"BACKGROUND: Successful stroke transitions rely on effective self-management abilities to address stroke deficits and to prevent recurrent stroke. Patient activation and self-efficacy (confidence) are two behavioral constructs that influence successful self-management and are associated with healthier lifestyles and better health outcomes. OBJECTIVE: This cross-sectional, secondary analysis of the Michigan Stroke Transitions Trial aimed to determine the associations between 4 PROMIS self-efficacy (SE) measures [managing medications and treatment, activities of daily living, emotions, and social interactions] and the Patient Activation Measure (PAM). METHODS: Self-reported outcomes were collected 7-days after returning home. PAM measures skill, knowledge, and confidence to manage health and healthcare, while PROMIS SE measures confidence across 4 unique domains. Independent associations of patient characteristics with each PROMIS SE and PAM were determined using a staged multivariable regression model-building approach. Finally, multivariable regression between each PROMIS SE and PAM were explored along with confounding and interaction effects. Variables significantly associated with both SE and PAM were considered as confounders and moderators. Age and education were forced into all models. RESULTS: For 180 patients mean PAM scores were 64.5 (SD: 16) and SE T-scores were near the standard mean of 50 except for SE for managing daily activities (43.5, SD: 7.5). PAM was positively correlated with each SE measure (r=0.28 to r=0.46). Only perceived emotional support and post-stroke disability were associated with both PAM and SE. Emotional support attenuated the association between all SE domains and PAM, whereas post-stroke disability only affected SE for managing daily activities. After adjusting for potential confounders, SE for managing daily activities was no longer associated with PAM. No significant interactions were found. CONCLUSIONS: During acute stroke recovery, PROMIS SE and PAM are associated. It is important to account for perceived support and disability. Longitudinal MISTT analyses will explore mediation effects to help inform causal associations between demographic, clinical, and psychosocial factors, intervention effects, and outcomes."--Page ii.
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