Development and validity testing of the Chinese Version People′s Voice Survey

Objective To develop the Chinese Version People′s Voice Survey (PVS-CN) that incorporates both international comparability and local characteristics and test its reliability and validity.

Methods On the basis of collaborative development of the global version of the evaluation tool, the PVS-CN was formed through localization revisions, translation–back translation, cross-cultural adaptation, and adjustments, with the scale items being tested. In October 2023, a mobile phone survey was conducted across China′s mainland (excluding Hong Kong, Macao, and Taiwan), where mobile phone numbers were randomly selected. A total of 534 valid questionnaires were collected, with 42 participants undergoing retesting after a two-week interval. The reliability and validity of the scale were assessed by item analysis, exploratory factor analysis, confirmatory factor analysis, and other methods of reliability and validity testing.

Results The PVS-CN scale consists of 27 items, covering five dimensions: self-assessed health status, recent healthcare experience, evaluation of the public healthcare system, overall evaluation of the health system, and expectations for the quality of the health system, explaining 67.663% of the total variance. The scale presents the item-level content validity index (I-CVI) ranging from 0.71 to 1.00, the scale-level content validity index/universal agreement (S-CVI/UA) of 0.85, and the average scale-level content validity index (S-CVI/Ave) of 0.98, demonstrating strong content validity. Confirmatory factor analysis shows that the structural validity of the scale is good, with χ²/df = 2.131, normed fit index (NFI) = 0.934, comparative fit index (CFI) = 0.964, goodness-of-fit index (GFI) = 0.910, Tucker-Lewis index (TLI) = 0.960, incremental fit index (IFI) = 0.964, and root mean square error of approximation (RMSEA) = 0.046. The reliability test results show that the overall scale has the Cronbach′s α coefficient of 0.942, the split-half reliability of 0.849, and the test-retest reliability of 0.874, indicating good internal consistency and stability of the scale.

Conclusion The PVS-CN developed in this study demonstrates good reliability and validity, serving as an effective tool for assessing China′s healthcare system from the public perspective, with potential for further application.