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Developing Assessment Indicators of HealthEducation and Health Promotion in NoncommunicableDisease Demonstration Districts: A Modified Delphi Study

Objectives: This study was designed to develop assessment indicators for noncommunicable disease (NCD) demonstration districts in Hunan province, China, providing both a framework for further field evaluation of the districts, and a reference for other similar studies. 
Methods: Thirty-eight consultative items were designed, followed by a two round modified Delphi process. The importance of each item was scored by experts with a 9-point Likert scale. Consensus was determined as experts’ agreement ≥ 70%, median score ≥ 7, and Coefficient of Variance (CV) <0.25 in the second round. 
Results: A total of 19 experts participated in the study, and the authoritative coefficient of experts was from 0.80 to 0.82 in the two rounds. The overall CV was from 0.20 to 0.16 in the two rounds. Kendall's W coefficient was 0.35 and 0.45 in the first and second rounds, respectively, and chi square tests indicated significant differences (p<0.05). Twenty-six items with a median scoring of 8 were chosen as assessment indicators, including the following themes: organizational management, fund support, personnel supplies, health education and promotion, NCDs awareness and healthy behaviors, NCD patients’ management and control, satisfaction with heath education and promotion, and civil health literacy. 
Conclusions: Twenty-six items produced by the modified Delphi method were constructed as assessment indicators of health education and promotion in NCD demonstration districts, which could provide both a basis for further field evaluation of the districts, and a reference for other similar, future studies.