title: Development of the competency scale for primary care managers in Thailand: Scale development.
abstract: BACKGROUND
  The complexity of the primary care system requires a competent manager to achieve high-quality healthcare. The existing literature in the field yields little evidence of the tools to assess the competency of primary care administrators. This study aimed to develop and examine the psychometric properties of the competency scale for primary care managers in Thailand.
  
  
  METHODS
  The scale was developed using in-depth interviews and focus group discussions among policy makers, managers, practitioners, village health volunteers, and clients. The specific dimensions were extracted from 35 participants. 123 items were generated from the evidence and qualitative data. Content validity was established through the evaluation of seven experts and the original 123 items were reduced to 84 items. The pilot testing was conducted on a simple random sample of 487 primary care managers. Item analysis, reliability testing, and exploratory factor analysis were applied to establish the scale's reliability and construct validity.
  
  
  RESULTS
  Exploratory factor analysis identified nine dimensions with 48 items using a five-point Likert scale. Each dimension accounted for greater than 58.61% of the total variance. The scale had strong content validity (Indices = 0.85). Each dimension of Cronbach's alpha ranged from 0.70 to 0.88.
  
  
  CONCLUSIONS
  Based on these analyses, this instrument demonstrated sound psychometric properties and therefore is considered an effective tool for assessment of the primary care manager competencies. The results can be used to improve competency requirements of primary care managers, with implications for health service management workforce development.
authors.affiliation: Faculty of Public Health Khon Kaen University, 123 Mitraparb Road, Muang District, Khon Kaen, 42000, Thailand. keeratik@gmail.com.
authors.forename: Keerati
authors.initials: K
authors.lastname: Kitreerawutiwong
authors.affiliation: Faculty of Public Health Khon Kaen University, Khon Kaen, Thailand. pirsri@kku.ac.th.
authors.forename: Chanaphol
authors.initials: C
authors.lastname: Sriruecha
authors.affiliation: Faculty of Public Health Khon Kaen University, Khon Kaen, Thailand. drwongsa@gmail.com.
authors.forename: Wongsa
authors.initials: W
authors.lastname: Laohasiriwong
mesh_terms: D000288:Administrative Personnel / Q000458:organization & administration*; D000328:Adult; D004650:Employee Performance Appraisal / Q000379:methods*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D013785:Thailand