Patient Activation Measure

PAM-13

health sciencespsychologyLicensed: permission required

Permission: Licensed: permission required. Obtain permission from the copyright holder before using it in a study.

A 13-item measure of patient knowledge, skill, and confidence for self-management of chronic conditions and general health. Items vary in difficulty and are scored using a Rasch-calibrated algorithm that converts raw responses to a 0–100 activation score, classified into four activation levels.

Items

Response format

4-point Likert scale + N/A

Version

1.0

Ready-to-cite methods sentence

Patient activation was measured using the 13-item Patient Activation Measure (PAM-13; Hibbard, Mahoney, Stockard, & Tusler, 2005) under license from Insignia Health/Phreesia. Raw responses were converted to a 0–100 activation score using the licensed Rasch-calibrated algorithm, and participants were classified into one of four activation levels.

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Permission required

Importing PAM-13 into a Surveyor study is disabled: Folio holds the instrument’s metadata, not a license to pass on its wording. The citation, scoring and reliability details on this page are free to use and cite.

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Reliability & validation

Notes

Rasch person reliability for the 13-item PAM was .81 (real) and .85 (model) in the development sample (Hibbard et al., 2005).

Validation population

National random telephone sample of US adults aged 45 and older (n = 1,515; 79% reported at least one chronic condition; Hibbard et al., 2005)

Known limitations

Licensed: obtain a research license from Phreesia before administration. Do not publish a raw-sum score as a "PAM score"; the 0–100 metric requires the proprietary conversion table. Item wording here is from published academic reproductions; the licensed scoring kit is authoritative and may differ in minor wording. The PAM is unidimensional by design; subscales are not interpretable.

Original citation

Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health Services Research, 40(6 Pt 1), 1918-1930.

https://doi.org/10.1111/j.1475-6773.2005.00438.x

This instrument is licensed. Folio does not distribute its item wording. Obtain permission from the copyright holder before using it in your study.

Questions researchers ask

What does the PAM-13 measure?

How many items does the PAM-13 have?

The Patient Activation Measure (PAM-13) has 13 items.

Is the PAM-13 free to use?

The PAM-13 is licensed. You must obtain permission from the copyright holder before using it in a study. Folio does not distribute its item wording without that permission.

Who developed the PAM-13, and how do I cite it?

Hibbard, J. H., Mahoney, E. R., Stockard, J., & Tusler, M. (2005). Development and testing of a short form of the patient activation measure. Health Services Research, 40(6 Pt 1), 1918-1930. https://doi.org/10.1111/j.1475-6773.2005.00438.x

Or track new research mentioning PAM-13 as it publishes

Library entry verified September 2026. Metadata is provided for reference; item wording is available inside Folio Surveyor, subject to each instrument's licensing.