03/05/2026
By Maureen Martin

The Zuckerberg College of Health Sciences, Solomont School of Nursing, invites you to attend a doctoral dissertation defense by Linette C. Wilson on "The Association Between Patient Activation and Health Behaviors and Outcomes in Community Dwelling Older Adults ."

Date: Thursday, March 19, 2026
Time: 1-4 p.m.
Location: This will be a virtual defense via Zoom. Those interested in attending should email Linette_Wilson@student.uml.edu and committee chair Yuan_Zhang@uml.edu at least 24 hours prior to the defense to request access to the meeting.

Committee:

  • Yuan Zhang, Ph.D., RN, FAAOHN, FAAN, Associate Professor, Solomont School of Nursing, Zuckerberg College of Health Sciences, UMass Lowell
  • Lisa Abdallah, Ph.D., RN, CNE, Professor Emerita, Solomont School of Nursing, Zuckerberg College of Health Sciences, UMass Lowell
  • Jason Rydberg, Ph.D., Associate Professor, School of Criminology and Justice Studies, UMass Lowell

Abstract:

Background: Within the next five years, all Baby Boomers will be aged 65 years and over, representing over 17% of the United States population. As one ages, the risk for developing chronic disease increases, with most older adults living with at least one chronic disease. As the primary consumers of healthcare, it is important for older adults to actively engage in their provider visits and participate in making decisions regarding management of their chronic disease. Effectively managing chronic disease will help decrease healthcare costs and symptom burden.

Aims: Guided by the Social Ecological Model, the aims of this study were (1) to examine intrapersonal, interpersonal and community factors associated with patient activation; and (2) to explore health behaviors and outcomes associated with patient activation, in a sample of community dwelling older adults participating in the 2022 Medicare Current Beneficiary Survey (Centers for Medicare and Medicaid Services, 2025).

Methods: This was a cross-sectional, secondary data analysis of the 2022 MCBS. Sample size was 9,365 (weighted N=55,276,504) beneficiaries aged 65 years and older who completed the patient activation items. Multivariable linear regression analyzed the association of patient activation with demographic factors, social isolation, trouble getting to the provider’s office, difficulty communicating due to hearing, being accompanied to appointments, and satisfaction with care. We utilized multivariable linear and logistic regression to examine the association between patient activation and health care utilization, health screenings, general health status, and three scales measuring ability to perform activities of daily living, physical disability, and depressive symptoms while controlling for gender, age, race, marital status, income, and education level.

Results: Of the 9,364 beneficiaries, 22.3% were aged 70-74 years, 57% were female, and 38% had a high level of patient activation. Being female, having higher income, a higher level of education, and a higher level of satisfaction with care were associated with higher patient activation scores. Being 85 years and over, divorced, reporting a higher level of social isolation, and reporting difficulty communicating with their provider due to hearing problems were associated with lower patient activation scores. Beneficiaries with higher patient activation scores were more likely to utilize health care services, have recent blood pressure and cholesterol measurements, have preventive health screenings for bone mass, colon cancer, or oral cancer, and have had a wellness visit in the last year. Additionally, beneficiaries with higher patient activation scores were more likely to have fewer depressive symptoms and less difficulties with ADLs.

Conclusions: It is important for healthcare providers to assess patients’ level of activation in order to recognize those with lower scores. Providers should elicit feedback from the patient related to their health goals, and overall physical, mental, and social health. Providers and office staff need to follow up appropriately with patients to encourage more interaction and information sharing. Evidence-based interventions should be developed and implemented in the healthcare delivery system to increase patient activation, and in turn to improve patient health behaviors and outcomes. Older adults will benefit from higher activation to remain more independent, and have better chronic disease management, higher quality of life, and lower healthcare costs.

Keywords: patient activation, community dwelling older adults, Medicare Current Beneficiary Survey, chronic disease