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Using cognitive interviews to improve a measure of organizational readiness for implementation

BACKGROUND: Organizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC(2) heuristic posits that organizational readiness stems from an organizat...

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Autores principales: McClam, Maria, Workman, Lauren, Dias, Emanuelle M., Walker, Timothy J., Brandt, Heather M., Craig, Derek W., Gibson, Robert, Lamont, Andrea, Weiner, Bryan J., Wandersman, Abraham, Fernandez, Maria E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881511/
https://www.ncbi.nlm.nih.gov/pubmed/36707829
http://dx.doi.org/10.1186/s12913-022-09005-y
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author McClam, Maria
Workman, Lauren
Dias, Emanuelle M.
Walker, Timothy J.
Brandt, Heather M.
Craig, Derek W.
Gibson, Robert
Lamont, Andrea
Weiner, Bryan J.
Wandersman, Abraham
Fernandez, Maria E.
author_facet McClam, Maria
Workman, Lauren
Dias, Emanuelle M.
Walker, Timothy J.
Brandt, Heather M.
Craig, Derek W.
Gibson, Robert
Lamont, Andrea
Weiner, Bryan J.
Wandersman, Abraham
Fernandez, Maria E.
author_sort McClam, Maria
collection PubMed
description BACKGROUND: Organizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC(2) heuristic posits that organizational readiness stems from an organization’s motivation, capacity to implement a specific innovation, and its general capacity. This paper describes a process used to examine the face and content validity of items in a readiness survey developed to assess organizational readiness (based on R = MC(2)) among federally qualified health centers (FQHC) implementing colorectal cancer screening (CRCS) EBIs. METHODS: We conducted 20 cognitive interviews with FQHC staff (clinical and non-clinical) in South Carolina and Texas. Participants were provided a subset of items from the readiness survey to review. A semi-structured interview guide was developed to elicit feedback from participants using “think aloud” and probing techniques. Participants were recruited using a purposive sampling approach and interviews were conducted virtually using Zoom and WebEx. Participants were asked 1) about the relevancy of items, 2) how they interpreted the meaning of items or specific terms, 3) to identify items that were difficult to understand, and 4) how items could be improved. Interviews were transcribed verbatim and coded in ATLAS.ti. Findings were used to revise the readiness survey. RESULTS: Key recommendations included reducing the survey length and removing redundant or difficult to understand items. Additionally, participants recommended using consistent terms throughout (e.g., other units/teams vs. departments) the survey and changing pronouns (e.g., people, we) to be more specific (e.g., leadership, staff). Moreover, participants recommended specifying ambiguous terms (e.g., define what “better” means). CONCLUSION: Use of cognitive interviews allowed for an engaged process to refine an existing measure of readiness. The improved and finalized readiness survey can be used to support and improve implementation of CRCS EBIs in the clinic setting and thus reduce the cancer burden and cancer-related health disparities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-09005-y.
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spelling pubmed-98815112023-01-27 Using cognitive interviews to improve a measure of organizational readiness for implementation McClam, Maria Workman, Lauren Dias, Emanuelle M. Walker, Timothy J. Brandt, Heather M. Craig, Derek W. Gibson, Robert Lamont, Andrea Weiner, Bryan J. Wandersman, Abraham Fernandez, Maria E. BMC Health Serv Res Research BACKGROUND: Organizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC(2) heuristic posits that organizational readiness stems from an organization’s motivation, capacity to implement a specific innovation, and its general capacity. This paper describes a process used to examine the face and content validity of items in a readiness survey developed to assess organizational readiness (based on R = MC(2)) among federally qualified health centers (FQHC) implementing colorectal cancer screening (CRCS) EBIs. METHODS: We conducted 20 cognitive interviews with FQHC staff (clinical and non-clinical) in South Carolina and Texas. Participants were provided a subset of items from the readiness survey to review. A semi-structured interview guide was developed to elicit feedback from participants using “think aloud” and probing techniques. Participants were recruited using a purposive sampling approach and interviews were conducted virtually using Zoom and WebEx. Participants were asked 1) about the relevancy of items, 2) how they interpreted the meaning of items or specific terms, 3) to identify items that were difficult to understand, and 4) how items could be improved. Interviews were transcribed verbatim and coded in ATLAS.ti. Findings were used to revise the readiness survey. RESULTS: Key recommendations included reducing the survey length and removing redundant or difficult to understand items. Additionally, participants recommended using consistent terms throughout (e.g., other units/teams vs. departments) the survey and changing pronouns (e.g., people, we) to be more specific (e.g., leadership, staff). Moreover, participants recommended specifying ambiguous terms (e.g., define what “better” means). CONCLUSION: Use of cognitive interviews allowed for an engaged process to refine an existing measure of readiness. The improved and finalized readiness survey can be used to support and improve implementation of CRCS EBIs in the clinic setting and thus reduce the cancer burden and cancer-related health disparities. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-022-09005-y. BioMed Central 2023-01-27 /pmc/articles/PMC9881511/ /pubmed/36707829 http://dx.doi.org/10.1186/s12913-022-09005-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research
McClam, Maria
Workman, Lauren
Dias, Emanuelle M.
Walker, Timothy J.
Brandt, Heather M.
Craig, Derek W.
Gibson, Robert
Lamont, Andrea
Weiner, Bryan J.
Wandersman, Abraham
Fernandez, Maria E.
Using cognitive interviews to improve a measure of organizational readiness for implementation
title Using cognitive interviews to improve a measure of organizational readiness for implementation
title_full Using cognitive interviews to improve a measure of organizational readiness for implementation
title_fullStr Using cognitive interviews to improve a measure of organizational readiness for implementation
title_full_unstemmed Using cognitive interviews to improve a measure of organizational readiness for implementation
title_short Using cognitive interviews to improve a measure of organizational readiness for implementation
title_sort using cognitive interviews to improve a measure of organizational readiness for implementation
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9881511/
https://www.ncbi.nlm.nih.gov/pubmed/36707829
http://dx.doi.org/10.1186/s12913-022-09005-y
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