基于重要性与可及性的高血压防控措施重要性-绩效分析决策模型构建  

Construction of an importance-performance analysis decision-making model based on the importance and accessibility of hypertension prevention and control

作　　者：徐婷玲 李靓[2] 冯佳雨 宜准 徐晓慧 杨静[1] 周脉耕[1] 张岩波[2] 董文兰[1] XU Ting-ling;LI Jing;FENG Jia-yu;YI Zhun;XU Xiao-hui;YANG Jing;ZHOU Mai-geng;ZHANG Yan-bo;DONG Wen-lan(National Center for Chronic and Noncommunicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 100050,China;不详)

机构地区：[1]中国疾病预防控制中心慢性非传染性疾病预防控制中心,北京100050 [2]山西医科大学重大疾病风险评估山西省重点实验室 [3]山东省疾病预防控制中心慢性非传染性疾病防制所

出　　处：《中国慢性病预防与控制》2022年第10期726-730,共5页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家重点研发计划项目(2018YFC1315304)。

摘　　要：目的构建高血压防控优先决策模型,确定高血压防控措施的优先级,为各地开展高血压防控提供决策依据。方法该研究以全国被评为国家级慢性病综合防控示范区的全部488个区(县)为调查地区,由各示范区疾病预防控制中心慢性病防控业务骨干负责调查问卷的具体填写。收集高血压防控措施实施的重要性、可及性情况。采用重要性-绩效分析(IPA)模型对高血压防控的维度指标进行象限划分;采用验证性因子分析的标准化因子载荷系数对同一象限内的维度指标进行排序;采用项目反应理论的区分度指标对措施条目的优先级进行排序。统计分析软件为R 4.0。结果实际回收468份有效问卷。高血压防控维度可及性-重要性IPA模型分析结果显示,最高优先级象限内,各维度指标优先级顺序为政策制定、体系建设、社区规范化管理;其次改进级象限内,维度指标为环境支持;最低优先级象限内,维度指标为监测与评估。结合区分度对同一维度指标内的具体措施进行了排序,所有具体措施中,优先级最高的3个措施为生活方式干预中的适量运动、控制体重和合理膳食措施。分维度来看,实施35岁以上人群首诊测血压制度是政策制定维度优先级最高的措施,高血压管理团队建设是体系建设维度优先级最高的措施,适量运动是社区规范化管理维度优先级最高的措施,社区健康教育是环境支持维度优先级最高的措施。结论对高血压防控措施重要性和可及性进行评分,从而构建的高血压防控优先决策模型,可以为各地开展高血压防控工作提供决策依据。Objective To construct a priority decision-making model for hypertension prevention and control,determine the priority of hypertension prevention and control measures,and provide the basis for decision-making in the development of hypertension prevention and control in various regions.Methods All 488 districts,which were rated as national-level comprehensive prevention and control demonstration areas for chronic diseases,were selected as the investigation areas.The business backbone of chronic disease prevention and control majors in each district center for disease control and prevention filled out the questionnaires.The information on the importance and accessibility of hypertension prevention and control measures was collected.The Importance-Performance Analysis(IPA)model was used to divide the dimensional indicators of hypertension prevention and control into quadrants.The standardized factor loading coefficients of confirmatory factor analysis were used to rank the dimensional indicators in the same quadrant.The discrimination index of item response theory was used to prioritize the action items.Statistical analysis software was R 4.0.Results The study actually collected 468 valid questionnaires.The analysis results of the IPA model of the accessibility-importance of hypertension prevention and control dimensions showed that in the highest priority quadrant,the priority of each dimension indicator was policy formulation,system construction,and standardized management of communities.The dimensional indicator of the second improvement quadrant was environmental support,and the dimensional indicator of the lowest priority quadrant was monitoring and evaluation.Also the specific measures within the same dimension indicators in combination with the discrimination were sorted.Among all measures,the three measures with the highest priority were moderate exercise,weight control and reasonable diet measures in lifestyle interventions.From different dimensions,the implementation of the first-diagnosis blood pressure m

关 键 词：高血压 防控措施 重要性 可及性 重要性-绩效分析模型 

分 类 号：R544.1[医药卫生—心血管疾病]