Development of a competency framework for public health nurses in China: A modified Delphi study
4 affiliations
- 1Emergency Department, The Third People's Hospital of Chengdu, Chengdu, China.
- 2Innovation Center of Nursing Research, West China Hospital, Sichuan University, Chengdu, China.
- 3Nursing Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China.
- 4Nursing Department, Shang Jin Hospital of West China Hospital, Sichuan University, Chengdu, China.
Abstract
Background: Public health nurses play a pivotal role in primary public health services, yet China lacks a systematic, context-specific competency framework to support workforce development. This study aimed to develop a competency framework for public health nurses in China to guide capacity-building initiatives. Methods: A preliminary competency framework was constructed based on a literature review, job analysis, and semi-structured interviews with 22 frontline practitioners and comprised six domains, 16 subdomains, and 52 competencies. A two-round Delphi survey was then conducted with 21 experts from multiple regions with expertise in community nursing, public health, primary care medicine, and nursing education and related specialties. Consensus was defined as a mean importance rating ≥4.0 (5-point Likert scale) and a coefficient of variation ≤0.25. The Delphi consultation process was characterized by expert engagement, the expert authority coefficient, and the coordination of expert opinions. Finally, the Analytic Hierarchy Process was applied to determine the relative weights of the agreed-upon items at each level. Results: Across the two Delphi rounds, the response rates were 95.45% and 100%, the expert authority coefficient was 0.90, and Kendall’s coefficients of concordance were 0.156 and 0.171, respectively (both P < 0.001). The final competency framework comprised six domains, 16 subdomains, and 46 competencies. All Analytic Hierarchy Process judgment matrices showed acceptable consistency (CR < 0.10). Health education and health promotion was assigned the highest weight (0.280) among the domains. Conclusion: The resulting competency framework demonstrates methodological rigor, a comprehensive structure, and contextual relevance. It provides theoretical and practical implications for competency-based education, workforce development, and the professionalization of public health nursing in China.
Related
- Development and psychometric validation of a health literacy competency scale for nurses, and its application in a cross-sectional survey: a methodological study
- AI literacy as a core competency for health professionals: A consolidated framework for implementation research (CFIR)-Informed perspective
- F.11. Skills building seminar: Defining AI literacy for public health: a participatory competency co-creation exercise
- Rethinking success in public health education and promotion: a narrative ownership framework for sustainable health behavior change
- A safety-first machine learning framework for precision public health: segmenting vaccine hesitancy among Iranian adults
BibTeX
@article{he2026development,
title = {{Development of a competency framework for public health nurses in China: A modified Delphi study}},
author = {Chunxia He and Lingli Yan and Jia Yin and Qian Yao and Jiali Zhang and Jimei Zhang and Xiuying Hu},
journal = {PLOS One},
year = {2026},
month = oct,
doi = {10.1371/journal.pone.0361940},
url = {https://doi.org/10.1371/journal.pone.0361940},
note = {CC BY},
}
RIS
TY - JOUR
TI - Development of a competency framework for public health nurses in China: A modified Delphi study
AU - Chunxia He
AU - Lingli Yan
AU - Jia Yin
AU - Qian Yao
AU - Jiali Zhang
AU - Jimei Zhang
AU - Xiuying Hu
PY - 2026
DA - 2026/10/30
JO - PLOS One
DO - 10.1371/journal.pone.0361940
UR - https://doi.org/10.1371/journal.pone.0361940
AB - Background: Public health nurses play a pivotal role in primary public health services, yet China lacks a systematic, context-specific competency framework to support workforce development. This study aimed to develop a competency framework for public health nurses in China to guide capacity-building initiatives. Methods: A preliminary competency framework was constructed based on a literature review, job analysis, and semi-structured interviews with 22 frontline practitioners and comprised six domains, 16 subdomains, and 52 competencies. A two-round Delphi survey was then conducted with 21 experts from multiple regions with expertise in community nursing, public health, primary care medicine, and nursing education and related specialties. Consensus was defined as a mean importance rating ≥4.0 (5-point Likert scale) and a coefficient of variation ≤0.25. The Delphi consultation process was characterized by expert engagement, the expert authority coefficient, and the coordination of expert opinions. Finally, the Analytic Hierarchy Process was applied to determine the relative weights of the agreed-upon items at each level. Results: Across the two Delphi rounds, the response rates were 95.45% and 100%, the expert authority coefficient was 0.90, and Kendall’s coefficients of concordance were 0.156 and 0.171, respectively (both P < 0.001). The final competency framework comprised six domains, 16 subdomains, and 46 competencies. All Analytic Hierarchy Process judgment matrices showed acceptable consistency (CR < 0.10). Health education and health promotion was assigned the highest weight (0.280) among the domains. Conclusion: The resulting competency framework demonstrates methodological rigor, a comprehensive structure, and contextual relevance. It provides theoretical and practical implications for competency-based education, workforce development, and the professionalization of public health nursing in China.
SN - 1932-6203
ER -