Deng Qingwen, Lu Junhong, Zeng Zhichao, Zheng Yuhang, Liu Wenbin
Department of Health Management, School of Public Health, Fujian Medical University, Fuzhou 350122, People's Republic of China.
Risk Manag Healthc Policy. 2021 Jan 27;14:331-344. doi: 10.2147/RMHP.S293144. eCollection 2021.
Limited diffusion of health technology has greatly halted the improvement of resource integration and healthcare outcomes. The importance of understanding the dynamics of health technology diffusion is increasingly highlighted. However, the dynamic mechanism of health technology diffusion in the context of the integrated care system (ICS) remained largely unknown.
To develop and validate the scale on Dynamics of Health Technology Diffusion in Integrated Care System (DHTDICS) for providing an instrument to investigate the health technology diffusion in the ICS in China, by taking the Des-gamma-Carboxy Prothrombin (DCP) test as an example.
Based on previous classical theories such as the theory of planned behavior (TPB), technology acceptance model (TAM), and technology-organization-environment framework (TOE), the scale with 34 items was initially developed. It was tested in a cross-sectional questionnaire survey including 246 participants from February to August 2019 in China. Cronbach's alpha, corrected item-total correlation, and factor loadings were used to assess reliability. Exploratory factor analysis and confirmatory factor analysis were applied to evaluate the validity by assessing factor structures and correlations.
Reliability analysis revealed excellent internal consistency. Acceptable validity was confirmed through tests of convergent validity and discriminant validity. Regarding the domains that DHTDICS contributes, the results highlighted 4 domains: personal beliefs (including dimensions of attitudes, subjective norms and perceived behavioral control), technical drivers (including dimensions of ease of use and price rationality), organizational readiness (including dimensions of organizational culture, technology absorptive willingness and technology sharing willingness), and external environment (dimension of industry competition pressure).
The findings confirmed the reliability and validity of the scale on DHTDICS. The scale will be not only a scientific tool in determining the dynamics of health technology diffusion in the ICS, but also a helpful reference for developing future interventions to promote health technology diffusion.
卫生技术的有限传播极大地阻碍了资源整合和医疗保健效果的改善。理解卫生技术传播动态的重要性日益凸显。然而，在整合照护系统（ICS）背景下卫生技术传播的动态机制在很大程度上仍不为人所知。
开发并验证整合照护系统中卫生技术传播动态量表（DHTDICS），以提供一种工具来调查中国整合照护系统中的卫生技术传播情况，以去γ-羧基凝血酶原（DCP）检测为例。
基于先前的经典理论，如计划行为理论（TPB）、技术接受模型（TAM）和技术-组织-环境框架（TOE），初步开发了一个包含34个条目的量表。于2019年2月至8月在中国对246名参与者进行了横断面问卷调查测试。采用克朗巴哈α系数、校正的项目-总分相关系数和因子载荷来评估信度。应用探索性因子分析和验证性因子分析，通过评估因子结构和相关性来评价效度。
信度分析显示出优异的内部一致性。通过收敛效度和区分效度检验证实了可接受的效度。关于DHTDICS所涵盖的领域，结果突出了4个领域：个人信念（包括态度、主观规范和感知行为控制维度）、技术驱动因素（包括易用性和价格合理性维度）、组织准备情况（包括组织文化、技术吸收意愿和技术共享意愿维度）以及外部环境（行业竞争压力维度）。
研究结果证实了DHTDICS量表的信度和效度。该量表不仅是确定整合照护系统中卫生技术传播动态的科学工具，也是开发未来促进卫生技术传播干预措施的有益参考。
