Adaptation and validation of the German Patient Activation Measure for adolescents with chronic conditions in transitional care: PAM^® 13 for Adolescents

Abstract

Measuring adolescent patients' engagement in their health care is especially important in preparing for chronically ill adolescents' transition into adult care. In this study, we aimed to create an adolescent version of the German language Patient Activation Measure (PAM-13-D) originally tested in in adults and psychometrically test the adapted measure (PAM 13 for Adolescents). After linguistic and content-related adaptations, the PAM 13 for Adolescents was tested in a large sample of adolescents with different chronic conditions (N = 586, mean age 17.5 years, SD = 1.4) in 40 health centers. Internal consistency was assessed with Cronbach's alpha and test-retest reliability with Pearson correlation. Convergent and divergent validity were calculated with Pearson correlations between the two IE-4 scales (internal and external Locus of Control) and the PAM 13 for Adolescents. Known-group validity (type 1 diabetes vs. IBD, higher vs. lower education level) was checked by Mann-Whitney-U-tests. The PAM 13 for Adolescents showed good test-retest reliability (rtt = .68), internal consistency (α = .79) and demonstrated good validity. The original structure of the PAM 13-D was replicated. Rasch analysis using the partial credit model was used to investigate the operating characteristics of the items. Rasch analysis indicated a sufficient fit of 12 of the 13 items. PAM 13 for Adolescents is the first instrument measuring patient activation of adolescents with chronic conditions in a broad age range. Patient activation level can be used by clinicians to better plan and structure transition processes.

Supporting the Health Care Transition From Adolescence to Adulthood in the Medical Home

“…Some examples of standardized scorable tools include the Transition Readiness Assessment Questionnaire, 216 Am I ON TRAC for Adult Care Questionnaire (ON TRAC), 217 University of North Carolina TR(x) ANSITION Scale, 218 Self-Management and Transition for Adulthood with Rx = Treatment (STARx Questionnaire), 219,220 Transition Q, 221 an electronic medical record-based transition planning tool, 222 California Healthy and Ready to Work, 223 Got Transition's Transition Readiness and Self-Care assessment tools, 134 and the Patient Activation Measure. 131,224 More information about transition-related codes and case scenarios can be found in the AAP and Got Transition Coding and Reimbursement Tip Sheet 225 as well as a report on value-based payment options. 226…”

Assessing empowerment as multidimensional outcome of a patient education program for adolescents with chronic conditions: A latent difference score model

“…The reported internal consistency of the previous study is satisfactory with a Cronbach's alpha coefficient of α = .79. The retest reliability was reasonably high, with r tt = .68 [25].…”

“…Patient Activation Measure (PAM). The patient activation has previously been operationalized through the Patient Activation Measurement adapted for adolescents with chronic conditions [25]). This instrument consists of 13 items with response categories located on a 4-point Likert scale ranging from 1 (strongly disagree) to 4 (strongly agree).…”

Pediatric rheumatology: addressing the transition to adult-orientated health care

“…It has good test–retest reliability and internal consistency. 56 Continued analysis of patient satisfaction of their transition process and outcome will provide valuable feedback on what elements should be included in transitional care programs.…”