Cross-cultural Adaptation and Psychometric Testing of the Malay Version of Patient Education Materials Assessment Tool

Abstract

Introduction: The Patient Education Materials Assessment Tool (PEMAT) evaluates the understandability and actionability of patient education materials. There are PEMAT-P and PEMAT-A/V for printable and audio-visual materials respectively. This study cross-culturally adapted these versions of PEMAT into Malay and determine their psychometric properties. Materials and methods: The study proceeded in four stages: 1) translation and cross-cultural adaptation of PEMAT-P(M) and PEMAT-A/V(M) (four translators, five healthcare workers [HCWs]), followed by cross-sectional studies to 2) determine the internal consistency, inter-rater and test-retest reliabilities (nine HCWs), 3) determine the validity by correlation with the Suitability Assessment of Materials (SAM) (20 HCWs) and 4) determine the validity by correlation with the Consumer Testing Questionnaire (16 adult patients). These stages involved HCWs from different healthcare disciplines. Results: Cross-culturally adapted PEMAT-P(M) and PEMAT-A/V(M) were produced. The median Cronbach’s alpha for understandability and actionability domains ranged between 0.78 and 0.90. The domain-level inter-rater reliability showed ICCs ranging from 0.72 to 0.81, and test-retest reliability showed ICCs ranging from 0.82 to 0.90. The item-level inter-rater and test-retest reliability showed Gwet’s AC1 values above 0.60 for most items. Significant positive correlations were found between all PEMAT-P(M) and PEMAT-A/V(M) scores with the SAM score. Most domain scores were significantly correlated with the consumer testing comprehension score, while only one domain score was significantly correlated with consumer testing numerical score. Conclusion: The cross-culturally adapted PEMAT-P(M) and PEMAT-A/V(M) were found to be valid and reliable. PEMAT(M) can be used by raters from diverse backgrounds to evaluate printable and audiovisual patient education materials.