Translation, Adaptation, and Validation of Person-Centered Primary Care Measures for Patients in Family Doctor Contract Services within Mainland China

Abstract

Background: In the context of China's health reforms enhancing its primary care function through Family Doctor Contract Service Program, effectively measuring its health-beneficial features is paramount. This study endeavors to translate, adapt, and validate the Person-Centered Primary Care Measure (PCPCM) for primary care patients enrolled in family doctor contract services in mainland China. Methods Following the guidelines by Sousa and Rojjanasrirat, we translated and adapted the PCPCM into simplified Chinese and evaluated its psychometric properties. Our assessment involved 583 patients in family doctor contract services from 10 primary care facilities in Shanghai, China. We analyzed various aspects, including internal consistency, stability, homogeneity, construct-related validity, criterion-related validity, dimensionality, and model fit of the adapted PCPCM. Additionally, we conducted subgroup analyses focusing on patients with hypertension and/or diabetes and seniors aged 65 and above. Results: The adaptation resulted in the PCPCM for patients under the family doctor contract service program(PCPCM-SC-FDCP), tailored for primary care patients under the family doctor contract service program in mainland China. Initial pilot testing led to refinements for clearer applicability, particularly for Item 5. The PCPCM-SC-FDCP demonstrated excellent internal consistency (Cronbach's α = 0.94), homogeneity (Correlation = 0.67–0.85), construct-related validity (Correlation = 0.72, p < 0.001), and criterion-related validity (Correlation = 0.54, p < 0.001), alongside satisfactory dimensionality and model fit. Stability reliability (ICC = 0.56), while slightly below the ideal, was deemed acceptable. The instrument also performed well in subgroup analyses. Conclusions: The PCPCM-SC-FDCP proves to be an effective patient-reported outcome measure, for measuring patient experiences with primary care's functional features among those enrolled in family doctor contract services in mainland China. Its widespread adoption is anticipated to significantly aid the strategic reform of China's primary care system by highlighting and improving functional features within the local healthcare framework.