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Background: The aim of this study was to develop and evaluate a brief quantitative five-language measure of involvement and satisfaction in clinical decision-making (CDIS) - with versions for patients (CDIS-P) and staff (CDIS-S) - for use in mental health services. Methods: An English CDIS was developed by reviewing existing measures, focus groups, semistructured interviews and piloting. Translations into Danish, German, Hungarian and Italian followed the International Society for Pharmacoeconomics and Outcomes Research (ISPOR) Task Force principles of good practice for translation and cultural adaptation. Psychometricevaluation involved testing the measure in secondary mental health services in Aalborg, Debrecen, London, Naples, Ulm and Zurich. Results: After appraising 14 measures, the Control Preference Scale and Satisfaction With Decision-making English-language scales were modified and evaluated in interviews (n = 9), focus groups (n = 22) and piloting (n = 16). Translations were validated through focus groups (n = 38) and piloting (n = 61). A total of 443 service users and 403 paired staff completed CDIS. The Satisfaction sub-scale had internal consistency of 0.89 (0.86-0.89 after item-level deletion) for staff and 0.90 (0.87-0.90) for service users, both continuous and categorical (utility) versions were associated with symptomatology and both staff-rated and service userrated therapeutic alliance (showing convergent validity), and not with social disability (showing divergent validity), and satisfaction predicted staff-rated (OR 2.43, 95%CI 1.54- 3.83 continuous, OR 5.77, 95%CI 1.90-17.53 utility) and service user-rated (OR 2.21, 95%CI 1.51-3.23 continuous, OR 3.13, 95%CI 1.10-8.94 utility) decision implementation two months later. The Involvement sub-scale had appropriate distribution and no floor or ceiling effects, was associated with stage of recovery, functioning and quality of life (staff only) (showing convergent validity), and not with symptomatology

Clinical decision-making is the vehicle for mental health care delivery, and predictors of decision-making experience and adherence are under-researched. The aim was to investigate the relationship between decision topic and kind of involvement in the decision, satisfaction and subsequent implementation, from both staff and patient perspectives.

Clinical decision-making is the vehicle for mental health care delivery, and predictors of decision-making experience and adherence are under-researched. The aim was to investigate the relationship between decision topic and kind of involvement in the decision, satisfaction and subsequent implementation, from both staff and patient perspectives.

Clinical decision-making is the vehicle for mental health care delivery, and predictors of decision-making experience and adherence are under-researched. The aim was to investigate the relationship between decision topic and kind of involvement in the decision, satisfaction and subsequent implementation, from both staff and patient perspectives.

Clinical decision-making is the vehicle for mental health care delivery, and predictors of decision-making experience and adherence are under-researched. The aim was to investigate the relationship between decision topic and kind of involvement in the decision, satisfaction and subsequent implementation, from both staff and patient perspectives.

Clinical decision-making is the vehicle for mental health care delivery, and predictors of decision-making experience and adherence are under-researched. The aim was to investigate the relationship between decision topic and kind of involvement in the decision, satisfaction and subsequent implementation, from both staff and patient perspectives.