Construction of a practice model of evidence-based health service development for public health nursing in Japan: a Delphi survey

An effective and efficient response to health needs requires the development of an evidence-based health service. Public health nurses are considered to be key practitioners of health service development in Japanese health administration, increasing the importance of the role of health service development. The purpose of this study is to build a practice model for evidence-based health service development adapted to the context of public health nursing in Japan (“Practice Model”) by applying the knowledge of implementation science. The draft Practice Model consisted of 17 items grouped into three stages, was developed through literature research and regular consultations by the study team and feedback at two public gatherings. The framework and item-pool of the initial draft were built on implementation science models meeting one of the criteria set by the study team. The draft was revised repeatedly through self-administered questionnaire via e-mail using three rounds of the Delphi consensus method. The expert panel consisted of 608 practitioners and faculty in public health nursing who met the selection criteria, and 99 of them offered their cooperation (52 practitioners and 47 faculty), 81 of them cooperated in all three rounds of the survey. As a result, High percentages of agreement of 80% or over were obtained in all rounds for all items. In particular, all items gained even higher percentages of agreement in Round 3, reaching 95% or over. Thus, it is concluded that the Practice Model agreed upon in this survey comprises three stages (preparation, implementation, dissemination) integrating PDCA and key implementation.