Inclúyeme: measuring patient engagement in healthcare for Spanish-speaking patients: a measurement equivalence study.

OBJECTIVES

Some Spanish-language instruments assess patient engagement in healthcare, but, to our knowledge, none jointly measure engagement capacity and behaviors. We translated the Patient Engagement Capacity Survey (PECS) into Spanish and evaluated structural validity and measurement equivalence with the English version.

METHODS

Three native speakers used a team-based translation approach to translate the 18-item PECS (with subscales Engagement Behaviors [EB] and Engagement Capacity [EC]) into Spanish. We recruited Spanish-speaking adults in clinic and via social media and analyzed a previously collected English-speaking sample. We conducted confirmatory factor analyses (CFAs) and examined measurement invariance across languages.

RESULTS

The sample included 253 Spanish- and 1172 English-language respondents, predominantly female and White. CFA results supported the hypothesized structure in both languages, although fit varied across groups. RMSEA and SRMR exceeded benchmarks in the Spanish EC model (RMSEA = 0.103, SRMR = 0.083), and RMSEA slightly exceeded the benchmark for the English EB model (RMSEA = 0.065). The remaining fit indices met benchmarks (EC: CFI = 0.994, TLI = 0.991, RMSEA = 0.051, SRMR = 0.043 for English and CFI = 0.989, TLI = 0.984 for Spanish; EB: CFI = 0.981, TLI = 0.971, SRMR = 0.054 for English and CFI = 0.992, TLI = 0.987, RMSEA = 0.055, SRMR = 0.062 for Spanish). All factor loadings exceeded 0.40. Configural, metric, and scalar invariance were supported for both subscales by overlapping 90% RMSEA confidence intervals and decreases in CFI of no more than 0.01.

CONCLUSIONS

The Spanish PECS shows evidence of measurement equivalence with the English version, although absolute fit for Engagement Capacity was weaker in Spanish.

PRACTICAL IMPLICATIONS: The Spanish PECS provides a foundation for assessing engagement behaviors and capacity among Spanish-speaking patients. Using the PECS in patients' preferred language may help healthcare systems and providers identify needs for educational, navigational, or system-level support.