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 (RMIC), which provides a comprehensive theoretical framework for integrated care. To translate and adapt the original care provider version of the RMIC-MT 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 back-translation, experts 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. 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 48 items were retained with some detailed modifications. No item was found to have psychometric sensitivity problems. Six factors (person-& community-centeredness, care integration, professional integration, organizational integration, cultural competence and technical competence) with 45 items were determined by exploratory factor analysis, accounting for 61.46% of the total variance. A standard Cronbach's alpha of 0.940 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 Chinese RMIC-MT provider version. Its application in China will promote the development of people-centered integrated primary care. However, further psychometric testing is needed in multiple primary care settings with both public and private community institutes.

Implementation of Integrated Care for the Aged Population in Anhui and Fujian Province of China: A Qualitative Study

“…The six key domains provide a framework to characterize the degree of integration from a multifocal perspective. The literature suggests that the RMIC has been well applied to explore and analyse the integration perspectives of different stakeholders’ at different levels in various study settings including Australia [ 19 ], Norway [ 20 ], Singapore [ 21 ], China [ 22 23 24 25 ], etc. Furthermore, Chen Z 2019 have already explored and validated the RMIC in China’s context, which confirmed its adaptation and applicability in China particularly regarding the key domains covered in this model [ 25 ].…”

A Validation Study of the Rainbow Model of Integrated Care-Measurement Tool for Patients in China

“…clinical integration, professional integration, organizational integration, person-centeredness). Differently, care providers participated in validation of the provider version C-RMIC-MT didn't recognize differences between clinical and organizational integration [21]. The personcenteredness dimension did not meet the eigenvalue criteria of >1.…”

“…Factor 1 was named 'clinical integration' (5 items, 15.29% variance), factor 2 'professional integration' (3 items, 11.02% variance), factor 3 'team-based coordination' (3 items, 9.98% variance), factor 4 'organizational integration' (2 items, 9.44% variance), factor 5 'person-centeredness' (2 items, 7.78% variance). Items 1,11,15,19,20,21,22,23,24 were omitted because they had poor factor loadings (<0.60) (Table 3). Regarding model fit (15 items, five factors), the following test of significance and goodnessof-fit measures were obtained: RMSEA 0.046, SRMR 0.057, CFI 0.896, TLI 0.885.…”

“…Pilot validation of the provider version and patient version RMIC-MT were conducted in Chinese primary care systems in 2018, targeting on different populations and with different sampling and data collection methods. The validation of the provider version showed initial satisfactory psychometric properties [21]. This study aims to validate the RMIC-MT patient version in the context of the Chinese integrated primary care system.…”

Effect of Collaborative Governance on Medical and Nursing Service Combination: An Evaluation Based on Delphi and Entropy Method

“…The Rainbow Model of Integrated Care (RMIC) is becoming internationally recognized for integrated care as a suitable theoretical framework [7] (Valentijn 2016). Although RMIC measurement tools have been used to assess coordination capabilities within certain diseases [7][8][9][10][11] there is still a need for an evaluation model at the regional level that meets the evaluation needs in the region analyzed in this exercise. Researchers have applied the theory of synergy on local and international scenarios [12,13] to study regional medical resources [14], public health services [15], the retirement pension service supply [16], and a combination of medical and nursing services [17].…”