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Northwestern University Feinberg School of Medicine
Center for Applied Health Research on Aging
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Developing a Consumer Activation and Engagement Tool for the Kingdom of Saudi Arabia


October 2017-June 2020

Funding Source:

Eli Lilly and Company

Grant Number:



The objective of this study is to develop and evaluate an assessment of patient activation for diabetes care for use in the Kingdom of Saudi Arabia (KSA). Patients with diabetes are increasingly required to manage their health and make informed health-related decisions. This includes making healthy lifestyle choices, seeking medical care appropriately, and using prescription medications safely and according to instructions for use. Many of these activities occur outside the clinical setting, without provider monitoring or input. Thus, many healthcare stakeholders have an increased interest in measuring diabetic patients’ ‘activation’ or “willingness to take on the role of managing their diabetes-related health and healthcare.” Unfortunately, currently available measures of patient activation are not appropriate for patients with low literacy skills, are not diabetes-specific, require licensing to use, and can be difficult for patients to self-administer and healthcare professionals to interpret. Many are also not specific to patients living in KSA.

Measures previously developed by the Northwestern University for general use (Consumer Health Activation Index or ‘CHAI’) and chronic disease-specific use (Influence, Motivation and Patient Activation specific to the context of type 2 diabetes or ‘IMPACTD’) will serve as a starting point for this project, along with a guiding definition that patient activation refers to ‘the degree to which individuals value health and believe they can influence it.’ An individual’s activation in their diabetes care can be influenced by context-specific expectations of the healthcare system they must access and navigate, as well as culture and health beliefs. Therefore, we will seek to understand the unique context of diabetes care in KSA through a mixed methods approach, which will incorporate qualitative and quantitative feedback from patients and healthcare professionals to understand pertinent issues related to the self-management of diabetes within KSA. We will then further refine and develop items for the new measure. Items will be translated into Arabic, with every consideration made to the cultural adaptation of the tool for use among this specific population. Psychometric testing will then be conducted to ensure that items are valid and reliable; predictive validity will be determined through the acquisition of additional clinical data reflective of intermediary chronic disease outcomes.



• Principal Investigator: Michael S. Wolf, PhD MPH
• Project Lead: Guisselle Wismer, MPH

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