The mental-health patient-activation measure: assessing validity, reliability, and responsiveness in outpatient settings.

Authors

Tatiana Skliarova, Mariela L Lara-Cabrera, Mathias Forsberg Brobakken, Jørn Heggelund, Einar Vedul-Kjelsås, Ismail Cüneyt Güzey, Hege Hafstad, Solveig Klaebo Reitan, Mona Nygård

Published in

BMC psychiatry. Volume 25. Issue 1. Pages 520. May 22, 2025. Epub May 22, 2025.

Abstract

The patient activation measure-mental health (PAM-MH) scale, adapted from the Patient Activation Measure-13 Items (PAM-13) developed in the United States, was designed to assess patient engagement and activation in mental health care. Despite initial validation of the PAM-MH in its original context, its applicability in other settings and its comparison to the gold standard PAM-13 remain unexplored. Furthermore, research addressing the face and construct validity of the PAM-MH is limited. This multi-phase study evaluated the face validity, construct validity, reliability and responsiveness of the PAM-MH in a Norwegian outpatient setting.
A participatory approach was adopted to actively involve user representatives in validating the scale. The validation process consisted of four interconnected studies. In the first sub-study, user representatives were invited to contribute to establish face validity by providing quantitative feedback on the perceived value and burden of completing the PAM-MH. The second sub-study examined the construct validity. It was hypothesised that the PAM-MH measures the construct of patient activation and would therefore correlate with the PAM-13. This hypothesis was tested using Pearson's r in a sample of 55 outpatients. The third sub-study evaluated test-retest reliability (via ICC) and internal consistency (using Cronbach's α), in a sample of 27 outpatients who completed the PAM-MH on two separate occasions. The final sub-study explored the responsiveness of the scale to change, guided by predefined hypotheses, in a sample of 11 outpatients.
Adequate acceptability was established from users' views of the value and burden of the scale (overall mean "value" score was 59.7% and mean "burden" was 39.6%). All hypotheses, established a priori for construct validity, reliability, and responsiveness-to-change, were confirmed.
This multi-phase study employed a participatory approach to validate the PAM-MH in a Norwegian outpatient context. Preliminary results demonstrated satisfactory face validity and construct validity, along with good reliability and responsiveness-to-change. The findings suggest that the PAM-MH is both valid and reliable, making it a suitable questionnaire to measure patient activation in a Norwegian outpatient setting.

PMID:
40405139
Bibliographic data and abstract were imported from PubMed on 23 May 2025.

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