: Functional recovery following lumbar spine surgery may be influenced by the intermediary effect of participation in post-operative physical therapy. This participation and, in turn, functional recovery, may be affected by a host of bio-medical and psycho-social determinants. The long-term goal of the current research program is to understand the interplay of positive psychological strengths and resiliencies on recovery of function, reduction of pain, and improvement in quality of life among individuals undergoing surgery for back pain. ? ? Current psychological theory focuses on an individual's strengths and resources. These resources are ? included if the concept of patient activation (Hibbard, et. al. 2004). An activated patient has the skills, ? knowledge, and motivation to be an effective manager of their health and an active participant in their health care team. To this end, the specific aims of the current proposal are to determine the psychometric properties of the Patient Activation Measure (PAM); to determine the construct validity of the PAM; and to determine the influence of baseline patient activation as assessed by the PAM on participation in post-operative physical therapy. ? ? To achieve these specific aims, we will enroll a cohort of 65 individuals undergoing lumbar spine surgery. This cohort will be assessed pre-operatively and post-operatively in a prospective manner. This assessment will include collection of information regarding bio-medical and psycho-social determinants and health behavior. In addition to meeting these aims, the current research will inform future projects. This will be achieved through the development and refinement of recruitment methods for research in this population, the testing and evaluation of novel reporting mechanisms for health behavior, and the provision of reasonable estimates for sample size calculations and power estimates. ? ?