Xiong Shangzhi, Zhu Gangjiao, Malhotra Rahul, Chen Xinyue, Gong Enying, Wang Zhan, Zhang Jian'An, Peng Weixia, Wang Shiwei, Jin Xurui, Peoples Nicholas, Østbye Truls, Tian Maoyi, Yan Lijing L
Global Health Research Centre, Duke Kunshan University, Kunshan, China.
The George Institute for Global Health, Faulty of Medicine and Health, University of New South Wales, Sydney, Australia.
PLOS Glob Public Health. 2024 Aug 14;4(8):e0003549. doi: 10.1371/journal.pgph.0003549. eCollection 2024.
The importance of community-based non-communicable disease (NCD) management has been internationally recognized. However, currently, no instrument is available to evaluate a community's ability to provide NCD management for its residents. This study defined such an ability as "Community Efficacy for NCD Management" (COEN), and aimed to conceptualize, develop and validate a scale to measure COEN. We first conducted literature review, expert interviews, and Delphi panels to conceptualize COEN and select scale items. Then, we conducted two rounds of community surveys and interviews to validate the COEN scale among local residents in three cities in China. We used Cronbach's alpha to test the scale's internal consistency, Kappa test for test-retest reliability, and exploratory factor analysis for structural validity. COEN was conceptualized as "the ability of a community to provide NCD management for its residents, reflected by its natural environment, social relationships, community resources, health services, and resident-engaging activities." The first community research among 345 residents yielded a 38-item COEN scale with high internal consistency (Cronbach's alpha = 0.86) and acceptable test-retest reliability (Kappa value >0.2). The second community research tested a shortened COEN scale among 657 residents, yielding a final COEN scale with 14 items from five factors: community management (n = 3), social relationships (n = 4), resource accessibility (n = 3), community health services (n = 2), and resident engagement (n = 2), with an overall Cronbach's alpha of 0.79. COEN is a meaningful concept in contextualizing and evaluating NCD management anchored in the community, and the COEN scale is a multi-domain reliable tool to quantify COEN, which can be used to guide future related research and practice in public health.
基于社区的非传染性疾病（NCD）管理的重要性已得到国际认可。然而，目前尚无工具可用于评估社区为其居民提供非传染性疾病管理的能力。本研究将这种能力定义为“非传染性疾病管理的社区效能”（COEN），旨在概念化、开发并验证一个用于测量COEN的量表。我们首先进行了文献综述、专家访谈和德尔菲小组讨论，以概念化COEN并选择量表项目。然后，我们在中国三个城市对当地居民进行了两轮社区调查和访谈，以验证COEN量表。我们使用克朗巴哈系数（Cronbach's alpha）检验量表的内部一致性，用kappa检验重测信度，并用探索性因素分析检验结构效度。COEN被概念化为“社区为其居民提供非传染性疾病管理的能力，由其自然环境、社会关系、社区资源、卫生服务和居民参与活动所反映”。对345名居民进行的首次社区研究得出了一个包含38个条目的COEN量表，具有较高的内部一致性（克朗巴哈系数=0.86）和可接受的重测信度（kappa值>0.2）。第二次社区研究在657名居民中测试了一个简化的COEN量表，得出了一个最终的COEN量表，该量表包含来自五个因素的14个条目：社区管理（n = 3）、社会关系（n = 4）、资源可及性（n = 3）、社区卫生服务（n = 2）和居民参与（n = 2），总体克朗巴哈系数为0.79。COEN是一个在将非传染性疾病管理置于社区背景下并进行评估方面有意义的概念，而COEN量表是一个用于量化COEN的多领域可靠工具，可用于指导未来公共卫生领域的相关研究和实践。
