PUBH 520

Assignment10_PAM1.pdf

Below are some statements that people sometimes make when they talk about their health. Please indicate how much you agree or disagree with each statement as it applies to you personally by circling your answer. Your answers should be what is true for you and not just what you think others want you to say.

If the statement does not apply to you, circle N/A.

1. When all is said and done, I am the person who is responsible for taking care of my health

Disagree Strongly

Disagree Agree Agree Strongly

N/A

2. Taking an active role in my own health care is the most important thing that affects my health

Disagree Strongly

Disagree Agree Agree Strongly

N/A

3. I am confident I can help prevent or reduce problems associated with my health

Disagree Strongly

Disagree Agree Agree Strongly

N/A

4. I know what each of my prescribed medications do

Disagree Strongly

Disagree Agree Agree Strongly

N/A

5. I am confident that I can tell whether I need to go to the doctor or whether I can take care of a health problem myself

Disagree Strongly

Disagree Agree Agree Strongly

N/A

6. I am confident that I can tell a doctor concerns I have even when he or she does not ask

Disagree Strongly

Disagree Agree Agree Strongly

N/A

7. I am confident that I can follow through on medical treatments I may need to do at home

Disagree Strongly

Disagree Agree Agree Strongly

N/A

8. I understand my health problems and what causes them

Disagree Strongly

Disagree Agree Agree Strongly

N/A

9. I know what treatments are available for my health problems

Disagree Strongly

Disagree Agree Agree Strongly

N/A

10. I have been able to maintain (keep up with) lifestyle changes, like eating right or exercising

Disagree Strongly

Disagree Agree Agree Strongly

N/A

11. I know how to prevent problems with my health

Disagree Strongly

Disagree Agree Agree Strongly

N/A

12. I am confident I can figure out solutions when new problems arise with my health

Disagree Strongly

Disagree Agree Agree Strongly

N/A

13. I am confident that I can maintain lifestyle changes, like eating right and exercising, even during times of stress

Disagree Strongly

Disagree Agree Agree Strongly

N/A

Contact Insignia Health at www.insigniahealth.com

Score Table for Patient Activation Measure, 13 Items

Instructions: First, calculate a raw score: add up all of the responses to the 13 questions. For each “Strongly Disagree” response give the person a 1, for each “Disagree” response give the person a 2, for each “Agree” response give the person a 3, for each “Strongly Agree” response give the person a 4. If there are no items with "not applicable" responses, use the total as the raw score. If there are items with a response of "not applicable" or a question left blank, these items are scored as “missing.” In this case divide the point total by the number of items completed with a 1- 4 response (exclude the missing) and multiply by 13 to get the raw score. For example, if two questions were answered with a “not applicable” response, your denominator would be 11. Second, convert the raw score into the activation score. If necessary, round off your raw score to the nearest whole number. Then, using the table below, simply find the raw score in the column marked “Raw Score,” then read across to find the person’s activation score. Finally, we recommend that if any respondents who answer all 13 questions with a “strongly agree” response, that you carefully consider their score. They are likely not responding in a truthful or accurate way. The same is true for respondents who answer all 13 items with a “strongly disagree” response.

Raw Score Activation

13 0.0 33 41.7 14 8.2 34 43.4 15 13.3 35 45.2 16 16.5 36 47.4 17 18.9 37 49.9 18 20.9 38 52.9 19 22.7 39 56.4 20 24.3 40 60.0 21 25.7 41 63.2 22 27.1 42 66.0 23 28.4 43 68.5 24 29.7 44 70.8 25 31.0 45 73.1 26 32.2 46 75.3 27 33.5 47 77.5 28 34.7 48 80.0 29 36.0 49 82.8 30 37.3 50 86.3 31 38.7 51 91.6 32 40.1 52 100.0

Cut Points and percentages by Activation Level Segment

LEVEL 1: May not yet believe that the patient role is important (Having a PAM score of 47.0 or lower, 11.8%) LEVEL 2: Lacks confidence and knowledge to take action (Having a PAM score of 47.1 to 55.1, 29.3%) LEVEL 3: Beginning to take action (Having a PAM score of 55.2 to 67.0, 36.5%) LEVEL 4: Has difficulty maintaining behaviors over time (Having a PAM score of 67.1 or above, 22.3%)