This Article Full Text Full Text (PDF) All Versions of this Article: 0145721709335004v1 35/4/622    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Scopus Google Scholar Articles by Rask, K. J. Articles by Barnes, C. S. PubMed PubMed Citation Articles by Rask, K. J. Articles by Barnes, C. S. Pubmed/NCBI databases Medline Plus Health Information Diabetes Health Literacy Healthy Living Social Bookmarking                         What's this?

Patient Activation Is Associated With Healthy Behaviors and Ease in Managing Diabetes in an Indigent Population

From the Emory Center on Health Outcomes and Quality, Rollins School of Public Health, Emory University, Atlanta, Georgia (Dr Rask, Ms Kohler, Mr Hawley); Division of Endocrinology and Metabolism, Department of Medicine, Emory University, School of Medicine, Atlanta, Georgia (Dr Ziemer, Dr Barnes); International Association of National Public Health Institutes, Emory University, Atlanta, Georgia (Ms Arinde).

Correspondence to Kimberly J. Rask, MD, PhD, Emory University, 1518 Clifton Road NE, Room 636, Atlanta, GA 30322 (krask{at}emory.edu).

Purpose

The purpose of this study is to assess the validity of the patient activation construct as measured by the Patient Activation Measure (PAM) survey by correlating PAM scores with diabetes self-management behaviors, attitudes, and knowledge in a predominantly minority and uninsured population.

Methods

A convenience sample of patients presenting to an urban public hospital diabetes clinic was surveyed and contacted by phone 6 months later. The survey included questions about activation, health behaviors, and health care utilization.

Results

A total of 287 patients agreed to participate. Most were African American, female, and uninsured. Most respondents (62.2%) scored in the highest category of activation according to the PAM. Activated patients were more likely to perform feet checks, receive eye examinations, and exercise regularly. Activation was consistently associated with less reported difficulty in managing diabetes care but not with A1C knowledge. PAM scores at the initial interview were highly correlated with scores at 6-month follow-up. Activation level did not predict differences in health care utilization during the 6 months following the survey.

Conclusions

Higher scores on the PAM were associated with higher rates of self-care behaviors and ease in managing diabetes; however, the indigent urban population reported higher activation scores than found in previous studies. The relationship between activation and outcomes needs to be explored further prior to expanding use of this measure in this patient population.

This version was published on July 1, 2009

The Diabetes Educator, Vol. 35, No. 4, 622-630 (2009)
DOI: 10.1177/0145721709335004


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?