Assessing continuity of care in a community diabetes program: initial questionnaire development and validation

Area of Science:

• Health Services Research
• Diabetes Care Management
• Psychometrics

Background:

• Continuity of care is crucial for effective diabetes management.
• Existing measures may not fully capture continuity within community-based programs.
• Agency theory provides a framework for understanding patient-provider relationships in healthcare.

Purpose of the Study:

• To develop and validate a questionnaire assessing continuity of care.
• To apply agency theory to the measurement of continuity of care.
• To evaluate the questionnaire in a community-based diabetes control program in Shanghai.

Main Methods:

• Developed a questionnaire integrating scales from established instruments.
• Conceptualized continuity of care through information transfer and goal alignment.
• Validated the questionnaire using patient interviews (n=338) in Shanghai community health settings.

Main Results:

• The questionnaire demonstrated strong measurement properties, including item reliability and validity.
• Data completeness and score distribution met validation requirements.
• Principal components analysis supported the hypothesized scale-domain construction.

Conclusions:

• The validated questionnaire effectively measures continuity of care.
• The findings align continuity of care with agency theory principles.
• The tool is suitable for use in community-based diabetes control programs.