Validation of the Arabic Version of the Patient Activation Measure (PAM-13) for Application within the Primary Healthcare Context in Saudi Arabia

Abstract

Background: Empowering patients with behavioral issues or chronic conditions to actively participate in their healthcare can help improve health outcomes. However, in the Saudi Arabian context, evaluation tools for achieving this goal are lacking, considering cultural and healthcare system factors. Therefore, this study aimed to determine the psychometric properties of the Arabic version of the Patient Activation Measure. Methods: This cross-sectional validation study was conducted on a sample of 225 patients receiving treatment from primary healthcare centers located in Riyadh, Saudi Arabia. Item analyses and reliability and construct validity testing of the tool were conducted. Results: The item–total correlation coefficients ranged from 0.31 (item 2) to 0.57 (item 11). The item–total correlation coefficients for all 13 items were above 0.30. The reliability was 0.80. A two-factor model (“knowledge and beliefs” and “confidence and skills”) reflecting the instrument was constructed. The raw model did not sufficiently fit the data (χ2 = 170.98, degree of freedom (df) = 64, p < 0.001; Tucker–Lewis index (TLI) = 0.79; comparative fit index (CFI) = 0.83; root mean square error of approximation (RMSEA) = 0.86 [90% confidence interval {CI} = 0.07–0.10]). After all significant correlations between the items’ error terms were modeled, an adequate fit was achieved (χ2 = 76.76, df = 51, p < 0.01; TLI = 0.94; CFI = 0.96; RMSEA = 0.04 [90% CI = 0.02–0.07]). Conclusions: the Arabic version of the Patient Activation Measure can be utilized by healthcare providers to assess the activation levels and unique needs and preferences of Arabic-speaking individuals and tailor interventions accordingly to provide necessary support.