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Parent activation in the pediatric emergency department: Theory vs. reality
Danica B Liberman1, Phung K Pham2
1Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA, USA; Department of Pediatrics, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
Insights
Parent activation in pediatric care was measured using the Parent-Patient Activation Measure (P-PAM). Higher scores were linked to better comprehension and prescription adherence, but the theory needs refinement.
Area of Science:
- Pediatric Healthcare
- Patient Engagement
- Health Outcomes Research
Background:
- Parental activation is crucial for pediatric healthcare outcomes.
- The Parent-Patient Activation Measure (P-PAM) is a tool to assess this construct.
- Existing research on P-PAM psychometrics in pediatrics is limited.
Purpose of the Study:
- To measure parent activation in a pediatric emergency department (ED) setting.
- To examine associations between parent activation and sociodemographics, clinical factors, and short-term outcomes.
- To evaluate the fit of parent activation theory with collected data.
Main Methods:
- Convenience sampling of 246 parents of children treated in a pediatric ED.
- Administration of the Parent-Patient Activation Measure (P-PAM).
- Collection of sociodemographic data, clinical information, and short-term outcomes via medical records and follow-up calls.
Main Results:
- Higher than expected parent activation scores were observed (mean=73).
- Spanish language and child chronic illness status were associated with higher activation.
- Activation scores correlated with ED visit comprehension, discharge instruction comprehension, and prescription filling.
Conclusions:
- Parent activation shows potential associations with key pediatric outcomes.
- The current theory of parent activation may not fully explain findings in this pediatric sample.
- Further research is essential to validate and refine the P-PAM for pediatric use.
Objective:
To measure parent activation and test for its associations with sociodemographics, clinical factors, and short-term outcomes.
Methods:
By convenience sampling, 246 parents of children treated in an emergency department (ED) of a children's hospital completed the Parent-Patient Activation Measure (P-PAM) and answered sociodemographic questions. Clinical information was abstracted from medical records. Phone calls to parents and primary care physician offices were conducted within one-month post-ED visit for information about short-term outcomes.
Results:
We discovered higher than expected activation among our sample (mean = 73), higher activation scores by Spanish language and child chronic illness status, and associations between activation scores and ED visit and discharge instruction comprehension and filling prescriptions (short-term outcomes). However, the theory of parent activation did not adequately fit the data.
Conclusion:
Before the P-PAM in pediatric clinical care becomes widespread, further research is necessary to better understand parent activation and its associations with pediatric outcomes.
Practice Implications:
Although the PAM has shown promise in accurately measuring patient activation across various populations and disease processes, the same is not yet true of the P-PAM. To date, pediatric studies using the P-PAM have called its psychometric properties into question. Further research is needed to understand and measure parent activation.
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