# Development of a Patient-Reported Measure to Assess Healthcare Engagement

> **NIH VA I01** · VETERANS ADMIN PALO ALTO HEALTH CARE SYS · 2020 · —

## Abstract

Enhancing engagement with health care is the foundation for VHA's transformation to personalized,
proactive, patient-driven care that optimizes health and well-being. Patient engagement is linked to better care
experiences and better clinical outcomes at reduced costs: the “triple aim” of healthcare systems. The science
devoted to measurement must keep pace with new models of care. The ability to measure Veteran
engagement is a critical component of patient-centered care. A self-report measure could be incorporated into
patient-facing applications, inform personalized care plans and risk stratification, and facilitate research efforts.
Extant measures do not meet VHA needs with respect to literacy levels, measurement sensitivity, or feasibility.
 Our goal is to develop a Veteran-centered, precise, and predictive patient-report measure that
quantifies the propensity to engage with health care. Our approach builds on a Veteran-centered construct
definition and item pool derived through extensive pilot work. A multi-level stakeholder engagement strategy
will optimize Veteran usability and correspondence with VHA strategic priorities. The use of calibrated item
banks will enable flexible implementation for a range of treatment settings and Veteran populations.
 The proposed aims of this project are to: 1) establish an item bank and corresponding short form that
measures a Veteran's propensity to engage with health care; 2) assess concurrent validity and test-retest
reliability of the measure; and 3) evaluate the predictive validity of the new measure against objective
indicators of patient engagement. The item pool will be evaluated using a national survey of VHA primary care
users who have been diagnosed with a mental health condition (depression and PTSD) or chronic medical
condition (hypertension and diabetes), oversampling for women and racial minorities. Item Response Theory
models will be used to calibrate items. Convergent validity with self-report correlates of patient engagement will
provide preliminary validation. Predictive validity will be examined using global and condition-specific indicators
of engagement from VA administrative data aggregated over the year following the survey.
 The VHA population has a high burden of chronic illness. The treatment demands of complex chronic
conditions can be overwhelming to patients and account for a disproportionate amount of health care costs.
High value care is determined by how well services fit with Veteran needs, preferences, and opportunities to
benefit from care. A measure of engagement can help tailor care to Veteran needs and identify individuals who
require adjunctive intervention to achieve the most benefit from their care. This research will fill an important
gap in population health management, not only by enhancing risk prediction, but by integrating Veteran
perspectives through patient-report measures. This work will catalyze efforts to promote engagement with care
by providing flexib...

## Key facts

- **NIH application ID:** 9692258
- **Project number:** 5I01HX002317-02
- **Recipient organization:** VETERANS ADMIN PALO ALTO HEALTH CARE SYS
- **Principal Investigator:** Rachel Kimerling
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2020
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2018-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9692258

## Citation

> US National Institutes of Health, RePORTER application 9692258, Development of a Patient-Reported Measure to Assess Healthcare Engagement (5I01HX002317-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9692258. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*