基于IPA决策模型的促进身体活动措施优先级研究

杨静; 李靓; 冯佳雨; 徐晓慧; 徐婷玲; 张岩波; 周脉耕; 董文兰

doi:10.16462/j.cnki.zhjbkz.2023.11.010

基于IPA决策模型的促进身体活动措施优先级研究

doi: 10.16462/j.cnki.zhjbkz.2023.11.010

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科教与国际合作室，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，太原 030000
3.
山东省疾病预防控制中心慢性非传染性疾病防制所，济南 250014
4.
中国疾病预防控制中心慢性非传染性疾病预防控制中心综合防控与评价室，北京 100050
5.
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

基金项目:

国家重点研发计划项目 2018YFC1315304

详细信息

通讯作者:
董文兰，E-mail: dongwenlan@ncncd.chinacdc.cn

中图分类号: R195
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- 被引次数: 0
出版历程
- 收稿日期: 2022-07-25
- 修回日期: 2022-10-02
- 网络出版日期: 2023-11-20
- 刊出日期: 2023-11-10

Research on the priority of measures to promote physical activity based on IPA decision model

1.
Division of Science, Education and International Cooperation, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
2.
Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment, Shanxi Medical University, Taiyuan 030000, China
3.
Department for Chronic and Noncommunicable Disease Control and Prevention, Shandong Provincial Center for Disease Control and Prevention, Jinan 250014, China
4.
Division of Integrated Prevention and Control and Evaluation, National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China
5.
National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China

Funds:

China National Key Research and Development Program 2018YFC1315304

More Information

Corresponding author: DONG Wenlan, E-mail: dongwenlan@ncncd.chinacdc.cn

摘要

摘要: 目的探究促进人群身体活动措施的优先级排序，为制定促进身体活动相关策略和计划提供理论依据。方法由488个国家慢性病综合防控示范区的疾病预防控制中心专业人员对13个维度下的47项促进人群身体活动措施的可行性和重要性进行打分；采用重要性-绩效分析(importance-performance analysis, IPA)模型对促进身体活动维度指标进行象限划分；采用二阶验证性因子分析的标准化因子载荷系数确定同一象限内维度指标优先级和各维度内措施的优先级。结果最高优先级内各维度指标优先级顺序为：人员培训、工作场所干预、学校干预、宣传与社区活动、体育部门干预、提高设施/场所可及性。优先改进级内维度指标为改善环境。最低优先级内各维度指标优先级顺序为：其他场所和人群干预、领导力和合作伙伴关系、医疗保健机构干预、加强建筑设计、筹资与财政支持、监测与评估。结论结合验证性因子分析，IPA模型能够较好地实现身体活动促进决策模型构建。
- 身体活动 /
- 可行性 /
- 重要性 /
- 重要性-绩效分析模型
Abstract: Objective To explore the priority of physical activity promotion measures in China and provide a theoretical basis for developing strategies and plans on physical activity promotion. Methods Key personnel from district-level Centers for Disease Control and Prevention (CDCs) in 488 national demonstration areas for comprehensive control and prevention of chronic diseases were asked to rate the feasibly and importance of 47 physical activity promotion measures under 13 dimensional indicators. The Importance-Performance Analysis (IPA) model was used to divide the dimensional indicators of physical activity promotion into quadrants, and the standardized factor loading coefficients of the second-order Confirmatory Factor Analysis were used to determine the priority of the dimensional indicators in the same quadrant, and the priority of the measures in each dimension. Results In the highest priority quadrant, the priority order of the dimensional indicators was capacity building, workplace intervention, school intervention, communications and community events, sports sector intervention, and improved facilities/spaces accessibility. In the quadrant for prioritized improvement, the only indicator was environment improvement. In the quadrant for the least prioritized improvement, the priority order was interventions in other settings and population, leadership and partnership, healthcare intervention, enhanced building design, financing and fiscal support, and monitoring and evaluation. Conclusions Combining confirmatory factor analysis, IPA model can work well in constructing the decision model for physical activity promoting.
- Physical activity /
- Feasibility /
- Importance /
- Importance-Performance analysis model

HTML全文

图 1 促进人群身体活动维度可行性-重要性IPA模型

Figure 1. IPA model for feasibility-importance of dimensional indicators for physical activity promotion

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图 2 可行性二阶验证性因子分析模型

1. CFI：比较拟合指数；NFI：规范拟合指数；RMSEA：近似误差均方根。
2. PA代表总体，圆圈里的ASO_1等为各维度指标，方框里的ASO1等为各具体措施。模型拟合指标分别为: χ² /df=4.158，P＜0.001; CFI=0.860，NFI=0.824，RMSEA=0.086。

Figure 2. Second-order confirmatory factor analysis model for feasibility

1. CFI: comparative fit index; NFI: normed fit index; RMSEA: root mean square error of approximation.
2. PA represents the whole; ASO_1 and others in the circle are dimension indicators; ASO1 and others in the box are the specific measures. The model fit indices are as follows: χ² /df=4.158, P < 0.001; CFI=0.860, NFI=0.824, RMSEA=0.086.

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图 3 可行性-重要性象限气泡图

Figure 3. Feasibility-importance quadrant bubble chart

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图 4 促进人群身体活动措施优先决策旭日图

同一层颜色深浅表示排序先后顺序。颜色越深代表越优先。

Figure 4. Sunburst chart of priority for physical activity promotion measures

The color depth in the same layer indicales the sorting order. The darker the color, the higher the priority.

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表 1 促进人群身体活动维度指标的可行性和重要性平均值

Table 1. Mean score of feasibility and importance of dimensional indicators for physical activity promotion

层面Level	维度指标(英文缩写) Dimension indicator (abbreviation)	可行性平均值 Mean score of feasibility	重要性平均值 Mean score of importance
营造富有活力的社会Create active societies	宣传与社区活动(ASO_1) Communications and community events (ASO_1)	4.06	4.66
	人员培训(ASO_2) Capacity building (ASO_2)	3.84	4.58
创建利于活动的环境Create active environments	改善环境(AE_1) Improve the environments (AE_1)	3.58	4.52
	提高设施或场所可及性(AE_2) Improve access to facilities or spaces (AE_2)	4.23	4.80
	加强建筑设计(AE_3) Strengthen building design (AE_3)	3.62	4.49
培养热爱活动的人群Create active people	学校干预(AP_1) School based intervention (AP_1)	4.17	4.68
	医疗保健机构干预(AP_2) Healthcare based intervention (AP_2)	3.62	4.50
	工作场所干预(AP_3) Workplace based intervention (AP_3)	3.93	4.60
	体育部门干预(AP_4) Sports sector based intervention (AP_4)	4.09	4.66
	其他场所和人群干预(AP_5) Intervention in other settings and people (AP_5)	3.43	4.32
建立支持活动的系统Create active systems	领导力和合作伙伴关系(ASY_1) Leadership and partnership (ASY_1)	3.35	4.38
	监测与评估(ASY_2) Monitoring and evaluation (ASY_2)	3.03	4.19
	筹资与财政支持(ASY_3) Financing and fiscal support (ASY_3)	3.19	4.31

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表 2 促进人群身体活动措施优先级排序

Table 2. Priority order of physical activity promotion measures

象限 Quadrant	维度层 Dimension	措施层 Measure	标准化因子载荷系数 Standardized factor load coefficient
最高优先级 The highest priority grade	人员培训Capacity building	纳入专业教育Inclusion in professional education	0.859
		教育系统人员培训Training for school personnel	0.843
		医疗卫生人员培训Training for healthcare personnel	0.836
		道路安全培训Training on road safety	0.808
		社会体育指导员培训Training for social sports instructors	0.805
	工作场所干预Workplace based intervention	开展综合性干预Comprehensive intervention	0.873
		建设/提供健身活动场地Provide facilities	0.854
		制定指南Develop guidelines	0.808
		采用能减少久坐的工作台Use workstations that reduce sedentariness	0.775
		组织健走活动Organize walking programs	0.738
		实施工间操制度Exercise during work	0.734
	学校干预 School based intervention	幼托和学龄前机构干预Intervention in preschool settings	0.891
		积极的课间活动Active school recess	0.890
		高等教育机构干预Intervention in colleges	0.865
		优质体育课程Good-quality physical education	0.859
		积极的通学方式和课后活动Active transportation and after school activity	0.837
		开展“健康促进学校” Health Promoting Schools	0.821
	宣传与社区活动Communications and community events	持续的大众宣传运动Sustained public education	0.891
		多重效益宣传Communications on co-benefits	0.885
		利用相关领域的活动和宣传日Use events on related issues	0.882
		制定宣传策略Develop communication strategies	0.854
		开展群众参与活动Mass participation events	0.738
	体育部门干预Sports sector based intervention	运动小组/俱乐部活动Sports club programs	0.902
		建立健全健身组织Establishing fitness organizations	0.886
		举办全民健身赛事National fitness events	0.886
	提高设施/场所可及性Improve access to facilities/spaces	体育设施免费或低收费开放Free or low charged facilities	0.892
		建设全民健身场地设施Build fitness spaces/facilities	0.866
优先改进级 Prioritised improvement grade	改善环境Improve the environments	综合性城市设计和土地使用Comprehensive urban design and land use	0.929
		改进步行和骑行网络Improve walking and cycling network	0.908
		安排和整合设施Co-locate and integrate facilities	0.877
		整合城市和交通规划政策Integrate urban and transport planning policies	0.860
		改善安全Improve safety	0.848
最低优先级 The least prioritized improvement grade	其他场所和人群干预 Intervention in other settings and people	幼儿家庭干预Family based intervention for young children	0.877
		老年人干预Intervention for the elderly	0.873
		最不活跃人群干预Intervention for the least active people	0.863
		宗教场所干预Faith based intervention	0.764
	领导力和合作伙伴关系Leadership and partnership	发展合作伙伴关系Develop partnerships	0.888
		政策框架、领导和管理体系Policy frameworks, leadership and governance systems	0.881
	医疗保健机构干预Healthcare based intervention	制定国家标准化方案Develop national standardized protocols	0.919
		提供评估、咨询、转诊等服务Assessment, brief advice and referral	0.866
	加强建筑设计Strengthen building design	教育和儿童保育场所For education and childcare facilities	0.947
		休闲和运动场所For recreational and sports facilities	0.932
		公共建筑For public buildings	0.900
	筹资与财政支持Financing and fiscal support	财政手段Fiscal instruments	0.922
		筹资机制Financing mechanism	0.911
	监测与评估Monitoring and evaluation	研究和评估Research and evaluation	0.954
		信息系统和监测Information systems and monitoring	0.923

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参考文献(14)

[1]	国家卫生健康委疾病预防控制局. 中国居民营养与慢性病状况报告(2020年)[M]. 北京: 人民卫生出版社, 2021: 55. Bureau of Disease Prevention and Control, National Health Commission. Report on nutrition and chronic diseases of the Chinese population (2020)[M]. Beijing: People's Health Publishing House, 2021: 55.
[2]	Abbasi-Kangevari M, Abd-Allah F, Adekanmbi V, et al. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019[J]. Lancet, 2020, 396(10258): 1223-1249. DOI: 10.1016/S0140-6736(20)30752-2.
[3]	World Health Organization. Global action plan on physical activity 2018-2030: more active people for a healthier world[EB/OL]. (2018-06-01)[2022-06-01]. https://apps.who.int/iris/handle/10665/272722.
[4]	健康中国行动推进委员会. 健康中国行动(2019―2030年)[EB/OL]. (2019-07-15)[2022-06-10]. http://www.nhc.gov.cn/guihuaxxs/s3585u/201907/e9275fb95d5b4295be8308415d4cd1b2.shtml.
[5]	国家防控综合慢性病示范区. 国家慢性病综合防控示范区建设[EB/OL]. [2022-05-02]. http://www.ncdshifanqu.cn/workintro.
[6]	World Health Organization. ACTIVE: a technical package for increasing physical activity[EB/OL]. (2018-10-15)[2022-06-10]. https://apps.who.int/iris/handle/10665/275415.
[7]	陈旭. IPA分析法的修正及其在游客满意度研究的应用[J]. 旅游学刊, 2013, (11): 59-66. https://www.cnki.com.cn/Article/CJFDTOTAL-LYXK201311012.htm Chen X. Modification of IPA analysis and its application in the study of tourists' satisfaction[J]. Tourism Tribune, 2013, (11): 59-66. https://www.cnki.com.cn/Article/CJFDTOTAL-LYXK201311012.htm
[8]	Malhotra NK, Lopes EL, Veiga RT. Structural equation modeling with LISREL: an initial vision[J]. Brazilian J Market, 2014, 13(2): 28-43. DOI: 10.5585/remark.v13i2.2698.
[9]	徐秀娟, 倪进东, 王效军. 基于二阶验证性因子分析的SF-36量表结构效度的分析[J]. 中国卫生统计, 2013, 30(6): 846-848. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT201306018.htm Xu XJ, Ni JD, Wang XJ. Construct validity analysis of SF-36 scale based on second-order confirmatory factor analysis[J]. Chinese Journal of Health Statistics, 2013, 30(6): 846-848. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGWT201306018.htm
[10]	中华人民共和国国务院. 全民健身条例[EB/OL]. (2016-02-06)[2022-10-01]. http://www.gov.cn/zhengce/2020-12/27/content_5575063.htm.
[11]	周珂, 乔石磊. 我国学校体育政策注意力配置的现状与优化——基于1987—2021《教育部工作要点》的文本分析[J]. 体育学刊, 2022, 29(1): 76-83. https://www.cnki.com.cn/Article/CJFDTOTAL-TYXK202201011.htm Zhou K, Qiao SL. Current condition and optimization of policy attention allocation on school physical education in China——Text analysis based on 1987-2021 "key points of the work of the Ministry of Education"[J]. Journal of Physical Education, 2022, 29(1): 76-83. https://www.cnki.com.cn/Article/CJFDTOTAL-TYXK202201011.htm
[12]	2018 Physical Activity Guidelines Advisory Committee. 2018 Physical Activity Guidelines Advisory Committee Scientific Report[EB/OL]. (2021-08-24)[2022-06-15]. https://health.gov/our-work/nutrition-physical-activity/physical-activity-guidelines/current-guidelines/scientific-report.
[13]	World Health Organization. Tackling NCDs: 'best buys' and other recommended interventions for the prevention and control of noncommunicable diseases[EB/OL]. (2017-01-01)[2022-06-20]. https://apps.who.int/iris/handle/10665/259232.
[14]	康涛, 王明义. 体医融合的历史演进与现实启示[J]. 中国医学前沿杂志(电子版), 2022, 14(6): 1-5. DOI: 10.12037/YXQY.2022.06-01. Kang T, Wang MY. Historical evolution and practical implications of sports-medicine integration[J]. Chinese Journal of the Frontiers of Medical Science(Electronic Version), 2022, 14(6): 1-5. DOI: 10.12037/YXQY.2022.06-01.