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

组织准备在实施循证干预措施（EBI）方面发挥着关键作用， 癌症预防和控制。考虑到测量对于研究和实践的重要性， 需要一个全面的、有效的和可靠的组织准备度度量， 在整个实施过程中。拟议的研究将制定和验证一项措施， 评估在联邦政府实施结直肠癌筛查（CRCS）EBI的组织准备情况 合格的保健中心。它还将调整和测试该措施，以供学校使用， 营养计划。该措施是由互动系统框架和过去的研究 确定组织动机和能力（具体创新和一般创新）的重要性， R=MC2启发式算法。研究目标包括：目标1：适应和进一步发展目前的准备 监测工具，以评估实施循证干预措施的准备情况， 在社区卫生诊所进行癌症筛查。目的2：测试的结构，判别，和标准的有效性， 通过评估内部一致性，时间稳定性， 和评分者间的可靠性。目标3：调整和评估准备状态监测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将使用混合 方法的方法，以通知措施的适应和方法，从德伟利斯的规模发展过程。目的 2将通过将新开发的措施用于测试样本来测试有效性和可靠性， 采用多水平验证性因素分析模型，并对内部一致性，重测信度， 和评分者间的可靠性。目标3将采用混合方法，以使衡量标准适用于不同的 背景（学校）和主题领域（健康饮食），并评估在这方面的信度和效度。 这项研究是非常重要的，因为它将通过发展一种准备， 适用于各种环境的措施。它将验证一个全面的措施， 准备，这将有助于增加CRCS在CNOHC，并在学校实施营养计划。的 这项研究是创新的，因为它将是第一个使用大型嵌套样本进行开发和验证， 考虑到数据的多层次性质的统计方法。其他创新包括：1） 制定一个组织准备措施（在研究和实践中都有用）， 在整个实施过程中，2）验证实施CRCS EBI的准备程度 3）针对不同的环境（学校）系统地调整准备措施， 这将导致衡量各种环境的适应准则。 鉴于准备就绪是实施成功的一个重要预测因素， 由于研究和实践都需要准备就绪，因此拟议的研究有可能产生重大影响。

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.