Development and Validation of a Measure of Organizational Readiness (motivation x capacity) for Implementation

组织准备就绪在实施基于证据的干预措施（EBI）中发挥着关键作用 癌症预防和控制。鉴于测量对于研究和实践的重要性，有一个 需要对组织准备情况进行全面、有效和可靠的衡量，旨在捕获关键 整个实施过程的因素。拟议的研究将制定并验证一项措施 评估组织在联邦实施结直肠癌筛查 (CRCS) EBI 的准备情况 合格的健康中心 (FQHC)。它还将调整和测试该措施，以便在学校中使用，以提供 营养计划。该措施是根据交互式系统框架和过去的研究提供的 确定组织动机和能力（特定创新和一般创新）的重要性 由 R=MC2 启发法捕获。研究目标包括： 目标 1：适应并进一步发展当前的准备情况 用于评估实施循证干预措施以增加结直肠癌的准备情况的监测工具 社区卫生诊所的癌症筛查。目标 2：测试结构、判别和标准的有效性 通过评估内部一致性、时间稳定性、修订后的准备情况监控工具以及可靠性， 和评估者间的可靠性。目标 3：调整和评估准备情况监控工具的可用性和有效性 在学校环境中实施基于营养的计划。目标 1 将通过混合实现 方法 为 DeVellis 量表开发过程中的测量调整和方法提供信息的方法。目标 2 将通过对测试样本实施新开发的措施来测试有效性和可靠性 使用多级验证性因素分析模型，并测试内部一致性、重测可靠性， 和评估者间的可靠性。目标 3 将使用混合方法来调整该措施以用于不同的情况 环境（学校）和主题领域（健康饮食），并评估该领域的信度和效度。 这项研究非常重要，因为它将通过做好准备来推进实施科学 适用于各种设置的衡量标准。它将验证组织的综合措施 准备工作将有助于增加 FQHC 中的 CRCS，并在学校实施营养计划。的 研究的创新之处在于它将是第一个使用大型嵌套样本进行开发和验证的研究 考虑到数据的多层次性质的统计方法。其他创新包括：1) 制定可以使用的组织准备措施（在研究和实践中都很有用） 在整个实施过程中，2) 验证实施 CRCS EBI 的准备情况 FQHC 中，以及 3) 针对不同环境（学校）系统地调整准备情况测量，以及 主题（营养）并进行实证验证，这将导致跨环境的测量适应指南。 鉴于准备情况是实施成功的重要预测因素，并且验证了实施措施 研究和实践都需要做好准备，拟议的研究具有产生巨大影响的潜力。

Organizational readiness plays a critical role in the implementation of evidence-based interventions (EBIs) for cancer prevention and control. Given the importance of measurement for both research for practice, there is a need for a comprehensive, valid, and reliability measure of organizational readiness designed to capture key factors throughout the implementation process. The proposed study will develop and validate a measure to assess organizational readiness for implementing EBIs for colorectal cancer screening (CRCS) in federally qualified health centers (FQHCs). It will also adapt and test the measure for use in schools delivering a nutrition program. The measure is informed by the Interactive Systems Framework and past research identifying the importance of organizational motivation and capacity (innovation-specific and general) as captured by the R=MC2 heuristic. Study aims include: Aim 1: Adapt and further develop the current Readiness Monitoring Tool to assess readiness for implementing evidence-based interventions for increasing colorectal cancer screening in community health clinics. Aim 2: Test structural, discriminant, and criterion validity of the revised Readiness Monitoring Tool as well as reliability by assessing internal consistency, temporal stability, and inter-rater reliability. Aim 3: Adapt and assess the usability and validity of the Readiness Monitoring Tool in the school setting for implementing a nutrition based program. Aim 1 will be accomplished using a mixed methods approach to inform measure adaptation and methods from DeVellis's scale development process. Aim 2 will test the validity and reliability by administering the newly developed measure to a testing sample and using multilevel confirmatory factor analysis models, and tests for internal consistency, test-retest reliability, and inter-rater reliability. Aim 3 will use a mixed methods approach to adapt the measure for use in a different setting (school) and topic area (healthy eating), and, assess the reliability and validity in this area. This study is highly significant in that it will advance implementation science by developing a readiness measure that is applicable across settings. It will validate a comprehensive measure for organizational readiness that will help increase CRCS in FQHCs, and implementation of a nutrition program in schools. The study is innovative in that it will be the first to use large, nested samples for development and validation and a statistical approach that takes into account the multilevel nature of the data. Other innovations include: 1) developing an organizational readiness measure (useful in both research and practice) that can be used throughout the implementation process, 2) validating a measure of readiness for implementing EBIs for CRCS in FQHCs, and 3) adapting the readiness measure in a systematic manner for a different setting (schools) and topic (nutrition) and validating it empirically, which will lead to measure adaptation guidelines across settings. Given that readiness is an important predictor of implementation success and that validated measures of readiness are needed for both research and practice, the proposed study has the potential for high impact.