title: [Adaptation and validation of the CCAENA(©) scale for the measurement of continuity of care between healthcare levels in Colombia and Brazil].
abstract: OBJECTIVE
  To adapt and to validate the scale of the questionnaire Continuity of Care between Care Levels (CCAENA(©)) in the context of the Colombian and Brazilian health systems.
  
  
  METHODS
  The study consisted of two phases: 1) adaptation of the CCAENA(©) scale to the context of each country, which was tested by two pretests and a pilot test, and 2) validation by means of application of the scale in a population survey in Colombia and Brazil. The following psychometric properties were analyzed: construct validity (exploratory factor analysis), internal consistency (Cronbach's alpha and item-rest correlations), the multidimensionality of the scales (Spearman correlation coefficients), and known group validity (chi-square test).
  
  
  RESULTS
  Of the 21 items of the original scale, 14 were selected and reformulated based on a statement with response options of agreement to a question with frequency response options. Factor analysis showed that items could be grouped into three factors: continuity across healthcare levels, the patient-primary care provider relationship, and the patient-secondary care provider relationship. Cronbach's alpha indicated good internal consistency (>0.80 in all the scales). The correlation coefficients suggest that the three factors could be interpreted as separated scales (<0.70) and had adequate ability to differentiate between groups.
  
  
  CONCLUSIONS
  The adapted version of the CCAENA(©) shows adequate validity and reliability in both countries, maintaining a high equivalence with the original version. It is a useful and feasible tool to assess the continuity of care between healthcare levels from the users' perspective in both contexts.
authors.affiliation: Grupo de Investigación en Políticas de Salud y Servicios Sanitarios, Servicio de Estudios y Prospectivas en Políticas de Salud, Consorcio de Salud y Social de Cataluña, Barcelona, España; Programa de doctorado en Biomedicina, Departamento de Ciencias Experimentales y de la Salud, Universitat Pompeu Fabra, Barcelona, España. Electronic address: igarcia@consorci.org.
authors.forename: Irene
authors.initials: I
authors.lastname: Garcia-Subirats
authors.affiliation: Grupo de Investigación en Políticas de Salud y Servicios Sanitarios, Servicio de Estudios y Prospectivas en Políticas de Salud, Consorcio de Salud y Social de Cataluña, Barcelona, España.
authors.forename: Marta Beatriz
authors.initials: MB
authors.lastname: Aller
authors.affiliation: Grupo de Investigación en Políticas de Salud y Servicios Sanitarios, Servicio de Estudios y Prospectivas en Políticas de Salud, Consorcio de Salud y Social de Cataluña, Barcelona, España.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Vargas Lorenzo
authors.affiliation: Grupo de Investigación en Políticas de Salud y Servicios Sanitarios, Servicio de Estudios y Prospectivas en Políticas de Salud, Consorcio de Salud y Social de Cataluña, Barcelona, España.
authors.forename: María Luisa
authors.initials: ML
authors.lastname: Vázquez Navarrete
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003105:Colombia; D003266:Continuity of Patient Care / Q000458:organization & administration; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D017064:Process Assessment, Health Care; D011594:Psychometrics; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Brasil; Brazil; Colombia; Continuidad de la atención al paciente; Continuity of patient care; Cuestionario; Evaluación de procesos y resultados (atención de salud); Health care delivery; Outcome and process assessment (health care); Prestación de atención de salud; Questionnaires