Cross-cultural adaptation of the Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) and development and evaluation of an educational video for remote hip physical examination via telemedicine

Abstract

Introduction: The Patient Education Materials Assessment Tool for Audiovisual Materials (PEMAT-A/V) is widely used to assess the understandability and actionability of health education materials. However, no version adapted to Brazilian Portuguese is yet available. In addition, performing the remote physical examination remains one of the main challenges of musculoskeletal telemedicine, creating a need for educational technologies that can prepare patients before the teleconsultation.
Objective: To translate and cross-culturally adapt the PEMAT-A/V into Brazilian Portuguese and to apply the adapted version in the development and evaluation of an educational technology for the remote hip physical examination via telemedicine.
Methods: This was a two-stage methodological study. First, the PEMAT-A/V was translated and cross-culturally adapted following Beaton et al.'s recommendations, including translation, synthesis, back-translation, expert committee review, pre-testing, and content validation. In parallel, an educational video was developed to guide patients in performing the remote hip physical examination, designed according to the understandability and actionability principles of the PEMAT-A/V. The educational technology was subsequently evaluated using the Brazilian version of the instrument.
Results: The Brazilian version of the PEMAT-A/V showed excellent content validity, with S-CVI/Ave values between 0.988 and 1.000, and high inter-rater reliability (Gwet AC1 = 0.94). The educational video achieved an overall score of 97.2%, with 96.9% for understandability and 98.3% for actionability, indicating high quality of the developed educational technology.
Conclusion: The Brazilian version of the PEMAT-A/V showed adequate linguistic and cultural equivalence, along with adequate content validity and inter-rater reliability, for assessing audiovisual health education materials. Moreover, it demonstrates the use of the instrument not only as an assessment tool but also as a framework for developing educational technologies to prepare patients for the remote physical examination, expanding the potential use of the PEMAT-A/V in telemedicine.