RESUMO
BACKGROUND: This study examined the reliability of measures of correlates of dietary behaviours (DBs), physical activity (PA) and sedentary behaviour (SB) for Hong Kong adolescents. METHOD: Individual, social and environmental correlates of obesity-related behaviours were assessed twice, 15-27 days apart (average 20 days), via self-administered questionnaires. These questionnaire included measures of decisional balance, self-efficacy, enjoyment and social support related to intake of fruits, vegetables, high-fat foods and sugar-sweetened beverages, PA behaviour and SB. They also included measures of perceived barriers to PA, parental rules related to PA and SB, and environmental correlates of DB, PA and SB. The questionnaires were self-completed outside school hours. A sample of 119 12-17 year old Chinese-speaking secondary school students (60 girls; 59 boys) were recruited from four Hong Kong schools located in areas stratified by walkability and socio-economic status. RESULTS: The test-retest reliability of the examined measures ranged from poor to excellent (ICC: 0.30-0.99). All measures of correlates of PA and SB had excellent or substantial test-retest reliability, with the exception of self-efficacy for reducing SB (ICC: 0.59). Four of 18 measures of DBs showed moderate, and two poor (ICC < 0.41), test-retest reliability. Evidence of unidimensionality (Cronbach's α ≥ 0.70) was found for 10 of 28 multi-item scales. The evidence for the remaining 18 was either questionable or poor. CONCLUSIONS: Most of the self-report measures of correlates of obesity-related behaviours used in the iHealt(H) study have acceptable test-retest reliability in Hong Kong adolescents. The factorial structure of several scales needs to be investigated in a larger sample.
RESUMO
PURPOSE: Current health care reforms in China have an overall goal of strengthening primary care through the establishment and expansion of primary care networks based on community health centers (CHCs). Implementation in urban areas has led to the emergence of different models of ownership and management. The objective of this study was to evaluate the primary care experiences of patients in the Pearl River Delta as measured by the Primary Care Assessment Tool (PCAT) and the relationships with ownership and management in the 3 different models we describe. METHODS: This cross-sectional study was conducted on-site at CHCs in 3 cities within the Pearl River Delta, China, using a multistage cluster sampling method. A validated Mandarin Chinese version of the PCAT-Adult Edition (short version) was adopted to collect information from adult patients regarding their experiences with primary care sources. PCAT scores for individual primary care attributes and total primary care assessment scores were assessed with respect to sociodemographic characteristics, health characteristics, and health care service utilization across 3 primary care models. RESULTS: One thousand four hundred forty (1,440) primary care patients responded to the survey, for an overall response rate of 86.1%. Respondents gave government-owned and -managed CHCs the highest overall PCAT scores when compared with CHCs either managed by hospitals (95.18 vs 90.81; P = .005) or owned by private and social entities (95.18 vs 90.69; P =.007) as a result of better first-contact care (better first-contact utilization) and coordination of care (better service coordination and information system). Factors that were positively and significantly associated with higher overall assessment scores included the presence of a chronic condition (P <.001), having medical insurance (P = .006), and a self-reported good health status (P <.001). CONCLUSIONS: This study suggests that government-owned and -managed CHCs may be able to provide better first-contact care in terms of utilization and coordination of care, and may be better at solving the problem of underutilization of the CHCs as the first-contact point of care, one key problem facing the reforms in China.
