Cross-cultural translation and content validity of the Determinants of Physical Activity Questionnaire (DPAQ) in a Dutch stroke rehabilitation population and their peers without stroke

BACKGROUND: Stroke patients are less physically active than the general population. Various determinants can affect post-stroke physical activity; understanding these determinants can help tailor targeted interventions. The Determinants of Physical Activity Questionnaire (DPAQ), based on the Theoretical Domains Framework, assesses determinants of physical activity. This study aimed to translate the DPAQ into Dutch and evaluate its content validity (comprehensibility, relevance and comprehensiveness) in a stroke population and their peers without stroke. METHODS: The DPAQ was translated according to international guidelines. Content validity was assessed at an outpatient neurorehabilitation clinic. Seven stroke patients completed the DPAQ using think aloud and cognitive debriefing. Audio-recorded data were transcribed, coded and analysed. The DPAQ was adapted and re-tested in seven other stroke patients and seven peers. RESULTS: The translation and content validity test resulted in the following adaptations: the DPAQ introduction was clarified; the response option ‘Do not want to answer’ was changed to ‘Cannot answer’; and some negatively phrased items were converted to positive. Of the adapted version, most items were found comprehensible and relevant by both stroke patients and peers, except for items on coping planning (complex sentence structure and abstract item-wording) and goal conflict (irrelevant for some patients and peers). The DPAQ was found comprehensive for both patients and peers. CONCLUSIONS: A Dutch version of the DPAQ was created, which was considered comprehensible, relevant and comprehensive for both stroke patients and peers without stroke. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41687-026-01058-5.