Parent Activation Measure for Developmental Disabilities (PAM-DD) in Caregivers of Individuals With ASD

Abstract

Activation refers to patients’ belief, knowledge, ability, and persistence to manage care. The concept is adapted to parent activation in developmental disorders. This study examined the psychometrics of the Parent Activation Measure for Developmental Disabilities (PAM-DD) and factors related to parent activation in ASD. Data from 658 caregivers of children with ASD in the Autism Treatment Network Registry Call Back Assessment study were analyzed. The actual ordering of the scale items was inconsistent with the assumptions of a Guttman scaling. Factor analysis revealed two PAM-DD factors. Lower child symptom severity was related to higher Factor 1 and lower Factor 2 activation. Future studies should use caution when treating PAM-DD as a Guttman and unidimensional scale.

Factor structure and internal consistency of the parent patient activation measure (P-PAM) in parents of children with ADHD in Norwegian paediatric mental health

“…Recent studies have shown that ADHD in children often affect parent-child interactions negatively and that parents of children with ADHD present with higher levels of stress and irrational beliefs related to emotion-focused strategies [47,48]. Compared to other paediatric studies by Pennarola, DeCamp, Liberman and Yu [12,[14][15][16], we found higher activation scores for parents than what have previously been reported. The authors from a study of parent activation in a sample of caregivers of children in an emergency department [15] reported a mean activation score of 73 (SD = 15.74), while Yu et al [16] reported a mean activation score of 67.36 (SD = 5.82) in a sample of caregivers of children with autism spectrum disorders.…”

“…The exploratory factor analysis in our study suggests an extraction of two factors and demonstrates a strong positive correlation between the factors. Similar to our findings, factor analyses in previous studies have uncovered that the data did not fit the theoretical four-factor model of parent activation and the theoretical structure of patient activation as four factors (beliefs, confidence, action, perseverance) [14][15][16].…”

“…There are various adapted versions of parent activation measures in circulation, such as the Parent Activation Measure for Developmental Disabilities (PAM-DD) [16], and Parent Patient Activation Measure-Mental Health (P-PAM-MH) [3]. Although evidence indicates that the measures are valid and reliable, it does not necessarily follow that the same applies to different populations and chronic illnesses [13].…”

“…In addition, several adapted versions may impede the comparability of studies, as well as increase concerns regarding the underlying factor structure on whether the P-PAM measure the same construct as the PAM. Another aspect is that most studies that have evaluated the P-PAM include and compare English-and Spanishspeaking parents with the aim of evaluating differences in demographics and socio-economic conditions [14][15][16]43], which may cause bias in the findings.…”

“…The initial assessment of the P-PAM has shown a high internal consistency value (Cronbach's alpha for PAM-13, α = 0.86; and P-PAM α = 0.85) and a high correlation to the PAM-13 in terms of the univariate comparison of PAM-13 and P-PAM (r = 0.55, p < 0.001) [12]. However, there have been limited empirical studies to validate the internal consistency and factor structure to implement the P-PAM for use in clinical settings [12,[14][15][16]. Even though the original PAM-13 has shown good psychometric properties across various contexts [3,7,12,14,[17][18][19][20][21][22], there is a scarcity in research results that have confirmed that the factor model of the P-PAM is consistent with the theory of the PAM-13 and the four-factor model (beliefs, confidence, action, and perseverance) for parent activation [4,[14][15][16].…”