one across all items.


Patient activation measure short form (PAM-13) performs well in some areas, but not all. In general, more items need to be added to cover the upper end of the trait. The four response categories of PAM-13 should be collapsed into three.


Patient activation measure Electronic medical record Psychometric Rasch Health care management Quality of life 



This investigation was supported by the Agency for Healthcare Research and Quality research grant number R18-HS-017308.


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Copyright information

© Springer Science+Business Media B.V. 2012

Authors and Affiliations

  • Man Hung
    • 1
  • Marjorie Carter
    • 3
  • Candace Hayden
    • 2
  • Rhonda Dzierzon
    • 2
  • Jose Morales
    • 2
  • Laverne Snow
    • 2
  • Jorie Butler
    • 3
  • Kim Bateman
    • 2
  • Matthew Samore
    • 3
  1. 1.Department of Orthopaedic Surgery OperationsUniversity of UtahSalt Lake CityUSA
  2. 2.Division of Epidemiology, Department of Internal MedicineUniversity of UtahSalt Lake CityUSA
  3. 3.Veterans Affairs Salt Lake City Health Care SystemSalt Lake CityUSA

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