Non-communicable diseases (NCDs) have become a major challenge that threatens the health of residents and the national economy. Besides individual factors, community-level forces are potentially important for NCD prevention and control too. We conducted a series of investigations that built upon the theory of “community empowerment” and focused on the innovative concept of “community efficacy.”

Led by Dr. Lijing Yan, Professor of Global Health at Duke Kunshan University, and funded by the National Natural Science Foundation of China, this four-year project was completed this year.

The project was divided into two phases. The aim of the first phase was to develop and validate the “Community Efficacy for NCD (COEN)” evaluation system, which was defined as the communities’ abilities to provide NCD prevention and management and health promotion. Methods in this phase included literature review, expert interviews, Delphi consultation, and validation surveys. Researchers conducted two rounds of Delphi expert consultation among 27 Chinese and international experts. They then established a community efficacy evaluation system and collected data to validate the reliability and validity of the COEN scale.

The aim of the second phase was to collect information through the COEN scale to evaluate community-level factors associated with NCD control. A cohort of residents with hypertension and/or diabetes was established in 12 communities in Kunshan city, Taicang city, and Shanghai. They conducted the baseline survey in 2019 and two annual follow-up surveys in 2020 and 2021, including resident questionnaires, resident interviews, and key informant interviews.