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Development of a personal competency evaluation indicator system for tuberculosis health educators: a scoping review
Xu Song1, Qingjun Jia1, Qingchun Li1
1Department of Tuberculosis Control and Prevention, Hangzhou Center for Disease Control and Prevention (Hangzhou Health Supervision Institution), Hangzhou, China.
Objective:
To systematically synthesize evidence on the personal competency of tuberculosis (TB) health educators and to develop a scientifically robust and comprehensive evaluation indicator system.
Methods:
A two-phase mixed-methods design was employed. Phase 1 involved a scoping review of seven databases (PubMed/MEDLINE, Web of Science, Scopus, Embase, CINAHL, ERIC, and the Cochrane Library) to identify competency-related literature on TB health educators, with no restrictions on publication date, language, or geographic setting. Extracted competency elements were synthesized into a preliminary framework. Phase 2 used a modified Delphi method with two rounds of consultation among 20 Chinese experts in TB control and health education. Indicator importance was rated on a 5-point Likert scale, and the Analytic Hierarchy Process (AHP) was applied to calculate indicator weights. Validity and reliability were assessed using content validity indices and intraclass correlation coefficient (ICC).
Results:
The scoping review included 36 studies, from which seven core dimensions, 24 categories, and 63 specific competency elements were extracted. Both Delphi rounds achieved a 100% response rate. The expert authority coefficient (Cr) was 0.84. Kendall's W increased significantly from 0.295 (first round) to 0.328 (second round, both p < 0.001). After the second round, all indicators met the retention criteria: mean importance ≥3.5, coefficient of variation <0.25, and expert agreement rate ≥50.0%. AHP results showed good consistency (first-level indicator CR = 0.043; all second-level CRs < 0.10). The overall scale demonstrated good reliability (ICC = 0.86) and content validity (scale-level CVI = 0.92; item-level CVI range: 0.85-1.00). The highest-weighted dimension was Communication and Health Education Skills (0.235).
Conclusion:
The personal competency evaluation indicator system for TB health educators developed in this study is scientifically sound, reliable, and practical. It provides a validated tool for competency assessment, targeted training design, and workforce development in TB health education.
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