| [Background]Facing up with more and more public health emergencies and the increasing of resource input into the emergency prevention, response and disposing, public health emergency attracts more and more social attentions nowadays. Although the government has a lot of preponderance in dominating resource and leading different departments to cooperate with each other, it still has some limitation inevitably. Consequently, we should absorb and exert the effect of the social potency, including every relative department and even the whole society, to control and eliminate the emergency and make the loss to the lowest level.Social mobilization is an effective method to control and treat with public health emergencies. There used to be many researches in social mobilization in the past, which only limited to certain aspect of it. However, no comprehensive social mobilization indicators system has been reported to be established so far. There are many grades of public health emergencies, and different mobilizing level for different emergency grades. This research aims to develop a comprehensive public health emergency social mobilization indicator system, including all the possible and feasible indicators, so it probes into the most serious emergency grade.[Objectives]This research is to develop a comprehensive index system of public health emergency social mobilization by Delphi-Method. It aims to establish a scientific feasibility and comprehensive index system through two rounds of Delphi-Method, explore the main content of the system and screen out the appropriate scientific indicators.Calculating the reasonable weight of each indicator with mathematic ways and rank them according to the weights to find out the important and primary parts in the system.This research is aimed at primarily establishing a scientific and feasible comprehensive index system evaluation model of social mobilization in public health emergencies. It has theoretical and practical value in dealing with public health emergencies.[Methods]1. Establish the indexes system of comprehensive evaluation of the social mobilization in public health emergencies and set down weight coefficients of each index using the advanced Delphi method. The initial questionnaire was developed through literature review and semi-structured interview. First, mail the experts selected by the leader group two times. The experts include epidemiologists, specialists of treating public health emergencies, social medical experts, and specialists from the Center of Disease Prevention and Control, specialists of health administration, and officials of the government. And then, collect the information mailed back, and analyze the weight of each index given by the experts. Authority coefficient is used to estimate the authority degree of the experts. The higher the authority coefficient, the more authoritative the expert is. And the precision of the result is better. Average and full mark rate are used to evaluate the concentricity of the experts opinions. The higher the average and the full mark rate, the more important the index is. We use standard variance and variation coefficient to estimate the disperse degree of the experts' opinions. The higher the standard variance and variation coefficient, the worse the concentricity of the experts' opinions are. Harmony coefficient and Chi-square test are used to evaluate the harmonious degree of the experts' opinions. Harmony coefficient fluctuates from zero to one. If the harmony coefficient is more than 0.5, and has statistics significance, we thought the concentricity of the experts is good. Colligate the qualitative analysis of Delphi by the experts and mathematic ways to calculate the reasonable weight coefficient of each index, and rank the indexes by the coefficients. The higher the weight coefficient, the more important the index is.2. Verify whether the interior structure of the comprehensive index system is scientific by using factor analysis, primarily.3. Establish the indexes system of comprehensive evaluation and comprehensive index evaluation model of the social mobilization in public health emergencies by using analytic hierarchy process (AHP), primarily.4. Analyze the results of Delphi investigation using descriptive statistics, factor analysis, and Chi-square test by SPSS13.0.[Results]1. Results of DelphiThis research went on two-round Delphi consultation. We sent out 35 questionnaires in the first round, and received 34 mails back, 32 of which are effective. The effective rate is 94.118%. In the second round, we sent out 30 questionnaires, and received 25 copies back, all of which are effective. The effective rate is 100%. There were 14 experts in the first round and 5experts in the second round giving some suggestions. The proportion of the experts giving suggestions in the two round consultations is 43.75% and 20.00% respectively. The positivity coefficients of the two round consultations are comparatively high. The authority coefficients of the experts in the two round consultations are 0.756 and 0.754 respectively, both of which are high comparatively. The coordination coefficients of all the indicators in the two round consultations are 0.11 and 0.195 respectively. The coordination coefficient of the first-class indicators in the first round consultation is 0.66, and 0.211 in the second round consultation. The coefficients of the second-class indicators are 0.11 and 0.183 respectively in the two-round consultations. And the coefficients of the third-class indicators are 0.43 and 0.103 respectively in the two-round consultations. The results of the Chi-square test of the coordination coefficients are all no statistically significant. We modified, incorporated, deleted and fine-tuned the indicators according to the experts' suggestions. After filtering, we finally established a comprehensive index system of social mobilization in public health emergencies which included 6 one-grade indicators, 23 two-grade indicators, and 30 three-grade indicators.2. Results of Weight coefficientsSet down weight coefficients of each index using the advanced Delphi method and analytic hierarchy process (AHP).The weight coefficient of each indicator is different. The highest weight coefficient of one-grade indicators is 0.1762, and the indicator is "Domestic systematically commanding". And the next is "Mobilization of other social resources", of which the weight coefficient is 0.1744; the weight coefficient of "Mobilization of manpower" is 0.1649; "Mobilization of information and communication" is 0.1643; "Mobilization of material" is 0.1629; the lowest weight coefficient of the one-grade indicators is 0.1572, and the indicator is "Mobilization of economy". The highest weight coefficient of two-grade indicators is 0.06135, and the indicator is "Improving the leadership of the government, and establish a long-term mechanism of public health emergencies supported by relative codices." And the next is "the promulgating of authoritative information by the government", of which the weight coefficient is 0.06017; "the comprehensive mobilization of education, electric power, agriculture, post-office, land office and many other departments, dealing the emergencies actively, and reducing the loss" is 0.05933; "Mobilization of traffic and transportation" is 0.005923; "Quest of international aid and cooperation in scientific research, technology, and economy" is 0.0559; "Punishing or deposing the officials breaching of duty, prizing the meritorious, and protecting the prosecutor" is 0.05468; the lowest weight coefficient of the two-grade indicators is 0.03098, and the indicator is "Setting up an effective resource assigning net which communicating with each area domestic freely" . And the 30 three-grade indicators were also given relevant weight coefficients.3. Results of factor analysis The two-grade indicators were classified to six factors by factor analysis. This is consilient to the six one-grade indicators designed in the questionnaire. The accumulative contribution rate of the six chief factors is 78.468%, and the contribution rates of the fist five chief factors are all more than 10%. There are no superpositions among the factors. The three-grade indicators were classified to nine factors by factor analysis, and the accumulative contribution rate of he nine chief factors is 87.442%. The contribution rates of the first four chief factors are all more than 10%. There are no superpositions among the factors. We primarily proved that the structure of the index system finally obtained was relatively scientific.4. Establishment of index system and evaluation modelWe established the indexes system of comprehensive evaluation and comprehensive index evaluation model of the social mobilization in public health emergencies, primarily.[Conclusion]1. This research based on large literature review and semi-structured interview. After two rounds of Delphi procedure, the comprehensive index system of social mobilization in public health emergencies including three-grade indexes was finally obtained. The first grade included 6 items, the second grade included 23 items, and the third grade consisted of 30 items. The three grades' indexes depended on and contacted with each other, but emphasized particularly on different aspects. The index system is dialectic unification.2. The method of Delphi is straightforward and feasible. It can make use of the intelligences and experiences of the experts to fetch up the deficiency of the basic data or primary indexes. The positivity, the authority coefficient and the harmony coefficient of the experts in this study show that the comprehensive index system obtained is accurate and reliable. The index system can reflect the content of the social mobilization in public health emergencies whole and systematically.3. This research made some beneficial try and exploration on the capacity evaluation of treating public health emergencies. It has some effects on guiding the preparation before the emergency and leading the treatment of the emergency when it comes. The outcome of this preliminary research can provide a basis for the further study on concrete indexes and an evaluation more exactly.[Suggestions]1. To use existing information when collect data. Make use of the data reported by health office and board of health to reduce the cost of the job, and make sure of the veracity and reliability.2. To test the reliability and validity first before use this comprehensive evaluation index system of social mobilization in public health emergencies. Validity of content is a subjective index, and it's ascertained by the experts. It's used to estimate whether all the aspects of the content we want to evaluate are included in the index system. Construct Validity is often tested by principal components analysis (PCA) in factor analysis. It is used to estimate whether the structure of the index system is accordant with academic frame and get the expected results. We explain the interior relations of the indexes by factor analysis of statistic multianalysis. We often use clustering analysis and analysis of variance (ANOVA) to verify the discern capability and sensitivity of the comprehensive evaluation index system. |
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