Faculty of Nursing, SOKA University, 1-236 Tangi-machi, Hachioji, 192-8577, Tokyo, Japan.
Department of Community and Public Health Nursing, Graduate School of Health Sciences and Faculty of Medicine, Hokkaido University, N12-W5, Kita-ku, Sapporo, 060-0812, Japan.
BMC Public Health. 2022 Jul 26;22(1):1416. doi: 10.1186/s12889-022-13779-5.
Community health workers in Japan are commissioned to work on a voluntary basis on behalf of their communities, to promote healthy behaviors. They are a valuable resource because they can often provide health information and services for local residents with whom professionals find it difficult to engage. However, no instruments exist for evaluating perceptual and behavioral competencies for prevention of non-communicable diseases among voluntary unpaid community health workers in developed countries. This study aimed to develop a community health workers perceptual and behavioral competency scale for preventing non-communicable diseases (COCS-N), and to assess its reliability and validity.
We conducted a cross-sectional study using a self-reported questionnaire. A total of 6480 community health workers across 94 local governments in Japan were eligible to participate. We evaluated the construct validity of the COCS-N using confirmatory factor analysis, and assessed internal consistency using Cronbach's alpha. We used the European Health Literacy Survey Questionnaire and the Community Commitment Scale to assess the criterion-related validity of the COCS-N.
In total, we received 3140 valid responses. The confirmatory factor analysis identified eight items from two domains, with perceptions covered by "Sharing the pleasure of living a healthy life" and behavioral aspects by "Creating healthy resources" (goodness-of-fit index = 0.991, adjusted goodness-of-fit index = 0.983, comparative fit index = 0.993, root mean square error of approximation = 0.036). Cronbach's alpha was 0.88. COCS-N scores were correlated with European Health Literacy Survey Questionnaire scores and Community Commitment Scale scores (r = 0.577, P < 0.001 and r = 0.447, P < 0.001).
The COCS-N is a brief, easy-to-administer instrument that is reliable and valid for community health workers. This study will therefore enable the assessment and identification of community health workers whose perceptual and behavioral competency could be improved through training and activities. Longitudinal research is needed to verify the predictive value of the COCS-N, and to apply it to a broader range of participants in a wider range of settings.
日本的社区卫生工作者受雇于社区，以志愿者身份开展工作，以促进健康行为。他们是一种宝贵的资源，因为他们通常可以为当地居民提供健康信息和服务，而专业人员则很难与这些居民接触。然而，在发达国家，没有评估志愿和无偿社区卫生工作者预防非传染性疾病的感知和行为能力的工具。本研究旨在开发一种用于预防非传染性疾病的社区卫生工作者感知和行为能力量表（COCS-N），并评估其信度和效度。
我们采用自报式问卷进行了一项横断面研究。日本 94 个地方政府的 6480 名社区卫生工作者符合参与条件。我们采用验证性因子分析评估 COCS-N 的结构效度，并采用 Cronbach's alpha 评估内部一致性。我们使用欧洲健康素养调查问卷和社区承诺量表评估 COCS-N 的效标关联效度。
共收到 3140 份有效回复。验证性因子分析确定了两个领域的 8 个项目，其中感知领域涵盖“分享健康生活的乐趣”，行为方面涵盖“创造健康资源”（拟合优度指数=0.991，调整拟合优度指数=0.983，比较拟合指数=0.993，均方根误差近似值=0.036）。Cronbach's alpha 为 0.88。COCS-N 得分与欧洲健康素养调查问卷得分和社区承诺量表得分呈正相关（r=0.577，P<0.001 和 r=0.447，P<0.001）。
COCS-N 是一种简洁、易于管理的工具，对社区卫生工作者具有可靠性和有效性。因此，本研究将能够评估和确定那些感知和行为能力可以通过培训和活动得到提高的社区卫生工作者。需要进行纵向研究来验证 COCS-N 的预测值，并将其应用于更广泛的参与者和更广泛的环境中。
