School of Health Management, Fujian Medical University, Fuzhou, 350122, China.
Department of Social Medicine and Health Education, School of Public Health, Peking University, No. 38 Xueyuan Road, Beijing, 100191, China.
BMC Public Health. 2023 Jun 6;23(1):1092. doi: 10.1186/s12889-023-15982-4.
Beijing initiated the nation's most comprehensive tobacco control program that adheres to the WHO Framework Convention on Tobacco Control. This study aimed to identify a set of indicators for the scoping of an Health Impact Assessment (HIA) to assess this policy.
This study used a modified Delphi process. It proposed a tobacco control health impact framework based on the Driving forces- Pressure- State- Exposure- Effect- Action model and the Determinants of Health Theory. After a review of current surveillance system and literature, a working group of 13 experts with multidisciplinary background was established to formulate indicator evaluation criteria and conduct indicator scoring. Each indicator was scored by experts according to four evaluation criteria chosen. Indicators that obtained a total score above 80% and with standard error less than 5 were selected as the final set of indicators. Kendall's coefficient of concordance was calculated.
Twenty-three out of 36 indicators were selected. Smoking prevalence, mortality rate, hospital admission rate, tobacco consumption and hospital admission fees of smoking related diseases achieved more than 90% of total scores and ranked as the top five. Kendall's concordance coefficient was 0.218 for all indicators. For all model composition, Kendall's concordance coefficients were statistically significant.
This study identified a set of twenty-three indicators for scoping of HIA of a comprehensive tobacco control policy in Beijing based on a tobacco control health impact conceptual framework. The set of indicators achieved high scores and statistically significant consistency and has great potential to promote the evaluation of tobacco control policy in a global city. Further study might use the set of indicators for HIA on tobacco control policy to analyze empirical data.
北京启动了全国最全面的控烟计划,该计划遵循世界卫生组织《烟草控制框架公约》。本研究旨在确定一组指标,以进行健康影响评估(HIA)来评估该政策。
本研究采用改良德尔菲法。它基于驱动因素-压力-状态-暴露-影响-行动模型和健康决定因素理论,提出了一个烟草控制健康影响框架。在对当前监测系统和文献进行审查后,成立了一个由 13 名具有多学科背景的专家组成的工作组,制定指标评估标准并进行指标评分。每位专家根据四个选择的评估标准对每个指标进行评分。总得分超过 80%且标准误差小于 5 的指标被选为最终指标集。计算 Kendall 系数的一致性。
从 36 个指标中选出了 23 个。吸烟率、死亡率、住院率、烟草消费和与吸烟有关的疾病的住院费用总得分超过 90%,排名前五。所有指标的 Kendall 一致性系数为 0.218。对于所有模型组成部分,Kendall 一致性系数均具有统计学意义。
本研究基于烟草控制健康影响概念框架,确定了一套 23 个用于北京全面控烟政策健康影响评估的指标。该指标集得分较高,且具有统计学意义的一致性,对于评估全球城市的控烟政策具有很大的潜力。进一步的研究可能会使用该套指标对烟草控制政策进行 HIA,以分析实际数据。