Development of Shared Decision Making Instrument for Public Health Volunteers in Health Promotion Planning in Primary Health Care

Abstract

Objective: To develop measurement instrument for shared decision making in health promotion planning in primary health care for public health volunteers (PHVs). Methods: The researchers reviewed literature related to shared decision making, decision making, planning, and health promotion in primary health care for villagers and used the review information in an in-depth interview with PHVs. The decision making process proposed by Plunkett and Attner was modified and employed as a conceptual framework. The process comprised 4 steps: defining and identifying problems and causes, identifying potential alternatives in solving the problems, analyzing the alternatives, and selecting the best alternative. The developed questionnaire for shared decision making of PHVs was in a 5-point Likert scale. The study conducted 3 rounds of validation. Results: The questionnaire was first tested in 42 PHVs. It had only one dimension (PHVs involvement in shared decision making with community). The researchers reviewed and tested the questionnaire for the second time in another 57 PHVs. Cronbach’s alpha coefficients for both “PHV’s provision of opportunity for community in shared decision making” and “PHVs’ involvement in shared decision making with community” were 0.86 and 0.86 whereas that of the whole scale was 0.93. Correlation coefficients of an item with the sum of other items in the same dimension ranged from 0.44–0.66. Content validity was tested by examining index of item and objective congruence rated by 3 experts. The indexes were 0.64, 0.75, 0.70 for “PHV’s provision of opportunity for community in shared decision making”, “PHVs’ involvement in shared decision making with community” and the whole scale, respectively. The questionnaire was further modified to reduce item redundancy and tested again in 69 PHVs. The Cronbach’s alpha for “PHV’s provision of opportunity for community in shared decision making”, “PHVs’ involvement in shared decision making with community” and the whole scale were 0.93, 0.93 and 0.96, respectively. The indexes of item-objective congruence rated by 4 experts were 0.96, 0.98, and 0.97, respectively. Correlation coefficients of an item with the sum of other items in the same dimension ranged from 0.54–0.82 (greater than a minimum acceptable value of 0.5). Conclusion: The developed shared decision making questionnaire in health promotion planning for PHVs was a reliable instrument and could be used in developing participatory working network in shared decision making in health promotion planning for primary health care.