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 Do not publish a raw-sum score as a "PAM score"; the 0–100 metric requires the proprietary conversion table.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. Questionnaires are built in Folio Surveyor, subject to each instrument's licensing, and can be taken to Qualtrics, Google Forms or Microsoft Forms, with their CSV responses brought back for scoring.