Cross-cultural adaptation of the Healthcare Provider-Patient Activation Scale to Japanese

[Purpose] This study aimed to investigate a cross-cultural adaptation of the 40-item Healthcare Provider-Patient Activation Scale (HP-PAS). [Participants and Methods] We followed a guideline for cross-cultural adaptation that recommended using two forward and backward translations. In pilot testing, participants were Japanese physical therapists who provided comments about expression readability. Two authors independently categorized each comment as either “unable to understand” or “suggestion to enhance clarity”, after which Cohen κ and % agreement were used to assess agreement. We then assessed the flooring and ceiling effects, internal consistency, and Spearman ρ between the factor scores of the patient-activation-approach and non-patient-activation-approach. [Results] A total of 58 Japanese physical therapists participated in the pilot test. The agreement on comments was κ=0.44 and 86.5%. We identified the flooring and ceiling effects for most items. In addition, the internal consistency was acceptable for each factor; however, the Spearman ρ between the patient-activation-approach and non-patient-activation-approach factor scores was positive when it should have been negative. [Conclusion] We developed a Japanese version of the HP-PAS which will serve as a foundation for future studies to establish a measurement method for the magnitude of patient activation in the physical therapist population.