The public and patient engagement evaluation tool: Forward-backwards translation and cultural adaption to Norwegian

Background: Patient engagement is recommended for improving health care services, and to evaluate its organisa- tion and impact appropriate, and rigorously evaluated outcome measures are needed. Methods: Interviews (N = 12) were conducted to assess relevance of the Canadian Public and Patient Engagement Evaluation Tool (PPEET) in a Norwegian setting were performed. The tool was translated, back translated, and assessed following cognitive interviews (N = 13), according to the COSMIN checklist. Data quality was assessed in a cross-sec- tional survey of patient advisory board members from different rehabilitation institutions (N = 47). Results: Interviews with patient board representatives confirmed the relevance of the PPEET Organisational ques- tionnaire in a Norwegian setting and contributed five additional items. Translation and back translation of the original PPEET showed no major content differences. Differences in vocabulary and sentence structure were solved by discus- sion among the translators. Comments from cognitive interviews mainly related to the use of different synonyms, layout, and minor differences in semantic structure. Results of the cross-sectional survey support the data quality and construct validity of PPEET items, including 95 score comparisons where 76 (80%) were as hypothesized. Conclusions: The PPEET Organisational questionnaire has been thoroughly translated and tested, and the resulting Evalueringsverktøy for Brukermedvirkning (EBNOR) has adequate levels of comprehensibility and content validity. Fur- ther testing for measurement properties is recommended, but given these results, the EBNOR should be considered for assessing patient engagement in a Norwegian health care organisational context