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Building the backbone for organisational research in public health systems: development of measures of organisational capacity for chronic disease prevention

¹ Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, Québec, Canada
² Department of Social and Preventive Medicine, University of Montreal, Montréal, Québec, Canada; Centre de recherche de Centre hospitalier de l’Université de Montréal; Institut national de santé publique du Québec, Montréal
³ Natalie Kishchuk Evaluation & Research Inc, Kirkland, Québec, Canada
⁴ School of Geography and Earth Sciences, McMaster University, Hamilton, Ontario, Canada
⁵ Department of Health Sciences and Gerontology, University of Waterloo, Waterloo, Ontario, Canada; Centre for Behavioural Research and Program Evaluation, University of Waterloo

Correspondence to:
Correspondence to:
Nancy Hanusaik
Department of Epidemiology, Biostatistics and Occupational Health, McGill University, 1020 Pine Avenue West, Montréal, Québec, Canada H3S 1A2; nancy.hanusaik{at}mail.mcgill.ca

Background: : Research to investigate levels of organisational capacity in public health systems to reduce the burden of chronic disease is challenged by the need for an integrative conceptual model and valid quantitative organisational level measures.

Objective: To develop measures of organisational capacity for chronic disease prevention/healthy lifestyle promotion (CDP/HLP), its determinants, and its outcomes, based on a new integrative conceptual model.

Methods: Items measuring each component of the model were developed or adapted from existing instruments, tested for content validity, and pilot tested. Cross sectional data were collected in a national telephone survey of all 216 national, provincial, and regional organisations that implement CDP/HLP programmes in Canada. Psychometric properties of the measures were tested using principal components analysis (PCA) and by examining inter-rater reliability.

Results: PCA based scales showed generally excellent internal consistency (Cronbach’s = 0.70 to 0.88). Reliability coefficients for selected measures were variable (weighted (_w) = 0.11 to 0.77). Indicators of organisational determinants were generally positively correlated with organisational capacity (r_s = 0.14–0.45, p<0.05).

Conclusions: This study developed psychometrically sound measures of organisational capacity for CDP/HLP, its determinants, and its outcomes based on an integrative conceptual model. Such measures are needed to support evidence based decision making and investment in preventive health care systems.

Abbreviations: CDP/HLP, chronic disease prevention/healthy lifestyle promotion; CVD, cardiovascular disease; NGO, non-governmental organisation; PCA, principal components analysis; PHU, public health unit

Keywords: organisational capacity; public health; chronic disease; psychometrics; preventive health services

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