Patient value co-creation behavior scale based on the DART model

Value co-creation focuses on customer participation and co-creates value with suppliers. Patients' support and cooperation can improve the quality of medical care. Value creation is closely related to participants' behavior. The DART (Dialogue, Access, Risk assessment, Transparency) model is widely used in commercial research because it defines and classifies value co-creation behavior clearly and systematically. However, there is little research using the DART model in the field of health care. This study aimed to develop and evaluate the psychometric properties of a scale measuring patient value co-creation behavior based on the DART model.The Delphi technique was used to determine the scale content with a panel of 17 experts. A cross-sectional survey was administered to 356 outpatients and inpatients of a hospital in Guangzhou, China.Internal consistency reliability and composite reliability (CR) were used to estimate the scale's reliability. Validity was assessed using convergent and discriminant validity.Three rounds of expert consultation were completed before a final consensus was reached regarding scale content. The patient value co-creation behavior scale was composed of 23 items and 4 dimensions. The overall Cronbach's α was 0.934, and the CRs of the 4 DART dimensions were 0.843, 0.872, 0.911, and 0.884, respectively, showing satisfactory reliability. The average variance extracted ranged from 0.473 to 0.659, and the χ2 difference between constrained and free models was significant, indicating convergent and discriminant validity.The scale exhibited acceptable reliability and validity and could serve as an evaluation tool for patient value co-creation behavior.