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Development and Validation of the Consumer Health Activation Index

Author

Listed:
  • Michael S. Wolf

    (Health Literacy and Learning Program, Division of General Internal Medicine, Feinberg School of Medicine at Northwestern University, Chicago, IL, USA
    Department of Learning Sciences, School of Education and Social Policy, Northwestern University, Evanston, 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
    Leeds Institute of Health Sciences, Faculty of Medicine and Health, University of Leeds, UK)

  • 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)

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

Suggested Citation

  • 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 & David Ma, 2018. "Development and Validation of the Consumer Health Activation Index," Medical Decision Making, , vol. 38(3), pages 334-343, April.
    • Handle: RePEc:sae:medema:v:38:y:2018:i:3:p:334-343
    DOI: 10.1177/0272989X17753392
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    References listed on IDEAS

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    1. Samuel G Smith & Laura M Curtis & Jane Wardle & Christian von Wagner & Michael S Wolf, 2013. "Skill Set or Mind Set? Associations between Health Literacy, Patient Activation and Health," PLOS ONE, Public Library of Science, vol. 8(9), pages 1-7, September.
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    1. Kinias, Ioannis & Chalis, Spyridon & Glyptis, Loukas, 2023. "Family business research: A systematic review and an uncelebrated role of marketing," Journal of Business Research, Elsevier, vol. 162(C).

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