Building the backbone for organisational research in public health systems: development of measures of organisational capacity for chronic disease prevention

BACKGROUND: : Research to investigate levels of organisational capacity in public health systems to reduce the burden of chronic disease is challenged by the need for an integrative conceptual model and valid quantitative organisational level measures. OBJECTIVE: To develop measures of organisational capacity for chronic disease prevention/healthy lifestyle promotion (CDP/HLP), its determinants, and its outcomes, based on a new integrative conceptual model. METHODS: Items measuring each component of the model were developed or adapted from existing instruments, tested for content validity, and pilot tested. Cross sectional data were collected in a national telephone survey of all 216 national, provincial, and regional organisations that implement CDP/HLP programmes in Canada. Psychometric properties of the measures were tested using principal components analysis (PCA) and by examining inter-rater reliability. RESULTS: PCA based scales showed generally excellent internal consistency (Cronbach's alpha = 0.70 to 0.88). Reliability coefficients for selected measures were variable (weighted kappa(kappa(w)) = 0.11 to 0.77). Indicators of organisational determinants were generally positively correlated with organisational capacity (r(s) = 0.14-0.45, p<0.05). CONCLUSIONS: This study developed psychometrically sound measures of organisational capacity for CDP/HLP, its determinants, and its outcomes based on an integrative conceptual model. Such measures are needed to support evidence based decision making and investment in preventive health care systems.