Development of a comprehensive measure of organizational readiness (motivation × capacity) for implementation: a study protocol.
Development of a comprehensive measure of organizational readiness (motivation × capacity) for implementation: a study protocol.
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DOI：
10.1186/s43058-020-00088-4
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发表时间：
2020-11-11
影响因子：
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通讯作者：
Fernandez ME
中科院分区：
文献类型：
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作者：
Walker TJ;Brandt HM;Wandersman A;Scaccia J;Lamont A;Workman L;Dias E;Diamond PM;Craig DW;Fernandez ME
组织准备对于实施循证干预措施非常重要。目前，迫切需要一种可在整个实施过程中使用的全面、有效、可靠和务实的组织准备情况衡量标准。本研究旨在制定一种准备措施，可用于支持在两个关键公共卫生环境中实施：联邦合格的卫生中心 (FQHC) 和学校。该衡量标准以互动系统传播和实施框架和 R = MC2 启发式（准备度 = 动机 × 特定创新能力 × 一般能力）为依据。该研究的目的是调整和进一步发展 FQHC 中实施结直肠癌筛查循证干预措施的准备措施，测试 FQHC 中制定的准备措施的有效性和可靠性，并调整和评估准备措施在实施基于营养的计划的学校中的可用性和有效性。对于目标 1，我们将进行一系列定性访谈，以适应 FQHC 中使用的准备情况衡量标准。然后，我们会将准备措施分发到 100 个健康中心站点的发展样本（每个站点最多 10 名工作人员）。我们将使用多级因素分析方法来完善准备情况衡量标准。对于目标 2，我们将将该措施分发到 100 个健康中心站点的不同样本。我们将使用多层次验证性因素分析模型来检查结构有效性。我们还将进行量表可靠性、重测可靠性和评估者间可靠性的测试。对于目标 3，我们将使用定性方法来调整该衡量标准以适用于学校，并进行类似于目标 2 中所述的信度和效度测试。本研究将严格制定适用于两种环境的准备情况衡量标准：FQHC 和学校。从准备情况衡量中获得的信息可以通过确定优先领域来为规划和实施工作提供信息。这些优先领域可以为支持策略的选择和定制提供信息，这些策略可以在整个实施过程中使用，以进一步改进实施工作，进而提高计划的有效性。
Organizational readiness is important for the implementation of evidence-based interventions. Currently, there is a critical need for a comprehensive, valid, reliable, and pragmatic measure of organizational readiness that can be used throughout the implementation process. This study aims to develop a readiness measure that can be used to support implementation in two critical public health settings: federally qualified health centers (FQHCs) and schools. The measure is informed by the Interactive Systems Framework for Dissemination and Implementation and R = MC2 heuristic (readiness = motivation × innovation-specific capacity × general capacity). The study aims are to adapt and further develop the readiness measure in FQHCs implementing evidence-based interventions for colorectal cancer screening, to test the validity and reliability of the developed readiness measure in FQHCs, and to adapt and assess the usability and validity of the readiness measure in schools implementing a nutrition-based program. For aim 1, we will conduct a series of qualitative interviews to adapt the readiness measure for use in FQHCs. We will then distribute the readiness measure to a developmental sample of 100 health center sites (up to 10 staff members per site). We will use a multilevel factor analysis approach to refine the readiness measure. For aim 2, we will distribute the measure to a different sample of 100 health center sites. We will use multilevel confirmatory factor analysis models to examine the structural validity. We will also conduct tests for scale reliability, test-retest reliability, and inter-rater reliability. For aim 3, we will use a qualitative approach to adapt the measure for use in schools and conduct reliability and validity tests similar to what is described in aim 2. This study will rigorously develop a readiness measure that will be applicable across two settings: FQHCs and schools. Information gained from the readiness measure can inform planning and implementation efforts by identifying priority areas. These priority areas can inform the selection and tailoring of support strategies that can be used throughout the implementation process to further improve implementation efforts and, in turn, program effectiveness.