Article(id=1320438266445288035, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, articleNumber=null, orderNo=null, doi=10.11847/zgggws1148618, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1754841600000, receivedDateStr=2025-08-11, revisedDate=1760976000000, revisedDateStr=2025-10-21, acceptedDate=1773072000000, acceptedDateStr=2026-03-10, onlineDate=1792746615277, onlineDateStr=2026-10-23, pubDate=1775750400000, pubDateStr=2026-04-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792746615277, onlineIssueDateStr=2026-10-23, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792746615277, creator=13701087609, updateTime=1792746615277, updator=13701087609, issue=Issue{id=1320438090615862080, tenantId=1146029695717560320, journalId=1319373219989389464, year='2026', volume='42', issue='4', pageStart='385', pageEnd='512', issueExtLink='null', onlineDate='null', pubDate='1775750400000', pubDateStr='2026-04-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792746573356, creator='13701087609', updateTime=1792748076043, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1320444393430040620, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1320444393430040621, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1320438090615862080, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=412, endPage=417, ext={EN=ArticleExt(id=1320438267158319718, articleId=1320438266445288035, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Developing the initial scale of behavioral capability in the prevention and control of respiratory infectious diseases: based on Delphi method, columnId=1320438091370836801, journalTitle=Chinese Journal of Public Health, columnName=Special Report—Development of Public Health Evaluation Indicator Frameworks, runingTitle=null, highlight=null, articleAbstract=
Objective

To develop the initial scale of behavioral capability in the prevention and control of respiratory infectious diseases, thereby providing a scientific tool for the surveillance and evaluation of respiratory infectious diseases in China.

Methods

From November 2024 to February 2025, literature retrieval and expert interviews were conducted to define the concept of behavioral capability in the prevention and control of respiratory infectious diseases. Subsequently, an item pool was constructed based on the social cognitive and behavioral change theories. Finally, the scale items were determined via the nominal group technique and Delphi expert consultation.

Results

Both rounds of Delphi expert consultation showed the response rate of 100% and the expert authority coefficient of 0.91. The mean score ranges of importance, necessity, feasibility, and semantic accuracy of each item were 3.33–4.81, 3.26–4.81, 3.41–4.81, and 3.48–4.70 in the first round of consultation and 4.04–4.89, 4.07–4.89, 3.78–4.74, and 3.96–4.78 in the second round, respectively. The full-score rates of the above four scoring dimensions in the first and second rounds were all >20% and >25%, respectively. The ranges of coefficients of variation of scores were 0.16–0.42, 0.16–0.43, 0.17–0.37, and 0.18–0.37 in the first round and 0.07–0.23, 0.07–0.35, 0.13–0.25, and 0.09–0.29 in the second round, respectively. The Kendall′s W values were 0.513, 0.496, 0.458, and 0.481 in the first round and 0.313, 0.299, 0.362, and 0.442 in the second round, respectively (all P < 0.01). Ultimately, the scale comprised 5 items for confidence, 9 items for competence, and 8 items for agency.

Conclusions

The constructed initial scale for behavioral capability in the prevention and control of respiratory infectious diseases and the selected items are scientific and reliable, which can provide an effective tool for the surveillance and evaluation of respiratory infectious diseases.

, authors=Meng QIAN1, Zhixin CHEN2, Huixian ZHANG2, Zhongliang ZHOU3, Shaoqing GONG4, Xiangyang TIAN1, 2, authorsList=Meng QIAN, Zhixin CHEN, Huixian ZHANG, Zhongliang ZHOU, Shaoqing GONG, Xiangyang TIAN, authorCompany=null, correspAuthors=Shaoqing GONG, Xiangyang TIAN, authorNote=null, correspAuthorsNote=
GONG Shaoqing, E-mail:
TIAN Xiangyang, E-mail:
, copyrightStatement=Copyright © 2026 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1320438268102038119, articleId=1320438266445288035, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=呼吸道传染病防控行为能力初始量表构建:基于德尔菲专家咨询法, columnId=1320438091530220355, journalTitle=中国公共卫生, columnName=专题报道——公共卫生评价指标体系构建, runingTitle=null, highlight=null, articleAbstract=
目的

构建呼吸道传染病防控行为能力初始量表,为中国呼吸道传染病防控监测和评估提供科学工具。

方法

于2024年11月—2025年2月通过文献检索和专家访谈定义呼吸道传染病防控行为能力,基于社会认知和行为改变理论构建条目池,采用Nominal Group、德尔菲专家函询方法遴选量表条目。

结果

2轮函询问卷回收率均为100%,专家权威系数0.91。2轮函询各条目重要性、必要性、可行性和语义准确性得分均值范围第1轮分别为3.33~4.81、3.26~4.81、3.41~4.81、3.48~4.70,第2轮分别为4.04~4.89、4.07~4.89、3.78~4.74、3.96~4.78,满分率第1轮均>20%,第2轮均>25%;2轮得分变异系数第1轮分别为0.16~0.42、0.16~0.43、0.17~0.37、0.18~0.37,第2轮分别为0.07~0.23,0.07~0.35,0.13~0.25、0.09~0.29;2轮Kendall′s W值第1轮分别为0.513、0.496、0.458、0.481,第2轮分别为0.313、0.299、0.362、0.442(均P<0.01)。最终构建的呼吸道传染病防控行为能力量表包括自信力5条,潜力9条,行动力8条。

结论

构建的呼吸道传染病防控行为能力初始量表和遴选条目科学可靠,可为防控呼吸道传染病防控监测评估提供有效工具。

, authors=钱梦1, 陈志昕2, 张慧娴2, 周忠良3, 巩少青4, *, *, 田向阳1, 2, *, *, authorsList=钱梦, 陈志昕, 张慧娴, 周忠良, 巩少青, 田向阳, authorCompany=null, correspAuthors=巩少青, 田向阳, authorNote=

钱梦(1991—),助理研究员,博士,研究方向:公共卫生与健康教育

, correspAuthorsNote=
巩少青,E-mail:
田向阳,E-mail:
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Initial scale of behavioral capability in the prevention and control of respiratory infectious diseases

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维度条目行为改变理论域度 行为能力
自信力1.有人在身旁打喷嚏、咳嗽时,应主动避开动机保护理论传播途径自我防护
2.流感大范围流行期间,去非常熟悉的公共场所,不用戴口罩动机保护理论传播途径自我防护
3.流感大范围流行期间,很熟悉的同事或朋友之间说话,不用保持距离健康信念模式传播途径自我防护
4.发热咳嗽很常见,乘用公共汽车时口罩可戴可不戴动机保护理论传播途径预防传播
5.家人出现高热咳嗽等症状,在家里不用佩戴口罩动机保护理论传播途径自我保护
潜力6.病死禽畜煮熟煮透仍可食用或售卖健康信念模式传染源预防传播
7.见面握手是传统礼仪,不会传播疾病健康信念模式传播途径预防传播
8.肺结核患者经治疗症状减轻后,就可恢复正常的工作、学习健康信念模式传染源预防传播
9.雾霾属于大气污染现象,与呼吸道传染病无关健康信念模式传播途径自我防护
10.多吃保健品有利于提高免疫力健康信念模式易感人群科学治疗
11.营养不良会增大患结核病的风险健康信念模式易感人群危险因素预防
12.只要接种流感疫苗就能预防流感的发生健康信念模式易感人群免疫接种
13.连续咳嗽咳痰>2周,怀疑自己得了肺结核动机保护理论传染源早发现
14.呼吸道传染病患者居家治疗期间,应保证相对独立的空间健康信念模式传染源传染源隔离
行动力15.感冒发烧不是什么大病,应该照常上班、上学健康信念模式传染源预防传播
16.只要手上没有污物,看起来干净,就没必要洗动机保护理论传播途径自我防护
17.出现持续高热、咳嗽等症状,应及时就医动机保护理论传染源早治疗
18.得了传染病要不要进行隔离、诊治,完全是个人的事,他人无权干预健康信念模式传染源法律责任
19.随地吐痰是不文明行为,但与传染病传播无关健康信念模式传播途径预防传播
20.咳嗽、打喷嚏时应立即用双手捂住口鼻动机保护理论传播途径预防传播
21.口罩只要不破损,可以反复佩戴动机保护理论传播途径自我防护
22.有时候小道消息比正规媒体上的消息更可靠健康信念模式易感人群信源辨别
), ArticleFig(id=1320438278722015908, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1320438266445288035, language=CN, label=表1, caption=

RIDs防控行为能力初始量表

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维度条目行为改变理论域度 行为能力
自信力1.有人在身旁打喷嚏、咳嗽时,应主动避开动机保护理论传播途径自我防护
2.流感大范围流行期间,去非常熟悉的公共场所,不用戴口罩动机保护理论传播途径自我防护
3.流感大范围流行期间,很熟悉的同事或朋友之间说话,不用保持距离健康信念模式传播途径自我防护
4.发热咳嗽很常见,乘用公共汽车时口罩可戴可不戴动机保护理论传播途径预防传播
5.家人出现高热咳嗽等症状,在家里不用佩戴口罩动机保护理论传播途径自我保护
潜力6.病死禽畜煮熟煮透仍可食用或售卖健康信念模式传染源预防传播
7.见面握手是传统礼仪,不会传播疾病健康信念模式传播途径预防传播
8.肺结核患者经治疗症状减轻后,就可恢复正常的工作、学习健康信念模式传染源预防传播
9.雾霾属于大气污染现象,与呼吸道传染病无关健康信念模式传播途径自我防护
10.多吃保健品有利于提高免疫力健康信念模式易感人群科学治疗
11.营养不良会增大患结核病的风险健康信念模式易感人群危险因素预防
12.只要接种流感疫苗就能预防流感的发生健康信念模式易感人群免疫接种
13.连续咳嗽咳痰>2周,怀疑自己得了肺结核动机保护理论传染源早发现
14.呼吸道传染病患者居家治疗期间,应保证相对独立的空间健康信念模式传染源传染源隔离
行动力15.感冒发烧不是什么大病,应该照常上班、上学健康信念模式传染源预防传播
16.只要手上没有污物,看起来干净,就没必要洗动机保护理论传播途径自我防护
17.出现持续高热、咳嗽等症状,应及时就医动机保护理论传染源早治疗
18.得了传染病要不要进行隔离、诊治,完全是个人的事,他人无权干预健康信念模式传染源法律责任
19.随地吐痰是不文明行为,但与传染病传播无关健康信念模式传播途径预防传播
20.咳嗽、打喷嚏时应立即用双手捂住口鼻动机保护理论传播途径预防传播
21.口罩只要不破损,可以反复佩戴动机保护理论传播途径自我防护
22.有时候小道消息比正规媒体上的消息更可靠健康信念模式易感人群信源辨别
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呼吸道传染病防控行为能力初始量表构建:基于德尔菲专家咨询法
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钱梦 1 , 陈志昕 2 , 张慧娴 2 , 周忠良 3 , 巩少青 4, *, * , 田向阳 1, 2, *, *
中国公共卫生 | 专题报道——公共卫生评价指标体系构建 2026,42(4): 412-417
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中国公共卫生 |专题报道——公共卫生评价指标体系构建 2026 , 42 (4) : 412 -417
呼吸道传染病防控行为能力初始量表构建:基于德尔菲专家咨询法
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钱梦1, 陈志昕2, 张慧娴2, 周忠良3, 巩少青4, *, * , 田向阳1, 2, *, *
作者信息
  • 1中国健康教育中心,北京 100000
  • 2安徽医科大学公共卫生学院营养与食品卫生系,合肥 230031
  • 3西安交通大学公共政策与管理学院,西安 710049
  • 4漯河医学高等专科学校,漯河 462002
通讯作者:
巩少青,E-mail:
田向阳,E-mail:
作者简介:

钱梦(1991—),助理研究员,博士,研究方向:公共卫生与健康教育

Developing the initial scale of behavioral capability in the prevention and control of respiratory infectious diseases: based on Delphi method
Meng QIAN1, Zhixin CHEN2, Huixian ZHANG2, Zhongliang ZHOU3, Shaoqing GONG4 , Xiangyang TIAN1, 2
Affiliations
  • 1Chinese Center for Health Education, Beijing 100000, China
  • 2Department of Nutrition and Food Hygiene, School of Public Health, Anhui Medical University, Hefei 230031, China
  • 3School of Public Policy and Administration, Xi′an Jiaotong University, Xi′an 710049, China
  • 4Luohe Medical College, Luohe 462002, China
  • Corresponding Author:
    GONG Shaoqing, E-mail:
    TIAN Xiangyang, E-mail:
出版时间: 2026-04-10 doi: 10.11847/zgggws1148618
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目的

构建呼吸道传染病防控行为能力初始量表,为中国呼吸道传染病防控监测和评估提供科学工具。

方法

于2024年11月—2025年2月通过文献检索和专家访谈定义呼吸道传染病防控行为能力,基于社会认知和行为改变理论构建条目池,采用Nominal Group、德尔菲专家函询方法遴选量表条目。

结果

2轮函询问卷回收率均为100%,专家权威系数0.91。2轮函询各条目重要性、必要性、可行性和语义准确性得分均值范围第1轮分别为3.33~4.81、3.26~4.81、3.41~4.81、3.48~4.70,第2轮分别为4.04~4.89、4.07~4.89、3.78~4.74、3.96~4.78,满分率第1轮均>20%,第2轮均>25%;2轮得分变异系数第1轮分别为0.16~0.42、0.16~0.43、0.17~0.37、0.18~0.37,第2轮分别为0.07~0.23,0.07~0.35,0.13~0.25、0.09~0.29;2轮Kendall′s W值第1轮分别为0.513、0.496、0.458、0.481,第2轮分别为0.313、0.299、0.362、0.442(均P<0.01)。最终构建的呼吸道传染病防控行为能力量表包括自信力5条,潜力9条,行动力8条。

结论

构建的呼吸道传染病防控行为能力初始量表和遴选条目科学可靠,可为防控呼吸道传染病防控监测评估提供有效工具。

呼吸道传染病  /  防控行为能力  /  自信力  /  潜力  /  行动力  /  德尔菲专家咨询法
Objective

To develop the initial scale of behavioral capability in the prevention and control of respiratory infectious diseases, thereby providing a scientific tool for the surveillance and evaluation of respiratory infectious diseases in China.

Methods

From November 2024 to February 2025, literature retrieval and expert interviews were conducted to define the concept of behavioral capability in the prevention and control of respiratory infectious diseases. Subsequently, an item pool was constructed based on the social cognitive and behavioral change theories. Finally, the scale items were determined via the nominal group technique and Delphi expert consultation.

Results

Both rounds of Delphi expert consultation showed the response rate of 100% and the expert authority coefficient of 0.91. The mean score ranges of importance, necessity, feasibility, and semantic accuracy of each item were 3.33–4.81, 3.26–4.81, 3.41–4.81, and 3.48–4.70 in the first round of consultation and 4.04–4.89, 4.07–4.89, 3.78–4.74, and 3.96–4.78 in the second round, respectively. The full-score rates of the above four scoring dimensions in the first and second rounds were all >20% and >25%, respectively. The ranges of coefficients of variation of scores were 0.16–0.42, 0.16–0.43, 0.17–0.37, and 0.18–0.37 in the first round and 0.07–0.23, 0.07–0.35, 0.13–0.25, and 0.09–0.29 in the second round, respectively. The Kendall′s W values were 0.513, 0.496, 0.458, and 0.481 in the first round and 0.313, 0.299, 0.362, and 0.442 in the second round, respectively (all P < 0.01). Ultimately, the scale comprised 5 items for confidence, 9 items for competence, and 8 items for agency.

Conclusions

The constructed initial scale for behavioral capability in the prevention and control of respiratory infectious diseases and the selected items are scientific and reliable, which can provide an effective tool for the surveillance and evaluation of respiratory infectious diseases.

respiratory infectious diseases  /  behavioral capability in prevention and control  /  confidence  /  competence  /  agency  /  Delphi method
钱梦, 陈志昕, 张慧娴, 周忠良, 巩少青, 田向阳. 呼吸道传染病防控行为能力初始量表构建:基于德尔菲专家咨询法. 中国公共卫生, 2026 , 42 (4) : 412 -417 . DOI: 10.11847/zgggws1148618
Meng QIAN, Zhixin CHEN, Huixian ZHANG, Zhongliang ZHOU, Shaoqing GONG, Xiangyang TIAN. Developing the initial scale of behavioral capability in the prevention and control of respiratory infectious diseases: based on Delphi method[J]. Chinese Journal of Public Health, 2026 , 42 (4) : 412 -417 . DOI: 10.11847/zgggws1148618
呼吸道传染病(respiratory infectious diseases, RIDs)大多通过飞沫和近距离接触传播,具有发病急、传播迅速、危害广泛等特点[1],容易造成流行或大流行[2]。RIDs的传播和流行与人类行为相关,特别是与必要时不佩戴口罩、近距离接触、不注意手卫生等高危行为(high-risk behaviors, HRBs)[3]关系密切,减少或消除RIDs-HRBs可以有效控制RIDs的传播和流行。截至目前,国际上虽然已经开发了多个有关RIDs相关行为的评估工具[4–7],但均依赖自我报告法测量个体的行为,存在误报、漏报或根据社会期望不如实报告的问题[8],可能导致较大的报告偏倚,影响量表的实际应用价值。另外,我国开发的相关量表则多聚焦于测量机构[9–10]或专业人员[11–12]的应急能力。已开发的RIDs健康素养测评工具[13–14]也仅用以测量个体传染病有关的信息认知能力,以及与传染病防控相关的知识和技能。行为能力是指个体通过学习获取的知识和技能实施行为的能力[15],是行为的关键预测因素[16]。在监测实际行为准确度低、不易实现的情况下,采用量表测量个体的行为能力,用以预测实际行为,可作为传染病高危行为监测的有效替代[15–16]。研究开发RIDs防控行为能力量表将为我国RIDs监测评估和防控的循证决策提供工具,具有重要实用价值。为此,本研究团队于2024年11月—2025年2月结合文献检索、专家访谈及专家函询等方法,构建了中国居民RIDs防控行为能力初始量表,为传染病监测和效果评估提供适宜工具。
本研究团队于2024年11月—2025年2月以“呼吸道传染病”(respiratory infectious/communicable disease)“行为能力”(behavioral capability)及其相应组合词为中英文检索关键词,在中国知网、万方、Pubmed 和 Medline 等数据库(网站)检索相关文献,在文献分析与课题组内部讨论的基础上,依据行为能力和预防控制等基本概念,并经与中国疾病预防控制中心(简称“中国疾控中心”)、中国健康教育中心和中华预防医学会等机构沟通,邀请3名具有正高职称和20年以上传染病研究和实践工作经验的资深专家(传染病防控、临床、健康教育专业各1人)进行咨询,将RIDs防控行为能力定义为:个人通过学习获取RIDs相关知识和技能,作出科学、理性、正确的行为决策并付诸实践,预防和控制RIDs的能力。根据社会认知理论(social cognitive theory)[15–16],行为能力包括自信力、潜力和行动力3个维度。自信力是指对自身能力的主观判断,即相信自己能在特定情境中取得成功的程度[17];潜力是指理解与分析的能力,决定个体能否清晰把握选项、评估信息[18];行动力是指执行行为决策的实际能力,包括能否调动资源、分步实施[15–16]。RIDs防控行为能力包括隔离/治疗传染源、切断传播途径、保护易感人群3个域度,涵盖预防(自我防护、“四早”、免疫接种、健康生活方式)、治疗(就医、服药、症状监测)、心理调适和信息获取等。本研究已通过漯河医学高等专科学校医学伦理委员会审查(批准号:LYZLL–2024015)。
基于社会认知理论[15–16]和行为改变理论(动机保护理论[19]、健康信念模式[20]、自我效能理论[21])中常见行为预测因素,研究团队构建了RIDs防控行为能力测评条目池及每个条目的考察点。在编制过程中严格采用符合中文语义学规范和中国公众语言认知习惯的表述,确保清晰性、客观性和文化适应性。条目池包括自信力、潜力和行动力3个维度共53个条目。
采用专家名义小组法(Nominal Group)[22]进行条目筛选,经与中国疾控中心、中国健康教育中心、中华预防医学会沟通,2025年1月研究团队通过邮件结合电话沟通邀请10名在公共卫生安全、传染病应急防控及健康教育领域具有副高级及以上职称、具备20年以上工作经验的专家组成专家小组。专家组就每个题项的重要性、必要性、可行性和语义准确性进行深入讨论,并就每个条目是否应该保留进行匿名投票。课题组通过对专家意见与投票结果进行整理,将表面效度≥0.8[23]的条目予以保留,最终形成供德尔菲法筛选的条目备选库,共32个条目。
在专家名义小组讨论遴选出条目的基础上,研究团队自制电子问卷,采用Likert 5级评分法收集专家对各条目重要性、必要性、可行性和语义准确性的评分(1~5分,从低到高)和修改意见。问卷对RIDs防控行为能力的概念、维度和域度进行了详细说明,并收集了专家的一般资料、对函询内容的熟悉程度(不熟悉、不太熟悉、一般、较熟悉、熟悉)和判断依据(理论分析、实践经验、国内外著作或体系了解和直观感觉)等方面的信息。
本研究根据研究目的遴选函询专家[24],通过微信、电话与专家沟通并完成邀请。纳入标准:(1)从事传染病防控研究、实践、教学和健康教育等工作≥10年;(2)本科及以上学历;(3)副高级及以上职称;(4)态度严谨认真,自愿参加函询。共遴选专家27人。
采用微信平台发送电子问卷链接的方式进行专家函询,并请专家在1周内提交,间隔2周进行下一轮专家函询。第2轮专家函询会附上第1轮专家对每个题项意见的总体情况,对重要性、必要性、可行性和语义准确性的评分均值,变异系数和肯德尔和谐系数,以及参照专家意见对题项的修改情况。通过专家积极程度[25]、权威系数[26]、意见集中程度[27]和协调程度[28–29]来判断各指标的合理性与可靠性。采用问卷回收率表示专家积极程度,当问卷回收率≥80%时,认为专家的积极程度较高[25]。采用专家权威系数(Cr)表示专家权威程度,Cr=[专家判断依据系数(Ca)+专家对条目的熟悉程度系数(Cs)]/2,其中Ca按照程度分高、中、低 3 个等级进行评分,分别按照理论分析(0.3,0.2,0.1)、实践经验(0.5,0.4,0.3)、参考国内外文献(0.1,0.1,0.1)和直觉(0.1,0.1,0.1)进行计算,Cs则分别将不熟悉、不太熟悉、一般、比较熟悉、很熟悉赋值为0.2、0.4、0.6、0.8、1进行计算,Cr≥ 0.8说明权威程度比较高[26]。采用各条目重要性、必要性、可行性与语义准确性评分的均值和满分率来表示专家意见的集中程度,两者值越高,表明专家意见越集中[27]。采用变异系数(CV)和肯德尔和谐系数(Kendall′s W)表示专家意见的协调程度,CV越小,表示专家意见的趋同性越强[28]。Kendall′s W值范围为0~1,W值越大表明专家意见的一致性越高。2轮咨询结束后进一步完善条目,形成最终的初始量表。
目前德尔菲研究通常采用重要性得分均值>3.5为入选标准[30],由于本研究第2轮专家函询过后,所有条目重要性得分均值均>3.5,因此本次自拟条目入选标准为:各条目重要性、必要性、可行性和语义准确性的评分均值均>4.5分。
所有数据均由2名研究人员使用Excel 2018软件独立录入完成。采用SPSS 26.0软件中非参数检验中的多个相关样本检验进行统计分析,P<0.05说明专家的评价结果具有一致性[29]。
本研究共邀请专家27人,专家分别来自高等院校14人(51.85%),医疗卫生技术机构12人(44.45%),科研机构1人(3.70%)。其中男性16人(59.26%),女性11人(40.74%);30~39岁1人(3.70%),40~49岁11人(40.74%),50岁及以上15人(55.56%);本科1人(3.70%),硕士9人(33.33%),博士17人(62.97%);工作年限10~20年11人(40.74%),21~30年11人(40.74%),>30年5人(18.52%);副高级职称4人(14.81%),正高级职称23人(85.19%);研究领域为公共卫生与预防医学14人(51.85%),健康教育与健康促进6人(22.22%),传染病防控5人(18.52%),传染病诊治2人(7.41%)。
本研究2轮专家函询各发放电子问卷27份,均回收有效问卷27份,回收率均为100%。第1轮专家函询Ca为0.93,Cs为0.89,第2轮专家函询Ca为0.92,Cs为0.91,2轮专家函询Cr均为0.91。
第1轮专家函询各条目重要性、必要性、可行性和语义准确性得分均值范围分别为3.33~4.81、3.26~4.81、3.41~4.81、3.48~4.70分,第2轮专家函询分别为4.04~4.89、4.07~4.89、3.78~4.74、3.96~4.78分。第1轮各条目4项评分满分率均>20%,第2轮满分率均>25%。第2轮函询后,按照拟定的筛选标准,剔除4项评分均值均<4.5的条目,共保留22个条目,保留条目所有得分均值均>4.0分,满分率>30%。
保留条目第1轮专家函询各条目重要性、必要性、可行性和语义准确性的Kendall′s W值分别为0.513、0.496、0.458和0.481(均P<0.01),CV范围分别为0.16~0.42、0.16~0.43、0.17~0.37,和0.18~0.37;第2轮专家函询各条目重要性、必要性、可行性和语义准确性的Kendall′s W值分别为0.313、0.299、0.362和0.442(均P<0.01),CV范围分别为0.07~0.23,0.07~0.35,0.13~0.25和0.09~0.29。表明专家对2轮函询后保留条目的评价结果具有一致性,可以结束函询。
经过2轮专家函询,共计10个条目重要性、必要性、可行性和语义准确性得分均值均<4.5分,因此删除。剩余22个条目纳入公众RIDs防控行为能力初始量表,其中自信力5条,潜力9条,行动力8条。初始量表以及各条目采用的行为改变理论等内容见表1。
本研究采用文献检索、专家咨询、Nominal Group及德尔菲专家函询等定性与定量结合的研究方法,首先系统定义了RIDs防控行为能力的概念与内涵,及其维度和域度,用于反映个体是否有能力在需要时采取适宜的行动,预防控制RIDs感染和传播。与已有的健康行为能力概念[31]强调个体的一般性健康生活方式不同,该能力则强调个体与RIDs防控相关的特异性防控行为。其次,在该定义的基础上最终遴选形成包括自信力、潜力和行动力3个维度与传染源、传播途径、易感人群3个防控域度共22个条目的初始量表,参与专家达成了良好共识,遴选条目能够真实反映个体RIDs防控行为能力水平。
本研究邀请了27名来自传染病防控相关领域的权威专家,专家组成员平均工作年限超过20年,均有副高及以上职称,在传染病防控方面均具有长期的研究和实践工作经验,满足德尔菲研究对专家数量与质量的要求[32]。其中,公共卫生领域专家从政策、传染病预防控制、监测、流行病学角度对条目的适用性进行评估,临床专家则从早诊、症状、治疗等方面对条目进行评估,健康教育领域的专家可从语言表述准确性、通俗性、文化适用性等方面对条目进行评估,这种多领域视角的相互交叉、互补,既能发挥不同领域专家的专业优势,又能通过学科交叉融合保证研究结果的全面性和科学性。本研究中,专家参与的积极系数高,2轮函询无一人退出,并提出多个针对性修改意见,而且2轮函询的专家权威系数(Cr)均超过0.91,明显高于同类研究0.8左右的平均水平[33–35],其中第1轮Ca为0.93,Cs为0.89,第2轮Ca为0.92,Cs为0.91,说明专家不仅具备扎实的专业基础,且对条目有深入的理解。
研究结果表明,经过2轮函询,专家对各条目重要性、必要性、可行性和语义准确性评分明显提升,各题项的满分率也由第1轮的>20%均提升至>25%。同时,第2轮时,专家对各条目重要性、必要性、可行性和语义准确性评分的CV值范围也明显收窄至较低水平。表明修改后的条目共识性增强,更符合专家的专业认知,专家意见呈现明显集中趋势。最终保留条目各项得分均>4分,满分率均>30%。由此可见,专家对保留的22个条目可有效用于反映个体RIDs防控行为能力水平达成了充分的共识。
Kendall′s W是一种独立于基础变量分析的、基于2个等级比较转化数的一种分析方法,常用于考察多位评分者评分的一致性程度[36]。现有部分采用德尔菲法构建量表或指标体系的相关研究[37–40]中Kendall′s W值均未达到0.3,但本次研究中2轮Kendall′s W值范围分别为0.481~0.513、0.299~0.442,明显高于上述相关研究。有学者[41]指出在德尔菲研究中,即便Kendall′s W值未达到理想标准,只要其P值显示有统计学意义,结果即可接受。此外,本研究中第2轮Kendall′s W值略低于第1轮,提示专家对条目评价的一致性较第1轮略有降低,但结合2轮函询的专家积极程度(均=100%)和权威系数(均>0.91)可知,专家的参与度与专业性未受到影响,因此,推测第2轮Kendall′s W值略有降低的原因可能为基于部分专家意见汇总修改的条目激发了其他专家差异化观点的表达,导致条目评价的一致性较第1轮有所下降,但不构成显著影响。结合2轮函询后较低的CV范围与较高的评分均值,表明专家意见集中、一致性程度较高,结果可信可靠。
综上所述,通过文献检索、专家访谈咨询、Nominal Group和德尔菲专家函询等方法,本研究构建了我国目前首个包含防控自信力、防控潜力及防控行动力3个维度,传染源、传播途径、易感人群3个域度共22个条目用于测量个体RIDs防控行为能力的“中国居民呼吸道传染病防控行为能力初始量表”。本研究也存在一定的局限性:(1)本研究首次界定RIDs防控行为能力的概念和内涵,但其科学性、严谨性有待进一步完善;(2)虽然本研究开发的用于反映个体RIDs防控行为能力的条目充分参考了国内外有关文献,但只在中国专家中进行了咨询,未邀请国外专家参与,其适用人群可能受限;(3)量表条目的实用性和适用性均需在实际应用中进一步验证和筛选。

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doi: 10.11847/zgggws1148618
  • 接收时间:2025-08-11
  • 首发时间:2026-10-23
  • 出版时间:2026-04-10
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  • 收稿日期:2025-08-11
  • 修回日期:2025-10-21
  • 录用日期:2026-03-10
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    1中国健康教育中心,北京 100000
    2安徽医科大学公共卫生学院营养与食品卫生系,合肥 230031
    3西安交通大学公共政策与管理学院,西安 710049
    4漯河医学高等专科学校,漯河 462002

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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