[Development and evaluation of the reliability and validity of a scale for basic actions relevant to public health]

The purpose of this study was to develop a Scale for Basic Action for Public Health (hereinafter referred to as the BAPH scale) to assess and improve the ability of public health nurses (PHNs) to contribute to the health and well-being of Japanese people. The present study was carried out to assess the reliability and validity of the BAPH scale.

One hundred and thirty-five prefectural public health centers and 115 municipal health centers in Japan were randomly chosen. Full-time PHNs working at the selected health centers were selected as the subjects of this study. Questionnaires were sent to the directors of the health centers and then distributed to the subjects. The questionnaire survey included some provisional questions formulated taking into account the assessment items derived from the existing literature as well as questions related to the respondent's age, years of experience as a PHN, academic background, and job title.

Of a total of 250 health centers, 184 (73.6%) responded. The questionnaire was completed and returned by 1,261 (70.1%) PHNs, 1,112 of whom provided valid responses and were thus included in the analysis. 1) Based on the results obtained from the factor analysis performed on the 18 provisional BAPH questions, 12 BAPH scale items were chosen for inclusion in the scale. These items consisted of three sub-scales, namely "promotion of accessibility and fairness" (five items), "assessment of quality and quantity of service" (four items), and "prevention action for health risk" (three items). 2) The Cronbach's coefficient alpha for the BAPH scale and its three sub-scales were 0.91, 0.84, 0.86, and 0.82, respectively. 3) As respondents experience become longer, their scores on the BAPH scale become higher. In addition, respondents who had given either presentations or speeches at academic conferences and those who subscribed to academic journals were significantly more likely than others to score high on the scale.

The results of the present study revealed that the BAPH scale is a reliable and valid method to evaluate the ability of PHNs to contribute to the health and well-being of people. Hitherto, there has been no method that can be used to evaluate the job performance of PHNs. The use of the BAPH scale to assess the effectiveness of basic education and in-service training for PHNs may not only improve the content of training/education offered but also help them fulfill their duties as providers of health care and welfare services.