Open Access Research article

Development of the patient approach and views toward healthcare communication (PAV-COM) measure among older adults

Derjung M Tarn1*, Henry N Young2 and Benjamin M Craig3

Author affiliations

1 Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, USA

2 School of Pharmacy, University of Wisconsin Madison, Madison, USA

3 Health Outcomes & Behavior, Moffitt Cancer Center, University of South Florida, Tampa, USA

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Citation and License

BMC Health Services Research 2012, 12:289  doi:10.1186/1472-6963-12-289

Published: 30 August 2012



This study examines the psychometric properties of 9 items on the Patient Activation component of the Medicare Current Beneficiary Survey (MCBS) that assess how patients approach and communicate with their physicians. The MCBS is a nationally representative, cross-sectional survey of Medicare beneficiaries.


We analyzed MCBS data collected in 2002 and 2005 from 15,165 adults aged 65 and older. Exploratory factor analysis was conducted using maximum likelihood to estimate a polychoric correlation matrix on the 2002 data, and confirmatory factor analysis was performed using the 2005 data.


Exploratory factor analysis of the 2002 data showed a 2-factor solution: approach to interactions (5 items) and views about physician’s healthcare communication (6 items). Findings were confirmed using the 2005 data. Items were combined to form the Patient Approach and Views toward Healthcare Communication (PAV-COM) scale (range 1 to 100; Cronbach’s alpha of 0.75, and item-rest correlations between 0.33 and 0.54). Higher PAV-COM scores were associated with greater fulfillment of preventive health behaviors such as vaccinations and cancer screenings.


The PAV-COM measure is a valid tool for assessing patient approaches and views toward communication with physicians. This measure can be used to evaluate interventions to improve patient participation during healthcare encounters.

Physician-patient communication; Patient activation; Factor analysis