Development of a personal competency evaluation indicator system for tuberculosis health educators: a scoping review and Delphi study.

OBJECTIVE

To systematically synthesize evidence on the personal competency of tuberculosis (TB) health educators and to develop a scientifically robust and comprehensive evaluation indicator system.

METHODS

A two-phase mixed-methods design was employed. Phase 1 involved a scoping review of seven databases (PubMed/MEDLINE, Web of Science, Scopus, Embase, CINAHL, ERIC, and the Cochrane Library) to identify competency-related literature on TB health educators, with no restrictions on publication date, language, or geographic setting. Extracted competency elements were synthesized into a preliminary framework. Phase 2 used a modified Delphi method with two rounds of consultation among 20 Chinese experts in TB control and health education. Indicator importance was rated on a 5-point Likert scale, and the Analytic Hierarchy Process (AHP) was applied to calculate indicator weights. Validity and reliability were assessed using content validity indices and intraclass correlation coefficient (ICC).

RESULTS

The scoping review included 36 studies, from which seven core dimensions, 24 categories, and 63 specific competency elements were extracted. Both Delphi rounds achieved a 100% response rate. The expert authority coefficient (Cr) was 0.84. Kendall's W increased significantly from 0.295 (first round) to 0.328 (second round, both p < 0.001). After the second round, all indicators met the retention criteria: mean importance ≥3.5, coefficient of variation <0.25, and expert agreement rate ≥50.0%. AHP results showed good consistency (first-level indicator CR = 0.043; all second-level CRs < 0.10). The overall scale demonstrated good reliability (ICC = 0.86) and content validity (scale-level CVI = 0.92; item-level CVI range: 0.85-1.00). The highest-weighted dimension was Communication and Health Education Skills (0.235).

CONCLUSION

The personal competency evaluation indicator system for TB health educators developed in this study is scientifically sound, reliable, and practical. It provides a validated tool for competency assessment, targeted training design, and workforce development in TB health education.