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Response process and test-retest reliability of the Context Assessment for Community Health tool in Vietnam
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Hanoi Sch Publ Hlth, Fac Social Sci Behav & Hlth Educ, 138 Giang Vo St, Hanoi, Vietnam. (Internationell barnhälsa och nutrition/Mårtensson)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). UCL, Inst Global Hlth, London, England.. (Internationell barnhälsa och nutrition/Mårtensson)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Vårdvetenskap. (Internationell barnhälsa och nutrition/Mårtensson)
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för kvinnors och barns hälsa, Internationell mödra- och barnhälsovård (IMCH). (Internationell barnhälsa och nutrition/Mårtensson)
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2016 (Engelska)Ingår i: Global Health Action, ISSN 1654-9716, E-ISSN 1654-9880, Vol. 9, artikel-id 31572Artikel i tidskrift (Refereegranskat) Published
Resurstyp
Text
Abstract [en]

Background: The recently developed Context Assessment for Community Health (COACH) tool aims to measure aspects of the local healthcare context perceived to influence knowledge translation in low-and middle-income countries. The tool measures eight dimensions (organizational resources, community engagement, monitoring services for action, sources of knowledge, commitment to work, work culture, leadership, and informal payment) through 49 items. Objective: The study aimed to explore the understanding and stability of the COACH tool among health providers in Vietnam. Designs: To investigate the response process, think-aloud interviews were undertaken with five community health workers, six nurses and midwives, and five physicians. Identified problems were classified according to Conrad and Blair's taxonomy and grouped according to an estimation of the magnitude of the problem's effect on the response data. Further, the stability of the tool was examined using a test-retest survey among 77 respondents. The reliability was analyzed for items (intraclass correlation coefficient (ICC) and percent agreement) and dimensions (ICC and Bland-Altman plots). Results: In general, the think-aloud interviews revealed that the COACH tool was perceived as clear, well organized, and easy to answer. Most items were understood as intended. However, seven prominent problems in the items were identified and the content of three dimensions was perceived to be of a sensitive nature. In the test-retest survey, two-thirds of the items and seven of eight dimensions were found to have an ICC agreement ranging from moderate to substantial (0.5-0.7), demonstrating that the instrument has an acceptable level of stability. Conclusions: This study provides evidence that the Vietnamese translation of the COACH tool is generally perceived to be clear and easy to understand and has acceptable stability. There is, however, a need to rephrase and add generic examples to clarify some items and to further review items with low ICC.

Ort, förlag, år, upplaga, sidor
2016. Vol. 9, artikel-id 31572
Nyckelord [en]
knowledge translation, context assessment, response process, think-aloud interview, test-retest, validity, reliability, implementation science
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi
Identifikatorer
URN: urn:nbn:se:uu:diva-299625DOI: 10.3402/gha.v9.31572ISI: 000377802800001PubMedID: 27293124OAI: oai:DiVA.org:uu-299625DiVA, id: diva2:949830
Forskningsfinansiär
VetenskapsrådetTillgänglig från: 2016-07-25 Skapad: 2016-07-25 Senast uppdaterad: 2017-11-28Bibliografiskt granskad
Ingår i avhandling
1. Healthcare context for knowledge translation in Vietnam: Development and application of the Context Assessment for Community Health (COACH) tool
Öppna denna publikation i ny flik eller fönster >>Healthcare context for knowledge translation in Vietnam: Development and application of the Context Assessment for Community Health (COACH) tool
2017 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

The failure to translate evidence into clinical practice has been repeatedly highlighted. This failure is partly attributed to disregarding the context within which healthcare is delivered. The aim of this thesis was to develop and psychometrically evaluate the Context Assessment for Community Health (COACH) tool, and, through that process, provide opportunities to measure aspects of context perceived to be important for Knowledge Translation (KT) interventions in low- and middle-income countries (LMIC).

All four studies in this thesis were mainly undertaken in Quang Ninh province, Vietnam during 2008–2014. Study II, however, was also conducted in four other LMICs (Bangladesh, Nicaragua, South Africa, and Uganda). Study I employed inductive content analysis of 16 focus group discussions to explore the influence of context in a community-based facilitation intervention in Vietnam. Studies II and III reported on the development of the COACH tool and assessment of its psychometric properties. Study IV used the COACH tool in a survey among health workers in Vietnam.

To date, three sources of evidence regarding validity of the COACH tool have been provided, that is, test content, response processes, and internal instrument structure, with promising psychometric characteristics. The COACH tool could be used as means of characterizing aspects of context ahead of KT interventions, for tailoring KT strategies, and for further understanding of the results of KT interventions.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2017. s. 67
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1297
Nyckelord
Knowledge translation, Vietnam, Low- and middle-income country, Healthcare context, Context Assessment for Community Health (COACH) tool, Psychometric properties, Tool development.
Nationell ämneskategori
Folkhälsovetenskap, global hälsa, socialmedicin och epidemiologi Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi
Forskningsämne
Hälso- och sjukvårdsforskning
Identifikatorer
urn:nbn:se:uu:diva-314366 (URN)978-91-554-9811-5 (ISBN)
Disputation
2017-03-22, Rosénsalen, Entrance 95/96, Akademiska sjukhuset, Uppsala, 09:15 (Engelska)
Opponent
Handledare
Projekt
Context Assessment for Community Health
Tillgänglig från: 2017-02-28 Skapad: 2017-02-03 Senast uppdaterad: 2018-11-15

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Duc, Duong M.Bergström, AnnaEriksson, LeifSelling, KatarinaWallin, Lars
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