基于SPO模型的控烟条例实施效果评价指标体系构建及应用研究

Construction and application of an evaluation index system for effectiveness of tobacco control regulations im⁃plementation based on SPO model

目的基于SPO(结构-过程-结果)模型构建《杭州市公共场所控制吸烟条例》实施效果评价指标体系,并以杭州市作为实证研究区域评价其新版《杭州市公共场所控制吸烟条例》的实际执行效果,为其他城市的无烟建设提供理论参考。方法采用德尔菲专家咨询法确定指标体系,通过层次分析法、均数法、连乘累计组合赋权法计算各级指标的权重,并使用所构建的指标体系对杭州市所辖区县的控烟实施效果进行评价。结果共邀请到17位专家和学者全程参与德尔菲专家咨询,2轮专家的积极系数分别为90.00%、94.44%,权威系数Cr分别为0.89、0.91;专家意见的协调系数分别为0.183和0.249;最终确定的指标体系重要性均数均>3.5,CV为0.07~0.21,CR均<0.1,专家意见趋于一致。经过2轮专家咨询,最终构建的指标体系包括3项一级指标、11项二级指标、41项三级指标。根据所构建的指标体系对杭州市11个区县的控烟实施效果进行评价,经百分制换算后二级指标得分最高分为89.66,最低分为26.05,各区县间总得分差距明显,其中,不同区县间管理支持、物力和人力资源、条例的宣传、监督执法、公众参与的得分差异具有统计学意义(P<0.05)。结论本研究所构建的《杭州市公共场所控制吸烟条例》实施效果评价指标体系具有科学性、合理性,适用于评价区域控烟条例的实施效果,能为其他城市无烟政策的实施效果评价提供理论参考。

Objective To establish an index system for evaluating implementation effect of the Regulations of Smoking Control in Public Places in Hangzhou based on SPO model,and to provide reference for the smoke⁃free construction in other cities as an empirical research.Methods The index system was determined by two rounds of Delphi Method,the weight of the index was calculated by Analytic Hierarchy Process,mean value method and continuous multiplication cumula⁃tive combination weighting method,and the index system were used to evaluate the effect of tobacco control in the districts of Hangzhou.Results A total of 17 experts and scholars were invited to participate in a Delphi expert consultation.The positive coefficients of two rounds of experts were 90.00%and 94.44%,respectively,and the authority coefficients Cr were 0.89 and 0.91,respectively.The coordination coefficients of expert opinions were 0.183 and 0.249,respectively.The mean im⁃portance of final index system was>3.5,CV was 0.07-0.21,CR was<0.1,and the expert opinions tended to be con⁃sistent.After two rounds of expert consultation,the index system of 3 first⁃level indicators,11 second⁃level indicators and 41 third⁃level indicators were finally constructed.According to the constructed index system,the implementation effect of tobac⁃co control in 11 districts and counties in Hangzhou was evaluated.The highest score of the secondary index was 89.66 and the lowest score was 26.05 after conversion by the percentage system.There was significant difference in the total score among all districts and counties.The scores of management support,material and human resources,publicity of regulations,supervi⁃sion and law enforcement,and public participation were statistically significant(P<0.05).Conclusion The evaluation index system of the implementation effect of tobacco control regulations constructed in this study is scientific and reasonable,and suitable for evaluating the effect of regional tobacco control,and can provide reference for implementing smoke⁃free poli⁃cy in other cities.