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Context matters: measuring implementation climate among individuals and groups

机译:背景很重要:衡量个人和团体之间的实施环境

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Background It has been noted that implementation climate is positively associated with implementation effectiveness. However, issues surrounding the measurement of implementation climate, or the extent to which organizational members perceive that innovation use is expected, supported and rewarded by their organization remain. Specifically, it is unclear whether implementation climate can be measured as a global construct, whether individual or group-referenced items should be used, and whether implementation climate can be assessed at the group or organizational level. Methods This research includes two cross-sectional studies with data collected via surveys at the individual level. The first study assessed the implementation climate perceptions of physicians participating in the National Cancer Institute’s (NCI) Community Clinical Oncology Program (CCOP), and the second study assessed the perceptions of children’s behavioral health clinicians implementing a treatment innovation. To address if implementation climate is a global construct, we used confirmatory factor analysis. To address how implementation climate should be measured and at what level, we followed a five-step framework outlined by van Mierlo and colleagues. This framework includes exploratory factor analysis and correlations to assess differences between individual and group-referenced items and intraclass correlations, interrater agreements, and exploratory factor analysis to determine if implementation climate can be assessed at the organizational level. Results The confirmatory factor analysis demonstrated that implementation climate is a global construct consisting of items related to expectations, support and rewards. There are mixed results, however, as to whether implementation climate should be measured using individual or group-referenced items. In our first study, where physicians were geographically dispersed and practice independently, there were no differences based on the type of items used, and implementation climate was an individual level construct. However, in the second study, in which clinicians practice in a central location and interact more frequently, group-referenced items may be appropriate. In addition, implementation climate could be considered an organizational level construct. Conclusions The results are context-specific. Researchers should carefully consider the study setting when measuring implementation climate. In addition, more opportunities are needed to validate this measure and understand how well it predicts and explains implementation effectiveness.
机译:背景技术已经注意到,实施环境与实施有效性正相关。但是,围绕衡量实施氛围或组织成员对组织期望,支持和奖励创新使用的感觉仍然存在问题。具体而言,目前尚不清楚是否可以将实施气氛作为一个整体来衡量,是否应该使用个人或小组参考的项目,以及是否可以在组或组织级别评估实施气氛。方法本研究包括两项横断面研究,这些研究通过个人层面的调查收集了数据。第一项研究评估了参加美国国家癌症研究所(NCI)社区临床肿瘤学计划(CCOP)的医师对气候实施的看法,第二项研究评估了实施疗法创新的儿童行为健康临床医生的看法。为了解决实施环境是否是全球构建的问题,我们使用了验证性因素分析。为了解决如何衡量实施环境以及在什么水平上实施气候变化,我们遵循了van Mierlo及其同事概述的五步框架。该框架包括探索性因素分析和相关性,以评估个体和小组所指项目之间的差异以及类别内的相关性,相互间的协议,以及探索性因素分析,以确定是否可以在组织级别评估实施环境。结果验证性因素分析表明,实施氛围是一个由预期,支持和奖励相关项目组成的全球架构。但是,关于是否应使用个人或团体参考项目来衡量实施环境,结果却有好有坏。在我们的第一项研究中,医生分散在各地并且独立执业,在使用的项目类型方面没有差异,实施环境是个人层面的构建。但是,在第二项研究中,临床医生在中心位置执业并更频繁地进行互动,团体参考项目可能是合适的。此外,可以将实施氛围视为组织级别的架构。结论结果是特定于上下文的。研究人员在衡量实施环境时应仔细考虑研究环境。此外,还需要更多机会来验证该措施并了解其对实施效果的预测和解释效果。

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