Measuring implementation: development of the implementation process assessment tool (IPAT)
Measuring implementation: development of the implementation process assessment tool (IPAT)
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DOI：
10.1186/s12913-019-4496-0
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发表时间：
2019-10-21
影响因子：
2.8
通讯作者：
Ruud, T.
中科院分区：
文献类型：
--
作者：
Hartveit, M.;Hovlid, E.;Ruud, T.
背景实施科学包括一个大的理论，建议在不同的组织层次的相互作用的因素。文献综述和实施框架的发展有助于全面描述实施情况。然而，目前缺乏衡量这些全面描述的相应工具。本研究旨在开发一种测量护理人员对实施工作的看法的工具，并探讨该工具的心理测量学特性。方法在现有实施文献的基础上，设计了一份调查问卷，其中包括个人和团队因素以及实施过程中的变化阶段。该工具在挪威一项关于实施精神病循证实践的研究中进行了测试。项目分析，因素结构，并在基线的内部一致性进行了检查。结果27个项目的实施过程评估工具（IPAT）的平均得分之间的差异较大。总量表得分在受访者中分布很广。内部一致性的总规模是高的（克朗巴赫的α：.962），所有，但一个项目的建设作出了积极贡献。结果表明，四个基本的结构：个人阶段的行为变化，个人活动和感知的支持，集体的准备和支持，以及个人的看法的干预。结论IPAT似乎是一个可行的工具，从那些作出改变的角度来调查实施过程。它可以审查被认为对执行结果至关重要的因素的相对重要性。它还可以为领导者提供持续的反馈，为团队提供支持，以改善执行情况。然而，需要进一步的研究，以检测仪器的性能后，在实施过程中，并在不同的情况下。
Background Implementation science comprises a large set of theories suggesting interacting factors at different organisational levels. Development of literature syntheses and frameworks for implementation have contributed to comprehensive descriptions of implementation. However, corresponding instruments for measuring these comprehensive descriptions are currently lacking. The present study aimed to develop an instrument measuring care providers' perceptions of an implementation effort, and to explore the instrument's psychometric properties. Methods Based on existing implementation literature, a questionnaire was designed with items on individual and team factors and on stages of change in an implementation process. The instrument was tested in a Norwegian study on implementation of evidence based practices for psychosis. Item analysis, factor structure, and internal consistency at baseline were examined. Results The 27-item Implementation Process Assessment Tool (IPAT) revealed large variation between mean score of the items. The total scale scores were widely dispersed across respondents. Internal consistency for the total scale was high (Cronbach's alpha: .962), and all but one item contributed positively to the construct. The results indicated four underlying constructs: individual stages for behavioural change, individual activities and perceived support, collective readiness and support, and individual perceptions of the intervention. Conclusions The IPAT appears to be a feasible instrument for investigating the implementation process from the perspective of those making the change. It can enable examination of the relative importance of factors thought to be essential for implementation outcomes. It may also provide ongoing feedback for leaders tailoring support for teams to improve implementation. However, further research is needed to detect the instrument's properties later in the implementation process and in different contexts.