Measurement properties of a novel survey to assess stages of organizational readiness for evidence-based interventions in community chronic disease prevention settings.
BACKGROUND
There is a great deal of variation in the existing capacity of primary prevention programs and policies addressing chronic disease to deliver evidence-based interventions (EBIs). In order to develop and evaluate implementation strategies that are tailored to the appropriate level of capacity, there is a need for an easy-to-administer tool to stage organizational readiness for EBIs.


METHODS
Based on theoretical frameworks, including Rogers' Diffusion of Innovations, we developed a survey instrument to measure four domains representing stages of readiness for EBI: awareness, adoption, implementation, and maintenance. A separate scale representing organizational climate as a potential mediator of readiness for EBIs was also included in the survey. Twenty-three questions comprised the four domains, with four to nine items each, using a seven-point response scale. Representatives from obesity, asthma, diabetes, and tobacco prevention programs serving diverse populations in the United States were surveyed (N=243); test-retest reliability was assessed with 92 respondents.


RESULTS
Confirmatory factor analysis (CFA) was used to test and refine readiness scales. Test-retest reliability of the readiness scales, as measured by intraclass correlation, ranged from 0.47-0.71. CFA found good fit for the five-item adoption and implementation scales and resulted in revisions of the awareness and maintenance scales. The awareness scale was split into two two-item scales, representing community and agency awareness. The maintenance scale was split into five- and four-item scales, representing infrastructural maintenance and evaluation maintenance, respectively. Internal reliability of scales (Cronbach's α) ranged from 0.66-0.78. The model for the final revised scales approached good fit, with most factor loadings >0.6 and all >0.4.


CONCLUSIONS
The lack of adequate measurement tools hinders progress in dissemination and implementation research. These preliminary results help fill this gap by describing the reliability and measurement properties of a theory-based tool; the short, user-friendly instrument may be useful to researchers and practitioners seeking to assess organizational readiness for EBIs across a variety of chronic disease prevention programs and settings.
Division of Public Health Sciences and Alvin J, Siteman Cancer Center, Washington University School of Medicine, St, Louis, MO, USA. stamatakisk@wustl.edu
Katherine A
KA
Stamatakis
Amy
A
McQueen
Carl
C
Filler
Elizabeth
E
Boland
Mariah
M
Dreisinger
Ross C
RC
Brownson
Douglas A
DA
Luke
D001249:Asthma / Q000517:prevention & control; D002908:Chronic Disease / Q000517:prevention & control*; D003153:Community Health Services / Q000458:organization & administration*; D003920:Diabetes Mellitus / Q000517:prevention & control; D019317:Evidence-Based Medicine / Q000458:organization & administration*; D005163:Factor Analysis, Statistical; D005240:Feasibility Studies; D006801:Humans; D009765:Obesity / Q000517:prevention & control; D015203:Reproducibility of Results; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires / Q000592:standards*; D014481:United States