PAM Survey Instrument for Measuring Patient Activation/Oral-Health Behaviors at OHSU

To employ the Patient Activation Measure for Oral Health survey instrument (PAM-OH) for the first time in a dental school clinic to assess patient activation and oral health behaviors.

Methods:

The PAM-OH is based on the general health PAM and evaluates an individual’s self-management ability through the domains of knowledge, skills and confidence in the context of accessing care, self-care and nutrition/diet. The degree of activation is predictive of health, behaviors, outcomes and healthcare utilization. The survey instrument assigns an individual to an activation level and numeric score. Over a 6-week period, in an OHSU IRB approved study, patients in the predoctoral dental clinic at OHSU were invited to complete the 11-question PAM-OH survey and questions about demographics, education, employment and access/use of the Internet. Respondents completed the paper survey in the reception area before their appointment. Active patients (AP) and newly admitted patients (NP) were invited to participate.

Results:

781 surveys were completed, n(AP)=710, n(NP)=71. For AP, 19.3% were low, 34.4% moderate, and 46.3% highly-activated. For NP, 46.5% were low, 23.9% moderate, and 29.6% highly-activated. 76.2% (AP) had high-speed, broadband Internet at home. For health information (AP), 58% used the Internet, 73.8% used healthcare providers, 72.9% family members/friends. For NP, 60.6% used healthcare providers for health information.

Conclusions:

The proportion of low activation for NP was 2x that of AP. Three-quarters of AP had high-speed, broadband Internet access at home. Over half of AP used the Internet for healthcare information. NP used healthcare providers for health information less than by AP. The next phase of this project is to train a cohort of dental students to use the PAM-OH to tailor their education and support to the patient's level of activation and to compare patient satisfaction, activation changes, and behaviors with a comparison group of dental students using traditional patient education methods.