Development and Validation of the Consumer Health Activation Index

Michael S. Wolf, Samuel G. Smith, Anjali U. Pandit, David M. Condon, Laura M. Curtis, James Griffith, Rachel O’Conor, Steven Rush, Stacy C. Bailey, Gordon Kaplan, Vincent Haufle and David Martin
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Michael S. Wolf: Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
Samuel G. Smith: Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
Anjali U. Pandit: Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
David M. Condon: Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
Laura M. Curtis: Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
James Griffith: Department of Medical Social Sciences, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
Rachel O’Conor: Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
Steven Rush: UnitedHealthcare and UnitedHealth Group, Minneapolis, MN, USA
Stacy C. Bailey: Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, USA
Gordon Kaplan: Optum, Consumer Solutions Group, Minneapolis, MN, USA
Vincent Haufle: Optum, Consumer Solutions Group, Minneapolis, MN, USA
David Martin: UnitedHealthcare and UnitedHealth Group, Minneapolis, MN, USA

Medical Decision Making, 2018, vol. 38, issue 3, 334-343

Abstract: Background. Although there has been increasing interest in patient engagement, few measures are publicly available and suitable for patients with limited health literacy. Objective. We sought to develop a Consumer Health Activation Index (CHAI) for use among diverse patients. Methods. Expert opinion, a systematic literature review, focus groups, and cognitive interviews with patients were used to create and revise a potential set of items. Psychometric testing guided by item response theory was then conducted among 301 English-speaking, community-dwelling adults. This included differential item functioning analyses to evaluate item performance across participant health literacy levels. To determine construct validity, CHAI scores were compared to scales measuring similar personality constructs. Associations between the CHAI and physical and mental health established predictive validity. A second study among 9,478 adults was used to confirm CHAI associations with health outcomes. Results. Exploratory factor analyses revealed a single-factor solution with a 10-item scale. The CHAI showed good internal consistency (alpha = 0.81) and moderate test–retest reliability (ICC = 0.53). Reading grade level was found to be at the 6 th grade. Moderate to strong correlations were found with similar constructs (Multidimensional Health Locus of Control, r = 0.38, P

Keywords: engagement; health; healthcare; literacy; measurement; patient activation (search for similar items in EconPapers)
Date: 2018
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Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:38:y:2018:i:3:p:334-343

DOI: 10.1177/0272989X17753392

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