Okamoto Reiko, Kageyama Masako, Koide Keiko, Tanaka Miho, Yamamoto Yoshiko, Fujioka Mana, Osuna Ayami, Saeki Kazuko, Hirokane Kazue, Nagano Fusami, Takemura Shinji
Division of Health Sciences, Osaka University Graduate School of Medicine, Yamadaoka 1-7, Suita-city, Osaka, 565-0871, Japan.
Former Division of Health Sciences, Osaka University Graduate School of Medicine, Osaka, Japan.
Implement Sci Commun. 2022 Feb 19;3(1):20. doi: 10.1186/s43058-022-00270-w.
More than 70% of public health nurses in Japan belong to government agencies, and there is a need for further evidence-based capacity development for program implementation. The purpose of this research was to develop an Implementation Degree Assessment Sheet (IDAS) by customizing the Consolidated Framework for Implementation Research (CFIR) to health programs in Japan.
The draft IDAS (five domains, 31 constructs) created by customizing the CFIR was refined by the researchers and modified through pre-testing. The survey covered full-time public health nurses (PHNs) affiliated to all prefectures and the cities with health centers of Japan. The survey was conducted as an anonymous, self-administered questionnaire survey by mail.
One hundred eighty-five of the 334 institutions (55.4%) agreed to participate in our survey. Of the 966 questionnaire forms distributed, 709 forms (73.4%) were collected, of which 702 responses (72.7%) were valid. No item required consideration of deletion based on the results of item analysis, and our confirmatory factor analysis on model fitness between the five IDAS domains and CFIR showed sufficient fit indices after modification. With regard to reliability, Cronbach's coefficient alpha, a measure of internal consistency, stayed above 0.8 overall. Our verification of stability with the split-half (odd/even) method resulted in a Spearman-Brown reliability coefficient of 0.95. The correlation coefficient between the IDAS scores and the research utilization competency score, used as an external criterion, was 0.51 (p<0.001), supporting the coexistence validity of the criterion-related validity of the IDAS. The significant differences were observed between known-groups, supporting the known-group validity of the IDAS.
This study developed the IDAS and confirmed constant reliability and validity. Hereafter, it is necessary to promote the required capacity development based on the actual degree of implementation in order to use the IDAS for the competency development of public health nurses and related professions to deliver health programs.
日本超过70%的公共卫生护士隶属于政府机构，在项目实施方面需要进一步开展循证能力建设。本研究旨在通过将实施研究整合框架（CFIR）针对日本的卫生项目进行定制，开发一份实施程度评估表（IDAS）。
研究人员对通过定制CFIR创建的IDAS草案（五个领域，31个构建块）进行了完善，并通过预测试进行了修改。该调查涵盖了日本所有都道府县及设有保健所的城市的全职公共卫生护士（PHN）。调查以邮件方式进行匿名的自填式问卷调查。
334个机构中的185个（55.4%）同意参与我们的调查。在分发的966份问卷中，回收了709份（73.4%），其中702份回复（72.7%）有效。基于项目分析结果，没有项目需要考虑删除，并且我们对五个IDAS领域与CFIR之间模型适配度的验证性因素分析在修改后显示出足够的适配指数。在可靠性方面，作为内部一致性度量的Cronbach's系数α总体上保持在0.8以上。我们使用分半（奇数/偶数）法对稳定性进行的验证得出Spearman-Brown可靠性系数为0.95。IDAS得分与用作外部标准的研究利用能力得分之间的相关系数为0.51（p<0.001），支持了IDAS标准关联效度的并存效度。在已知组之间观察到了显著差异，支持了IDAS的已知组效度。
本研究开发了IDAS并确认了其可靠性和效度的稳定性。此后，有必要根据实际实施程度推动所需的能力建设，以便将IDAS用于公共卫生护士及相关职业的能力发展，以实施卫生项目。
