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CONTENTS Chapter 1 Chapter 2 Chapter 3 Chapter 4 General introduction 9 Perceived ease of use and usefulness of the Dutch 23 Patient Specific Complaints Questionnaire by patients with Dutch and Turkish backgrounds and diverse levels of literacy Completing the Patient Specific-Complaint Question- 25 naire in physical therapy practice is problematic for high and low literate patients: a qualitative study Development of the Dutch Talking Touch Screen 49 Questionnaire Deriving guidelines for designing interactive question- 51 naires for low literate persons; development of a health assessment questionnaire Evaluation of the Dutch and Turkish version of 81 the Talking Touch Screen Questionnaire 4.1 Using plain language and adding communication 83 technology to an existing health related question- naire to help generate accurate information: qualita- tive study. 4.2 A Mobile Patient Reported Outcome Measure 109 (PROM) App for Physical Therapy Patients: Usability Assessment of the Dutch Talking Touch Screen Ques- tionnaire 4.3 Usability of the Turkish translation of the Dutch 139 Talking Touch Screen Questionnaire for physical ther- apy patients with a Turkish background; qualitative study Appendix 1 Screenshots Dutch Talking Touch Screen 168 Questionnaire Appendix 2 Screenshots Turkish Talking Touch Screen 175 Questionnaire