title: Development and initial validation of primary care provider mental illness management and team-based care self-efficacy scales.
abstract: Develop and validate self-efficacy scales for primary care provider (PCP) mental illness management and team-based care participation.
  
  
  
  We developed three self-efficacy scales: team-based care (TBC), mental illness management (MIM), and chronic medical illness (CMI). We developed the scales using Bandura's Social Cognitive Theory as a guide. The survey instrument included items from previously validated scales on team-based care and mental illness management. We administered a mail survey to 900 randomly selected Colorado physicians. We conducted exploratory principal factor analysis with oblique rotation. We constructed self-efficacy scales and calculated standardized Cronbach's alpha coefficients to test internal consistency. We calculated correlation coefficients between the MIM and TBC scales and previously validated measures related to each scale to evaluate convergent validity. We tested correlations between the TBC and the measures expected to correlate with the MIM scale and vice versa to evaluate discriminant validity.
  
  
  
  PCPs (n=402, response rate=49%) from diverse practice settings completed surveys. Items grouped into factors as expected. Cronbach's alphas were 0.94, 0.88, and 0.83 for TBC, MIM, and CMI scales respectively. In convergent validity testing, the TBC scale was correlated as predicted with scales assessing communications strategies, attitudes toward teams, and other teamwork indicators (r=0.25 to 0.40, all statistically significant). Likewise, the MIM scale was significantly correlated with several items about knowledge and experience managing mental illness (r=0.24 to 41, all statistically significant). As expected in discriminant validity testing, the TBC scale had only very weak correlations with the mental illness knowledge and experience managing mental illness items (r=0.03 to 0.12). Likewise, the MIM scale was only weakly correlated with measures of team-based care (r=0.09 to.17).
  
  
  
  This validation study of MIM and TBC self-efficacy scales showed high internal validity and good construct validity.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, USA. Electronic address: Danielle.loeb@ucdenver.edu.
authors.forename: Danielle F
authors.initials: DF
authors.lastname: Loeb
authors.affiliation: Department of Community and Behavioral Health, Colorado School of Public Health, The Adult and Child Center for Outcomes Research and Delivery Science, University of Colorado Anschutz Medical Campus, Aurora, USA. Electronic address: Lori.crane@ucdenver.edu.
authors.forename: Lori A
authors.initials: LA
authors.lastname: Crane
authors.affiliation: Department of Biostatistics & Informatics, Colorado School of Public Health, The Adult and Child Center for Outcomes Research and Delivery Science, Aurora, USA. Electronic address: Erin.leister@ucdenver.edu.
authors.forename: Erin
authors.initials: E
authors.lastname: Leister
authors.affiliation: Kaiser Permanente Colorado Institute for Health Research, Denver, USA; Department of Family Medicine, University of Colorado, Aurora, USA. Electronic address: Elizabeth.bayliss@kp.org.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Bayliss
authors.affiliation: Group Health Research Institute, Seattle, WA, USA. Electronic address: Ludman.e@ghc.org.
authors.forename: Evette
authors.initials: E
authors.lastname: Ludman
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Colorado, Aurora, USA; Kaiser Permanente Colorado Institute for Health Research, Denver, USA. Electronic address: Ingrid.a.binswanger@kp.org.
authors.forename: Ingrid A
authors.initials: IA
authors.lastname: Binswanger
authors.affiliation: Division of General Internal Medicine, Department of Internal Medicine, University of Colorado School of Medicine, Aurora, USA. Electronic address: Danielle.Kline@ucdenver.edu.
authors.forename: Danielle M
authors.initials: DM
authors.lastname: Kline
authors.affiliation: Cancer Center, University of Colorado, Aurora, USA. Electronic address: Meredith.smith@ucdenver.edu.
authors.forename: Meredith
authors.initials: M
authors.lastname: Smith
authors.affiliation: Department of Family Medicine, University of Colorado, Aurora, USA. Electronic address: Frank.deGruy@ucdenver.edu.
authors.forename: Frank V
authors.initials: FV
authors.lastname: deGruy
authors.affiliation: Department of Family Medicine, University of Colorado, Aurora, USA. Electronic address: Donald.nease@ucdenver.edu.
authors.forename: Donald E
authors.initials: DE
authors.lastname: Nease
authors.affiliation: Department of Family Medicine, University of Colorado, Aurora, USA; Department of Biostatistics & Informatics, Colorado School of Public Health, University of Colorado, Aurora, USA. Electronic address: Miriam.dickinson@ucdenver.edu.
authors.forename: L Miriam
authors.initials: LM
authors.lastname: Dickinson
mesh_terms: D000328:Adult; D019468:Disease Management; D005260:Female; D058006:General Practice / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000628:therapy*; D008875:Middle Aged; D058007:Physicians, Primary Care / Q000592:standards* / Q000706:statistics & numerical data; D011594:Psychometrics / Q000295:instrumentation*; D015203:Reproducibility of Results; D020377:Self Efficacy; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Chronic disease; Mental health; Primary care physicians; Primary health care; Self efficacy; Surveys and questionnaires; Validation studies