中国公众公共卫生安全素养量表的开发研究

陈颖; 侯晓辉; 宁艳; 王晓妍; 李英华; 聂雪琼; 李杰; 田向阳

Abstract

陈颖,侯晓辉,宁艳,王晓妍,李英华,聂雪琼,李杰,田向阳.中国公众公共卫生安全素养量表的开发研究[J].Chinese journal of Epidemiology,2022,43(7):1118-1126

中国公众公共卫生安全素养量表的开发研究

Study of development of public health safety literacy scale in China

Received:November 15, 2021

DOI：10.3760/cma.j.cn112338-20211115-00883

KeyWord: 公共卫生安全素养量表经典测试理论项目反应理论

English Key Word: Public health safety literacy Scale Classical test theory Item response theory

FundProject:国家社会科学基金(20VYJ047)

Author Name	Affiliation	E-mail
Chen Ying	Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei 230032, China
Hou Xiaohui	Academic Committee of Chinese Center for Health Education, Beijing 100011, China
Ning Yan	Publicity Office of Chinese Center for Health Education, Beijing 100011, China
Wang Xiaoyan	Science Popularization Department of Chinese Center for Health Education, Beijing 100011, China
Li Yinghua	Monitoring and Evaluation Department of Chinese Center for Health Education, Beijing 100011, China
Nie Xueqiong	Monitoring and Evaluation Department of Chinese Center for Health Education, Beijing 100011, China
Li Jie	Publicity Office of Chinese Center for Health Education, Beijing 100011, China
Tian Xiangyang	Academic Committee of Chinese Center for Health Education, Beijing 100011, China	healthtian@163.com

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Abstract:

目的开发公共卫生安全素养量表，为我国公众的公共卫生安全素养测评提供适宜工具。方法通过理论构想、指标池构建、现场验证、题项缩减等步骤编制中国公共卫生安全素养初始量表，转为“问卷星”电子问卷，随机抽取4个省份共2 809名居民进行现场测试。利用经典测试理论（CTT）和项目反应理论（IRT）进行题项缩减。使用SPSS 23.0软件进行探索性因子分析（EFA）和单维性检验。使用R 4.1.1软件ltm和mirt包进行题项的心理测量学指标分析，并绘制项目特征曲线（ICC）和信息函数曲线（IIC和TIF）。结果选用专家一致性系数最优的初始量表3，共30个题项（B1~B30），测试对象完成1个题项平均需9.8 s。根据CTT分析，删除校正题项-总相关系数（CITC）<0.3及题项-维度相关系数（IDCC）<0.4的B2题项；删除CITC<0.3、IDCC<0.4及难度指数<0.2的B23题项；删除CITC<0.3及难度指数<0.2的B30题项。删除后量表总内部一致性信度（Cronbach's α）值为0.923。EFA提示删除14个因子载荷较小的题项（<0.7），对保留的13个题项再进行EFA，提取2个公因子，各题项的因子载荷均>0.7，2个公因子累积方差贡献率为63.361%，总Cronbach's α值为0.891，符合单维性，根据IRT分析，题项B14和B20的区分度系数<0.3，难度界限系数超出范围［-3，3］，信息量较小，且ICC表现为平缓、聚堆、无单调性，IIC无峰值，提示删除。最终由11个题项组成的量表总Cronbach's α值为0.936，模型拟合度指标非规准适配指数为0.97，比较适配指数为0.99，渐进残差均方和平方根为0.03。结论最终量表具有较好的信度、效度、区分度、难易度和可行性，可较好地应用于中国公众公共卫生安全素养的快速测评。

English Abstract:

Objective To develop a suitable scale for assessing the public health safety literacy in residents in China. Methods The initial scale of Chinese public health safety literacy was developed through theoretical conceptualization, item pooling, field verifying and item inclusion and exclusion. Then the initial scale was converted into an electronic questionnaire. A total of 2 809 residents from 4 provinces were randomly selected for field testing. Classical test theory (CTT) and item response theory (IRT) were used for item reduction. SPSS 23.0 was used for exploratory factor analysis (EFA) and unidimensional testing. Package R 4.1.1 ltm and mirt were used for the analysis of the psychometric properties of items and generate the ICC, IIC and TIF. Results The initial scale had 30 items (B1-B30), and the test took 9.8 s to complete one item averagely. According to the CTT, B2 was deleted due to coefficient of total correlation (CITC) <0.3 and the item-dimension correlation coefficient (IDCC) <0.4. B23 was deleted due to CITC<0.3, IDCC<0.4 and difficulty index (W) <0.2. B30 was deleted due to CITC<0.3 and W<0.2. The total Cronbach's α of the scale was 0.923 after deletion. EFA indicated that 14 items should be deleted due to lower factor loadings <0.7. EFA was conducted for remaining 13 items and 2 common factors were extracted, the factor loadings of all items were >0.7, the accumulated variance contribution of the 2 common factors was 63.361%, and the total Cronbach's α was 0.891, showing unidimensionality, IRT was used to test the remaining items. B14 and B20 were deleted due to discrimination coefficient (a) <0.3, difficulty threshold coefficient (b) ∉[-3,3], the small amount of information and the flat, crowded, non-monotonic ICC, and IIC. Finally, the Cronbach's α of the 11-itemed scale was 0.936 with TLI=0.97, CFI=0.99, and RMSEA=0.03.Conclusion The final scale has good reliability, validity, discrimination, difficulty level and feasibility, and can be applied for the rapid assessment of public health safety literacy in China.

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