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Pragmatic adaptation of implementation research measures for a novel context and multiple professional roles: a factor analysis study.
BMC Health Services Research ( IF 2.8 ) Pub Date : 2020-03-30 , DOI: 10.1186/s12913-020-05118-4
Justin D Smith 1, 2, 3, 4 , Miriam R Rafferty 5 , Allen W Heinemann 6, 7 , Mariah K Meachum 1 , Juan Villamar 1 , Richard L Lieber 7, 8 , C Hendricks Brown 1, 2, 4
Affiliation  

BACKGROUND Although some advances have been made in recent years, the lack of measures remains a major challenge in the field of implementation research. This results in frequent adaptation of implementation measures for different contexts-including different types of respondents or professional roles-than those for which they were originally developed and validated. The psychometric properties of these adapted measures are often not rigorously evaluated or reported. In this study, we examined the internal consistency, factor structure, and structural invariance of four well-validated measures of inner setting factors across four groups of respondents. The items in these measures were adapted as part of an evaluation of a large-scale organizational change in a rehabilitation hospital, which involved transitioning to a new building and a new model of patient care, facilitated by a significant redesign of patient care and research spaces. METHODS Items were tailored for the context and perspective of different respondent groups and shortened for pragmatism. Confirmatory factor analysis was then used to test study hypotheses related to fit, internal consistency, and invariance across groups. RESULTS The survey was administered to approximately 1208 employees; 785 responded (65% response rate) across the roles of clinician, researcher, leader, support staff, or dual clinician and researcher. For each of the four scales, confirmatory factor analysis demonstrated adequate fit that largely replicated the original measure. However, a few items loaded poorly and were removed from the final models. Internal consistencies of the final scales were acceptable. For scales that were administered to multiple professional roles, factor structures were not statistically different across groups, indicating structural invariance. CONCLUSIONS The four inner setting measures were robust for use in this new context and across the multiple stakeholder groups surveyed. Shortening these measures did not significantly impair their measurement properties; however, as this study was cross sectional, future studies are required to evaluate the predictive validity and test-retest reliability of these measures. The successful use of adapted measures across contexts, across and between respondent groups, and with fewer items is encouraging, given the current emphasis on designing pragmatic implementation measures.

中文翻译:

实施研究措施的语用适应,以适应新的背景和多种职业角色:因素分析研究。

背景技术尽管近年来已经取得了一些进展,但是缺乏措施仍然是实施研究领域中的主要挑战。这导致与最初制定和验证的实施措施相比,经常针对不同的环境(包括不同类型的受访者或专业角色)调整实施措施。这些适应措施的心理测量特性通常没有得到严格的评估或报告。在这项研究中,我们检查了四组受访者内部设定因素的四个经过充分验证的度量的内部一致性,因素结构和结构不变性。这些措施中的项目作为对康复医院大规模组织变革的评估的一部分进行了修改,其中涉及到对患者护理和研究空间的重大重新设计,从而过渡到新的建筑和患者护理的新模型。方法针对不同受访者群体的情况和观点量身定制项目,并针对实用主义缩短项目。然后使用验证性因素分析来检验与适合度,内部一致性和组间不变性相关的研究假设。结果这项调查是针对大约1208名员工进行的。在临床医生,研究人员,领导者,支持人员或双重临床医生和研究人员的角色中,有785人做出了回应(回应率为65%)。对于这四个量表中的每个量表,验证性因子分析均显示出足够的拟合度,在很大程度上重复了原始量度。但是,一些物品装载不佳,因此从最终模型中删除。最终量表的内部一致性是可以接受的。对于分配给多个专业角色的量表,各组间的因子结构在统计学上没有差异,表明结构不变。结论四种内部设置措施在这种新情况下以及在所调查的多个利益相关者群体中都可以使用。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。鉴于当前的重点是设计务实的实施措施,因此,鼓励在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功使用适应措施是令人鼓舞的。对于分配给多个专业角色的量表,各组间的因子结构在统计学上没有差异,表明结构不变。结论四种内部设置措施在这种新情况下以及在所调查的多个利益相关者群体中都可以使用。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。考虑到当前的重点是设计务实的实施措施,令人鼓舞的是,在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功采用了适应措施。对于分配给多个专业角色的量表,各组间的因子结构在统计学上没有差异,表明结构不变。结论四种内部设置措施在这种新情况下以及在所调查的多个利益相关者群体中都可以使用。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。考虑到当前的重点是设计务实的实施措施,令人鼓舞的是,在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功采用了适应措施。指示结构不变性。结论四种内部设置措施在这种新情况下以及在所调查的多个利益相关者群体中都可以使用。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。考虑到当前的重点是设计务实的实施措施,令人鼓舞的是,在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功采用了适应措施。指示结构不变性。结论四种内部设置措施在这种新情况下以及在所调查的多个利益相关者群体中都可以使用。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。鉴于当前的重点是设计务实的实施措施,因此,鼓励在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功使用适应措施是令人鼓舞的。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。考虑到当前的重点是设计务实的实施措施,令人鼓舞的是,在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功采用了适应措施。缩短这些措施并不会显着损害其测量性能。但是,由于这项研究是横断面的,因此需要进一步的研究来评估这些措施的预测有效性和重测信度。考虑到当前的重点是设计务实的实施措施,令人鼓舞的是,在不同情况下,在受访者群体之间和之间以及在项目较少的情况下成功采用了适应措施。
更新日期:2020-03-31
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