Parent activation in the pediatric emergency department: Theory vs. reality

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 socio-demographic 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. (C) 2018 Elsevier B.V. All rights reserved.