Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.
Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial.
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DOI：
10.3389/fpubh.2018.00110
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发表时间：
2018
影响因子：
5.2
通讯作者：
Hannon PA
中科院分区：
文献类型：
--
作者：
Helfrich CD;Kohn MJ;Stapleton A;Allen CL;Hammerback KE;Chan KCG;Parrish AT;Ryan DE;Weiner BJ;Harris JR;Hannon PA
组织对变革的准备程度可能是实施成功的关键决定因素，也是实施干预措施有效性的中介。如果组织准备可以在变更计划开始时被可靠和有效地评估，那么它可以通过测量准备因素随时间的变化来评估实现支持活动的有效性。我们分析了两波准备改变调查数据，这些数据是三组随机对照试验的一部分，旨在在低工资行业的小型工作场所实施循证健康促进实践。我们测量了五个准备因素：环境（有利的更广泛的条件）；改变价值（重视健康促进）；信息评估（实施健康促进的需求和资源）；改变承诺（实施健康促进的意图）；改变功效（对共同实施健康促进能力的信念）。我们期望干预地点的承诺和有效性随着他们自我报告的实施健康促进实践的努力而增加，称为健康计划努力。我们比较了基线和15个月的平均值，以及干预点和对照点的平均值。我们使用线性回归来检验干预点和控制点的变化准备得分是否随时间而不同。只有上下文和变更承诺符合可靠性阈值。从基线到15个月，对照组（- 0.39）和干预点（- 0.29）的改变承诺都显著下降，而环境都没有改变。只有健康计划在15个月的努力，而不是在基线，在对照组和干预点之间有显著差异（对照组1.20，干预2.02）。回归分析显示，干预点与对照点从基线到15个月的变化有两个显著差异：(1)干预点在情境得分上的变化明显小于对照点；(2)干预点在健康计划努力方面的变化明显高于对照点。与我们的假设相反，健康链接和控制站点的改变承诺显著下降，即使健康链接站点的健康计划努力显著增加。回归均值可以解释改变承诺的下降。未来的研究需要评估基线承诺是健康计划努力的独立预测因子还是健康链接干预的效果调节因子。
Organizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time. We analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time. Only context and change commitment met reliability thresholds. Change commitment declined significantly for both control (−0.39) and interventions sites (−0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites. Contrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.
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DOI：
10.1186/1748-5908-4-50
发表时间：
2009-08-07
期刊：
Implementation science : IS
影响因子：
--
作者：
Damschroder LJ;Aron DC;Keith RE;Kirsh SR;Alexander JA;Lowery JC
通讯作者：
Lowery JC
影响因子：
2.2
作者：
Hannon PA;Hammerback K;Allen CL;Parrish AT;Chan KG;Kohn MJ;Teague S;Beresford SA;Helfrich CD;Harris JR
通讯作者：
Harris JR
影响因子：
2.7
作者：
Hannon, Peggy A.;Helfrich, Christian D.;Harris, Jeffrey R.
通讯作者：
Harris, Jeffrey R.
影响因子：
5.7
作者：
Holt, Daniel T.;Helfrich, Christian D.;Weiner, Bryan J.
通讯作者：
Weiner, Bryan J.
影响因子：
9.9
作者：
Herscovitch, L;Meyer, JP
通讯作者：
Meyer, JP