Validation of the care providers version of the Rainbow Model of Integrated Care-Measurement Tool in Chinese primary care systems

Abstract

Background:The original Rainbow Model of Integrated Care Measurement Tool (RMIC-MT) is based on the Rainbow Model of Integrated Care, which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the Rainbow Model of Integrated Care-Measurement Tool and evaluate its psychometric properties by a pilot study in Chinese primary care systems. Methods:The translation and adaptation process were performed in four steps, forward and backtranslation, expert review and pre-testing. We conducted a cross-sectional study with 1610 community care professionals in all 79 community health stations in the Nanshan district. We analyzed the distribution of responses to each item to study the psychometric sensitivity. Exploratory factor analysis with principal axis extraction method and promax rotation was used to assess the construct validity. Pearson's correlation was used to assess concurrent validity. Cronbach's alpha was utilized to ascertain the internal consistency reliability. Lastly, confirmation factor analysis was used to evaluate the exploratory factor analysis model fit. Results:During the translation and adaptation process, all 55 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Eight factors were determined by exploratory factor analysis, accounting for 66.41% of the total variance. According to exploratory factor analysis and discussion with all authors, the original ten dimensions were adjusted to nine dimensions in the Chinese version. A standard Cronbach's alpha of 0.960 and significant correlation among all items in the scale (>0.4) showed good internal consistency reliability of the tool. And, the model passed the majority of goodness-to-fit test by confirmation factor analysis Conclusions: The results showed initial satisfactory psychometric properties for the validation of the RMIC-MT care provider version. Its application in China will promote the development of peoplecentered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes. BackgroundHealth systems in some low-and middle-income countries, as well as in most high-income countries,