Public and Patient Engagement Evaluation Tool [PPEET]

Description

The Public and Patient Engagement Evaluation Tool (PPEET) was developed to systematically assess the quality, process, and impact of public and patient engagement within healthcare organizations and health system initiatives.

The tool was developed by Abelson and colleagues through collaboration between researchers and professionals working in patient and public engagement. It is designed to support organizations in evaluating how effectively patients, families, caregivers, and members of the public are involved in decision-making, service improvement, policy development, and health system planning.

The PPEET is not a single psychometric scale with one overall score. Rather, it consists of a family of three complementary questionnaires, each assessing engagement from a different perspective.

Objective

The primary objective of the PPEET is to evaluate whether public and patient engagement activities are meaningful, inclusive, well organized, and capable of influencing decisions and healthcare improvement.

The tool helps organizations identify strengths and weaknesses in their engagement practices, understand participants’ experiences, and improve future initiatives.

It can also provide information about whether participants feel respected, adequately informed, supported in their participation, and able to contribute meaningfully to healthcare-related decisions.

Structure

The PPEET includes three main questionnaires:

Participant Questionnaire: Assesses the experience of patients, family members, caregivers, citizens, or other individuals participating in an engagement activity. It focuses on the quality of participation, communication, inclusiveness, support, and perceived influence.

Project Questionnaire: Designed for project leaders or staff responsible for a specific engagement initiative. It evaluates the planning, implementation, management, and impact of the engagement process.

Organization Questionnaire: Assesses the broader organizational capacity, culture, resources, and infrastructure that support meaningful patient and public engagement.

Together, these questionnaires provide a multidimensional view of engagement at the participant, project, and organizational levels.

Main Areas of Assessment

The PPEET evaluates several important aspects of engagement.

Quality of the Engagement Process: Examines whether the engagement activity was appropriately designed, clearly structured, and effectively facilitated.

Inclusiveness and Representation: Assesses whether participants with different backgrounds, experiences, and perspectives were able to contribute.

Communication and Information: Evaluates whether participants received clear, understandable, and sufficient information to participate meaningfully.

Support for Participation: Examines whether participants were provided with the resources and assistance required to contribute effectively.

Influence on Decision-Making: Assesses whether participants believe that their views, experiences, and recommendations were considered and had an impact on decisions.

Organizational Capacity: Evaluates whether the organization has the culture, leadership, resources, and processes required to sustain meaningful engagement.

Scoring

The PPEET uses multiple response formats, depending on the questionnaire and item being assessed.

These may include Likert-type response scales, multiple-choice items, categorical responses, and open-ended questions.

Because the PPEET evaluates several distinct aspects of engagement, interpretation is generally performed by individual item, thematic area, or questionnaire, rather than by calculating one overall engagement score.

Quantitative responses can be summarized using frequencies, percentages, means, or other descriptive indicators, while qualitative responses can be analyzed thematically to identify recurring experiences, concerns, and recommendations.

Psychometric and Methodological Properties

The development of the PPEET included literature review, expert consultation, stakeholder involvement, and usability testing across different healthcare settings.

Research has supported its practical usefulness for evaluating public and patient engagement in health system organizations. Subsequent implementation studies have also examined its feasibility and utility in real-world healthcare environments.

Translated and culturally adapted versions of the PPEET have been developed, demonstrating its potential for use across different healthcare systems and cultural contexts.

When applied in a new language or setting, researchers should consider examining content validity, construct validity, reliability, comprehensibility, and cultural appropriateness.

Applications

The PPEET can be used in hospitals, healthcare organizations, research programs, patient advisory committees, quality-improvement initiatives, healthcare planning processes, and policy-development activities.

It may support both formative evaluation, in which results are used to improve an ongoing engagement process, and summative evaluation, in which the effectiveness and impact of a completed initiative are assessed.

The tool is particularly useful for organizations seeking to move beyond symbolic participation toward more meaningful forms of collaboration, co-design, and shared decision-making.

Research and Statistical Use

Data collected through the PPEET can be analyzed using descriptive statistics to summarize participants’ experiences and perceptions.

Comparative analyses may be conducted across projects, organizations, participant groups, or time periods. Where appropriate, researchers may also examine associations between engagement quality and variables such as participant characteristics, type of engagement activity, organizational support, or perceived impact.

Open-ended responses provide complementary qualitative information and may help explain why particular aspects of engagement were perceived positively or negatively.

Conclusion

The Public and Patient Engagement Evaluation Tool (PPEET) provides a structured and practical framework for evaluating the quality and effectiveness of patient and public engagement in healthcare.

Its main strength is its ability to assess engagement from three complementary perspectives: the participant, the project, and the organization. This multidimensional approach supports a more comprehensive understanding of engagement quality and can guide organizations toward more inclusive, meaningful, and effective participation practices.

References

Abelson, J., Li, K., Wilson, G., Shields, K., Schneider, C., & Boesveld, S. (2016). Supporting quality public and patient engagement in health system organizations: Development and usability testing of the Public and Patient Engagement Evaluation Tool. Health Expectations, 19(4), 817–827.

Abelson, J., Humphrey, A., Syrowatka, A., Bidonde, J., & Judd, M. (2019). Supporting the evaluation of public and patient engagement in health system organizations: Results from an implementation research study. Health Expectations, 22(5), 1132–1143.

Garratt, A. M., et al. (2022). The Public and Patient Engagement Evaluation Tool: Forward-backwards translation and cultural adaptation to Norwegian. BMC Musculoskeletal Disorders, 23.

Boote, J., Baird, W., & Sutton, A. (2006). Public involvement at different levels of health-care decision making: A systematic review. Health Policy, 75(3), 295–309.

Crawford, M. J., Rutter, D., Manley, C., et al. (2002). Systematic review of involving patients in the planning and development of health care. BMJ, 325, 1263.