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

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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.