Abstract
BackgroundA valid and reliable measure is essential to assess patient engagement and its impact on health outcomes. This study aimed to examine the psychometric properties of the 8-item Altarum Consumer Engagement Measure™ (ACE Measure) among English-speaking community-dwelling adults in Singapore.MethodsThis cross-sectional study involved 400 randomly selected community-dwelling adults (mean age: 49.7 years, 50.0% were female, 72.3% were Chinese) who completed the English version of the 8-item ACE Measure independently. The item-level statistics were described. The internal consistency of the measure was measured by Cronbach alpha and item-rest correlations. Validity of the tool was assessed by 1) factorial validity using confirmatory factor analysis (CFA), 2) hypothesis-testing validity by correlating ACE subscales (Commitment and Navigation) with health-related outcomes, and 3) criterion validity against the Patient Activation Measure and Health Confidence Measure.ResultsThere was no floor or ceiling effect for Commitment and Navigation subscales, and the Cronbach alpha for each subscale was 0.76 and 0.54, respectively. The two-factor structure was confirmed by CFA. In general, Commitment and Navigation subscales were positively correlated with frequency of activity participation (rho = 0.30 - 0.33) and EQ-5D visual analog scale (rho = 0.15 - 0.30). Individuals who perceived better health than peers had higher subscale scores (p < 0.01). Each subscale score had moderate and positive correlations with activation score (rho = 0.48 - 0.55) and health confidence score (rho = 0.35 - 0.47).ConclusionsThe two-subscale ACE Measure demonstrated good construct validity in English-speaking Singapore community-dwelling adults. Evidence in internal consistency was mixed, indicating further investigation.
Highlights
A valid and reliable measure is essential to assess patient engagement and its impact on health outcomes
A growing body of evidence demonstrated that individuals who are engaged in their health care tend to express a stronger motivation in self-management and are better able to make informed decisions about their care options, which contributes to improved adherence [7,8,9], better self-perceived health [10, 11] and health outcomes [8, 12, 13], and lower healthcare costs [14, 15]
After consulting the developer of the ACE Altarum Consumer Engagement MeasureTM (Measure) and considering that each subscale could be used independently, we only examined the psychometric properties of the two subscales - Commitment and Navigation of the 8-item ACE Measure in this study
Summary
A valid and reliable measure is essential to assess patient engagement and its impact on health outcomes. Prior literature has suggested that patient engagement is a multidimensional concept – where individuals are required to have the knowledge, skills, ability, and willingness to manage their own health, and to be actively involved in making competent and well-informed decisions together with their healthcare providers and commit to take actions for own health care [3, 5, 6]. A few instruments have been developed in recent years to measure different domains of patient engagement including patient activation [16], motivation [17], self-management [18,19,20], and shared decision making [21].
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