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Landsverk NG, Olsen NR, Titlestad KB, Pripp AH, Brovold T. Adaptation and validation of the evidence-based practice profile (EBP 2) questionnaire in a Norwegian primary healthcare setting. BMC MEDICAL EDUCATION 2024; 24:841. [PMID: 39107763 PMCID: PMC11301838 DOI: 10.1186/s12909-024-05842-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/30/2024] [Indexed: 08/10/2024]
Abstract
BACKGROUND Access to valid and reliable instruments is essential in the field of implementation science, where the measurement of factors associated with healthcare professionals' uptake of EBP is central. The Norwegian version of the Evidence-based practice profile questionnaire (EBP2-N) measures EBP constructs, such as EBP knowledge, confidence, attitudes, and behavior. Despite its potential utility, the EBP2-N requires further validation before being used in a cross-sectional survey targeting different healthcare professionals in Norwegian primary healthcare. This study assessed the content validity, construct validity, and internal consistency of the EBP2-N among Norwegian primary healthcare professionals. METHODS To evaluate the content validity of the EBP2-N, we conducted qualitative individual interviews with eight healthcare professionals in primary healthcare from different disciplines. Qualitative data was analyzed using the "text summary" model, followed by panel group discussions, minor linguistic changes, and a pilot test of the revised version. To evaluate construct validity (structural validity) and internal consistency, we used data from a web-based cross-sectional survey among nurses, assistant nurses, physical therapists, occupational therapists, medical doctors, and other professionals (n = 313). Structural validity was tested using a confirmatory factor analysis (CFA) on the original five-factor structure, and Cronbach's alpha was calculated to assess internal consistency. RESULTS The qualitative interviews with primary healthcare professionals indicated that the content of the EBP2-N was perceived to reflect the constructs intended to be measured by the instrument. However, interviews revealed concerns regarding the formulation of some items, leading to minor linguistic revisions. In addition, several participants expressed that some of the most specific research terms in the terminology domain felt less relevant to them in clinical practice. CFA results exposed partial alignment with the original five-factor model, with the following model fit indices: CFI = 0.749, RMSEA = 0.074, and SRMR = 0.075. Cronbach's alphas ranged between 0.82 and 0.95 for all domains except for the Sympathy domain (0.69), indicating good internal consistency in four out of five domains. CONCLUSION The EBP2-N is a suitable instrument for measuring Norwegian primary healthcare professionals' EBP knowledge, attitudes, confidence, and behavior. Although EBP2-N seems to be an adequate instrument in its current form, we recommend that future research focuses on further assessing the factor structure, evaluating the relevance of the items, and the number of items needed. REGISTRATION Retrospectively registered (prior to data analysis) in OSF Preregistration. Registration DOI: https://doi.org/10.17605/OSF.IO/428RP .
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Affiliation(s)
- Nils Gunnar Landsverk
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway.
| | - Nina Rydland Olsen
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Kristine Berg Titlestad
- Department of Welfare and Participation, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Are Hugo Pripp
- Faculty of Health Sciences, OsloMet - Oslo Metropolitan University, Oslo, Norway
| | - Therese Brovold
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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Steiner L, Sackey J, Cohen D, Brody R. Evidence-based practice attitudes and nutrition support guideline knowledge between holders and nonholders of the Certified Nutrition Support Clinician credential. Nutr Clin Pract 2024; 39:934-944. [PMID: 38366972 DOI: 10.1002/ncp.11136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 12/26/2023] [Accepted: 01/21/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Clinical practice frequently changes, and professionals should stay abreast of evidence-based practice (EBP) guidelines. Negative attitudes towards EBP are a barrier to guideline adoption. This study explored EBP attitudes and knowledge of a complex nutrition support clinical case scenario of individuals holding or not holding the Certified Nutrition Support Clinician (CNSC) credential. METHODS This cross-sectional study used an online survey sent to American Society for Parenteral and Enteral Nutrition (ASPEN) members with and without the CNSC credential and all CNSC credential holders from the National Board of Nutrition Support Certification email list. The survey included the Evidence-Based Practice Attitude Scale Score (EBPAS-15) and eight knowledge questions using a nutrition support case scenario. An independent samples t test compared knowledge and EBPAS-15 total scores and subscores between CNSC holders and nonholders. Pearson correlation determined the correlation between knowledge and EBPAS-15 scores. RESULTS The response rate was 7.8% (N = 706). CNSC holders (n = 536) had significantly higher mean knowledge scores (4.7 ± 1.6 out of 8) than nonholders (n = 159, 4.1 ± 1.7) (P < 0.001). Total EBPAS-15 scores were not significantly different between CNSC holders (n = 542, 2.9 ± 0.4 out of 4) and nonholders (n = 164, 2.8 ± 0.7) (P = 0.434), and knowledge scores and total EBPAS-15 scores (P = 0.639) or subscores were not significantly correlated. CONCLUSIONS Regardless of holding the CNSC credential, EBPAS-15 scores indicated respondents had positive EBP attitudes. CNSC holders had significantly higher knowledge scores of recent nutrition support EBP guidelines compared with non-CNSC credential holders. Positive EBP attitudes are a precursor to clinical decision-making, but future research should determine the use of guidelines in clinical practice.
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Affiliation(s)
- Lea Steiner
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
| | - Joachim Sackey
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
| | - Deborah Cohen
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
| | - Rebecca Brody
- Department of Clinical and Preventive Nutrition Sciences, School of Health Professions Rutgers University, Newark, New Jersey, USA
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Pervin M, Hansmann NM, Hagmayer Y. Attitudes Toward and Usage of Evidence-Based Mental Health Practices for Autistic Youth in Bangladesh and Germany: A Cross-Cultural Comparison. J Autism Dev Disord 2024:10.1007/s10803-023-06223-z. [PMID: 38277076 DOI: 10.1007/s10803-023-06223-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/27/2024]
Abstract
The implementation of evidence-based practices (EBPs) for autistic youth is a critical concern worldwide. Research examining factors facilitating the implementation of EBPs found that providers' attitudes are an important factor. In this study, we evaluated cross-cultural differences in attitudes toward and use of EBPs. We tested socio-demographic factors as predictors of attitudes, and attitudes as predictors of EBPs use among mental health professionals working with autistic youth in Bangladesh and Germany. We used purposeful sampling. Two-hundred-ninety-two professionals who worked in a clinical setting responded to the survey and fulfilled the inclusion criteria (101 in Bangladesh, 191 in Germany). Participants were asked to respond to nine subscales of the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), to indicate which of nine types of treatments they used, and to provide sociodemographic data. Measurement invariance across countries could be established for four subscales of the EBPAS-36. Comparative analyses of attitudes showed that professionals in both countries were open to using EBPs, but German practitioners were more likely to use EBPs when they appealed to them. By contrast, Bangladeshi professionals claimed to be more likely to adopt an EBP when required and to be more willing to learn EBPs to enhance job security. The relationship between caseload and attitudes varied between countries. A broader variety of EBPs was used in Germany. The findings highlight the importance of considering country-specific factors when implementing EBPs. Directions for conducting comparative studies on mental health professionals' attitudes towards EBP including methodological considerations are discussed.
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Affiliation(s)
- Maleka Pervin
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany.
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh.
| | - Nina Marie Hansmann
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany
| | - York Hagmayer
- Institute of Psychology, Georg August University of Göttingen, Göttingen, Germany
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Landsverk NG, Olsen NR, Brovold T. Instruments measuring evidence-based practice behavior, attitudes, and self-efficacy among healthcare professionals: a systematic review of measurement properties. Implement Sci 2023; 18:42. [PMID: 37705031 PMCID: PMC10500884 DOI: 10.1186/s13012-023-01301-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is well known to most healthcare professionals. Implementing EBP in clinical practice is a complex process that can be challenging and slow. Lack of EBP knowledge, skills, attitudes, self-efficacy, and behavior can be essential barriers that should be measured using valid and reliable instruments for the population in question. Results from previous systematic reviews show that information regarding high-quality instruments that measure EBP attitudes, behavior, and self-efficacy in various healthcare disciplines need to be improved. This systematic review aimed to summarize the measurement properties of existing instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy. METHODS We included studies that reported measurement properties of instruments that measure healthcare professionals' EBP attitudes, behaviors, and self-efficacy. Medline, Embase, PsycINFO, HaPI, AMED via Ovid, and Cinahl via Ebscohost were searched in October 2020. The search was updated in December 2022. The measurement properties extracted included data on the item development process, content validity, structural validity, internal consistency, reliability, and measurement error. The quality assessment, rating of measurement properties, synthesis, and modified grading of the evidence were conducted in accordance with the COSMIN methodology for systematic reviews. RESULTS Thirty-four instruments that measure healthcare professionals' EBP attitudes, behaviors or self-efficacy were identified. Seventeen of the 34 were validated in two or more healthcare disciplines. Nurses were most frequently represented (n = 53). Despite the varying quality of instrument development and content validity studies, most instruments received sufficient ( +) ratings on content validity, with the quality of evidence graded as "very low" in most cases. Structural validity and internal consistency were the measurement properties most often assessed, and reliability and measurement error were most rarely assessed. The quality assessment results and overall rating of these measurement properties varied, but the quality of evidence was generally graded higher for these properties than for content validity. CONCLUSIONS Based on the summarized results, the constructs, and the population of interest, several instruments can be recommended for use in various healthcare disciplines. However, future studies should strive to use qualitative methods to further develop existing EBP instruments and involve the target population. TRIAL REGISTRATION This review is registered in PROSPERO. CRD42020196009. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020196009.
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Affiliation(s)
- Nils Gunnar Landsverk
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway.
| | - Nina Rydland Olsen
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Therese Brovold
- Department of Rehabilitation Science and Health Technology, Faculty of Health Science, Oslo Metropolitan University, Oslo, Norway
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Merle JL, Cook CR, Locke JJ, Ehrhart MG, Brown EC, Davis CJ, Lyon AR. Teacher attitudes toward evidence-based practices: Exploratory and confirmatory analyses of the school-adapted evidence-based practice attitude scale. IMPLEMENTATION RESEARCH AND PRACTICE 2023; 4:26334895221151026. [PMID: 37091537 PMCID: PMC9924278 DOI: 10.1177/26334895221151026] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Background The Evidence-Based Practice Attitudes Scale (EBPAS) is widely used in implementation research, but it has not been adapted and validated for use among general education teachers, who are most likely to deliver evidence-based prevention programs in schools, the most common setting where youth access social, emotional, and behavioral health services. Method School-based stakeholders and a research team comprised of experts in the implementation of evidence-based practices in schools adapted the EBPAS for teachers (the S-EBPAS). The adapted instrument was administered to a representative sample ( n = 441) of general education teachers (grades K—5) to assess the reliability and internal consistency via factor analyses. The S-EBPAS included two forms (i.e., EBP-agnostic and EBP-specific item referents), therefore, a multiple-group confirmatory factor analysis (CFA) was also performed to establish measurement invariance between the two forms. Results After adaptation and refinement, a 9-item, 3-factor structure was confirmed, with the final model supporting three first-order factors that load onto a second-order factor capturing attitudes toward adopting evidence-based practices. Multiple-group CFA analyses of measurement invariance indicated there were no significant differences between the two forms. Conclusions Overall, this study provides a brief, flexible instrument capturing attitudes toward adopting EBPs that has high reliability and internal consistency, which support its use among general education teachers in school settings implementing evidence-based practices. Plain Language Summary The Evidence-Based Practice Attitudes Scale (EBPAS) is a popular instrument for measuring attitudes toward evidence-based practices (EBPs). This instrument provides valuable information during implementation initiatives, such as whether providers or front-line implementers have favorable attitudes toward a given practice. The EBPAS has been used in many different settings, such as in community-based mental health clinics, medical hospitals, and in child welfare. However, it's use in schools has been limited, and it has not yet been tested with general education teachers, who are key implementers of evidence-based practices in schools. In order to trust that the scores from an instrument are accurate, it needs to be evaluated when scaling it out to new populations and settings. One popular method to determine this is to use factor analysis, which was employed in this study. This study fills the identified gap by assessing the reliability (i.e., accuracy) and internal consistency of the EBPAS among a representative sample of general education teachers. Findings from this study indicate that the school-adapted EBPAS (S-EBPAS) is a brief, nine-item instrument that provides a reliable estimate of teachers’ attitudes toward evidence-based practices. Our results also provide evidence that the S-EBPAS can be used to capture attitudes toward specific EBPs as well as attitudes toward EBP -agnostic. This study provides a flexible instrument that can be used by school-based implementation researchers, practitioners, and intermediaries at multiple phases of implementation projects, such as when exploring a new EBP to adopt.
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Affiliation(s)
- James L. Merle
- Department of Population Health Science, University of Utah, Salt Lake City, UT, USA
| | - Clayton R. Cook
- Department of Organizational Leadership, Policy, and Development, University of Minnesota, Minneapolis, MN, USA
| | - Jill J. Locke
- Department of Psychiatry and Behavior Science, University of Washington, Seattle, WA, USA
| | - Mark G. Ehrhart
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Eric C. Brown
- Department of Public Health Science, University of Miami, Coral Gables, FL, USA
| | - Chayna J. Davis
- Department of Psychiatry and Behavior Science, University of Washington, Seattle, WA, USA
| | - Aaron R. Lyon
- Department of Psychiatry and Behavior Science, University of Washington, Seattle, WA, USA
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McHugh SM, Riordan F, Curran GM, Lewis CC, Wolfenden L, Presseau J, Lengnick-Hall R, Powell BJ. Conceptual tensions and practical trade-offs in tailoring implementation interventions. FRONTIERS IN HEALTH SERVICES 2022; 2:974095. [PMID: 36925816 PMCID: PMC10012756 DOI: 10.3389/frhs.2022.974095] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Accepted: 10/31/2022] [Indexed: 11/19/2022]
Abstract
Tailored interventions have been shown to be effective and tailoring is a popular process with intuitive appeal for researchers and practitioners. However, the concept and process are ill-defined in implementation science. Descriptions of how tailoring has been applied in practice are often absent or insufficient in detail. This lack of transparency makes it difficult to synthesize and replicate efforts. It also hides the trade-offs for researchers and practitioners that are inherent in the process. In this article we juxtapose the growing prominence of tailoring with four key questions surrounding the process. Specifically, we ask: (1) what constitutes tailoring and when does it begin and end?; (2) how is it expected to work?; (3) who and what does the tailoring process involve?; and (4) how should tailoring be evaluated? We discuss these questions as a call to action for better reporting and further research to bring clarity, consistency, and coherence to tailoring, a key process in implementation science.
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Affiliation(s)
| | - Fiona Riordan
- School of Public Health, University College Cork, Cork, Ireland
| | - Geoff M. Curran
- Department of Pharmacy Practice and Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Cara C. Lewis
- MacColl Center for Health Care Innovation, Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Luke Wolfenden
- College of Medicine, Health and Wellbeing, The University of Newcastle, Callaghan, NSW, Australia
| | - Justin Presseau
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Rebecca Lengnick-Hall
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO, United States
| | - Byron J. Powell
- Center for Mental Health Services Research, Brown School, Washington University in St. Louis, St. Louis, MO, United States
- Center for Dissemination and Implementation, Institute for Public Health, Washington University in St. Louis, St. Louis, MO, United States
- Division of Infectious Diseases, John T. Milliken Department of Medicine, School of Medicine, Washington University in St. Louis, St. Louis, MO, United States
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Professional wellbeing and turnover intention among child therapists: a comparison between therapists trained and untrained in Trauma-Focused Cognitive Behavioral Therapy. BMC Health Serv Res 2022; 22:1328. [DOI: 10.1186/s12913-022-08670-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 10/06/2022] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Poor professional wellbeing and job turnover is challenging for child mental health clinics and despite an increasing interest in implementing evidence-based practices (EBPs) in mental health services, little is known about if and how using EBPs may influence therapists’ professional wellbeing and turnover intention. To investigate this, we compare the average level of compassion satisfaction, burnout, secondary traumatic stress, and turnover intention between therapists trained in an EBP (Trauma-Focused Cognitive Behavioral Therapy – TF-CBT) and untrained therapists. We also explore the prevalence of and the associations between these personal and organizational outcomes.
Method
In this cross-sectional study, the data is collected from a national sample of 373 therapists 5 years after an implementation program began (i.e., in the sustainment phase). The variables were measured by the Professional Quality of Life and the Turnover Intention Scales. The Evidence-Based Practice Attitude Scale was also used to measure therapists’ attitudes toward EBPs.
Results
Over 70% of the respondents reported medium to high levels of burnout, secondary traumatic stress symptoms, and compassion satisfaction, whereas one-third of the respondents reported a high level of intention to leave their job in the current or near future. Higher ratings on burnout and secondary traumatic stress were significantly associated with lower compassion satisfaction and higher turnover intention. Finally, we found significantly lower degree of burnout and turnover intention along with higher compassion satisfaction among TF-CBT therapists (n = 96), compared to other therapists who were not trained in TF-CBT (n = 231). These differences could not be explained by between-group differences in age, job tenure, educational background, or therapists’ attitudes towards EBPs. However, mean differences in ratings on secondary traumatic stress symptoms were not statistically significant.
Conclusion
Although the prevalence findings are in general alarming, the present study provides the first empirical evidence for a potential positive effect of being trained in TF-CBT on therapists’ wellbeing and turnover intention. We discuss these findings in the light of self-efficacy theory and the job demands-resources model.
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Hartveit M, Hovlid E, Øvretveit J, Assmus J, Bond G, Joa I, Heiervang K, Stensrud B, Høifødt TS, Biringer E, Ruud T. Can systematic implementation support improve programme fidelity by improving care providers' perceptions of implementation factors? A cluster randomized trial. BMC Health Serv Res 2022; 22:808. [PMID: 35733211 PMCID: PMC9215018 DOI: 10.1186/s12913-022-08168-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 06/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Investigations of implementation factors (e.g., collegial support and sense of coherence) are recommended to better understand and address inadequate implementation outcomes. Little is known about the relationship between implementation factors and outcomes, especially in later phases of an implementation effort. The aims of this study were to assess the association between implementation success (measured by programme fidelity) and care providers' perceptions of implementation factors during an implementation process and to investigate whether these perceptions are affected by systematic implementation support. METHODS Using a cluster-randomized design, mental health clinics were drawn to receive implementation support for one (intervention) and not for another (control) of four evidence-based practices. Programme fidelity and care providers' perceptions (Implementation Process Assessment Tool questionnaire) were scored for both intervention and control groups at baseline, 6-, 12- and 18-months. Associations and group differences were tested by means of descriptive statistics (mean, standard deviation and confidence interval) and linear mixed effect analysis. RESULTS Including 33 mental health centres or wards, we found care providers' perceptions of a set of implementation factors to be associated with fidelity but not at baseline. After 18 months of implementation effort, fidelity and care providers' perceptions were strongly correlated (B (95% CI) = .7 (.2, 1.1), p = .004). Care providers perceived implementation factors more positively when implementation support was provided than when it was not (t (140) = 2.22, p = .028). CONCLUSIONS Implementation support can facilitate positive perceptions among care providers, which is associated with higher programme fidelity. To improve implementation success, we should pay more attention to how care providers constantly perceive implementation factors during all phases of the implementation effort. Further research is needed to investigate the validity of our findings in other settings and to improve our understanding of ongoing decision-making among care providers, i.e., the mechanisms of sustaining the high fidelity of recommended practices. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT03271242 (registration date: 05.09.2017).
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Affiliation(s)
- Miriam Hartveit
- Valen Hospital Helse Fonna HF, 5451, Valen, Norway. .,Department of Global Public Health and Primary Care, University of Bergen, Box 7804, 5020, Bergen, Norway.
| | - Einar Hovlid
- Department of Social Science, Western Norway University of Applied Sciences, Røyrgata 6, 6856, Sogndal, Norway
| | - John Øvretveit
- Stockholm Health Care Services, Region Stockholm (SLSO) and LIME/MMC, Tomtebodavägen 18A, Karolinska Institutet, Stockholm, Sweden
| | - Jørg Assmus
- Centre for Clinical Research, Haukeland University Hospital, Box 1400, 5021, Bergen, Norway
| | - Gary Bond
- Westat, Rivermill Commercial Center, 85 Mechanic Street, Lebanon, NH, USA
| | - Inge Joa
- Network for Clinical Research in Psychosis, Stavanger University Hospital, Box 8100, 4068, Stavanger, Norway.,Network for Medical Sciences, Faculty of Health, University of Stavanger, Stavanger, Norway
| | - Kristin Heiervang
- Division of Mental Health Services, Akershus University Hospital, Box 1000, 1478, Lørenskog, Norway
| | - Bjørn Stensrud
- Division of Mental Health, Innlandet Hospital Trust, Box 104, 2381, Brumunddal, Norway
| | | | - Eva Biringer
- Valen Hospital Helse Fonna HF, 5451, Valen, Norway.,Department of Research and Innovation, Helse Fonna HF, 5416, Stord, Norway
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Box 1000, 1478, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Box 1171 Blindern, 0318, Oslo, Norway
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Baumann A, Vázquez A, Macchione A, Lima A, Coelho A, Juras M, Ribeiro M, Kohlsdorf M, Carothers B. Translation and validation of the evidence-based practice attitude scale (EBPAS-15) to Brazilian Portuguese: Examining providers' perspective about evidence-based parent intervention. CHILDREN AND YOUTH SERVICES REVIEW 2022; 136:106421. [PMID: 35431379 PMCID: PMC9012479 DOI: 10.1016/j.childyouth.2022.106421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background Few existing evidence-based parent interventions (EBPIs) for prevention and treatment of child and youth mental health disorders are implemented in low-middle-income countries. This study aimed to translate and confirm the factor structure of the Evidence-Based Practice Attitude Scale (EBPAS-15) survey in Brazilian Portuguese with the goal of examining providers' perspective about EBPIs. Methods We translated and back translated the EBPAS-15 from English to Brazilian Portuguese. Participants were recruited via snowball sampling and data were collected using an online survey from July of 2018 through January of 2020. A confirmatory factor analysis was conducted to determine if the scale retained its original structure. Open-ended questions about providers' perspectives of their own clinical practice were coded using the Theoretical Domains Framework (TDF). Analyses included data from 362 clinicians (318 women, 41 men) from 20 of the 27 states of Brazil. Participants on average were 26.7 years old, held specialist degrees in the field of psychology, actively worked as therapists, and practiced in private clinics. Results The translation of the EBPAS to Brazilian Portuguese retained the same four-factor structure as the English version except for dropping one item from the Divergence domain. When asked about the challenges in their practices, providers generally referred to parents as clients with little skills to discipline their children and lacking knowledge about child development. Discussion The Brazilian version of the EBPAS-15 is promising, but future research should consider using quantitative data alongside qualitative information to better understand providers' attitudes about evidence-based interventions to inform implementation efforts. Trial registration N/A.
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Affiliation(s)
- A.A. Baumann
- Division of Public Health Sciences, Department of Surgery, Washington University in St. Louis, MO, USA
| | | | - A.C. Macchione
- Centro Paradigma de Ciências do Comportamento, São Paulo, Brazil
| | - A. Lima
- Sam Houston State University, TX, USA
| | - A.F. Coelho
- Universidade de Brasilia, Brasília-DF, Brazil
| | - M. Juras
- Florida Gulf Coast University, USA
| | - M. Ribeiro
- Aiutare Instituto de Psicologia, Brasília-DF, Brazil
| | - M. Kohlsdorf
- Centro Universitario UniCEUB, Brasília-DF, Brazil
| | - B.J. Carothers
- Brown School, Washington University in St. Louis, Missouri, United States
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Ben Charif A, Zomahoun HTV, Gogovor A, Abdoulaye Samri M, Massougbodji J, Wolfenden L, Ploeg J, Zwarenstein M, Milat AJ, Rheault N, Ousseine YM, Salerno J, Markle-Reid M, Légaré F. Tools for assessing the scalability of innovations in health: a systematic review. Health Res Policy Syst 2022; 20:34. [PMID: 35331260 PMCID: PMC8943495 DOI: 10.1186/s12961-022-00830-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 02/16/2022] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND The last decade has seen growing interest in scaling up of innovations to strengthen healthcare systems. However, the lack of appropriate methods for determining their potential for scale-up is an unfortunate global handicap. Thus, we aimed to review tools proposed for assessing the scalability of innovations in health. METHODS We conducted a systematic review following the COSMIN methodology. We included any empirical research which aimed to investigate the creation, validation or interpretability of a scalability assessment tool in health. We searched Embase, MEDLINE, CINAHL, Web of Science, PsycINFO, Cochrane Library and ERIC from their inception to 20 March 2019. We also searched relevant websites, screened the reference lists of relevant reports and consulted experts in the field. Two reviewers independently selected and extracted eligible reports and assessed the methodological quality of tools. We summarized data using a narrative approach involving thematic syntheses and descriptive statistics. RESULTS We identified 31 reports describing 21 tools. Types of tools included criteria (47.6%), scales (33.3%) and checklists (19.0%). Most tools were published from 2010 onwards (90.5%), in open-access sources (85.7%) and funded by governmental or nongovernmental organizations (76.2%). All tools were in English; four were translated into French or Spanish (19.0%). Tool creation involved single (23.8%) or multiple (19.0%) types of stakeholders, or stakeholder involvement was not reported (57.1%). No studies reported involving patients or the public, or reported the sex of tool creators. Tools were created for use in high-income countries (28.6%), low- or middle-income countries (19.0%), or both (9.5%), or for transferring innovations from low- or middle-income countries to high-income countries (4.8%). Healthcare levels included public or population health (47.6%), primary healthcare (33.3%) and home care (4.8%). Most tools provided limited information on content validity (85.7%), and none reported on other measurement properties. The methodological quality of tools was deemed inadequate (61.9%) or doubtful (38.1%). CONCLUSIONS We inventoried tools for assessing the scalability of innovations in health. Existing tools are as yet of limited utility for assessing scalability in health. More work needs to be done to establish key psychometric properties of these tools. Trial registration We registered this review with PROSPERO (identifier: CRD42019107095).
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Affiliation(s)
| | - Hervé Tchala Vignon Zomahoun
- Department of Social and Preventive Medicine, Université Laval, Quebec City, QC, Canada.,Faculty of Medicine and Health Science, School of Physical and Occupational Therapy, McGill University, Montreal, QC, Canada.,Institut national d'excellence en santé et en services sociaux (INESSS), Quebec City, QC, Canada
| | - Amédé Gogovor
- VITAM - Centre de recherche en santé durable, Université Laval, Quebec City, QC, Canada.,Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada.,Unité de soutien SSA Québec, Université Laval, Quebec City, QC, Canada
| | - Mamane Abdoulaye Samri
- VITAM - Centre de recherche en santé durable, Université Laval, Quebec City, QC, Canada.,Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, QC, Canada.,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada
| | - José Massougbodji
- Institut national de santé publique du Québec (INSPQ), Quebec City, QC, Canada
| | - Luke Wolfenden
- School of Medicine and Public Health, University of Newcastle, Callaghan, NSW, Australia.,Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,Hunter New England Population Health, Wallsend, NSW, Australia
| | - Jenny Ploeg
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Merrick Zwarenstein
- Department of Family Medicine, Centre for Studies in Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Andrew J Milat
- School of Public Health, University of Sydney, Sydney, NSW, Australia.,Centre for Epidemiology and Evidence, NSW Ministry of Health, Sydney, Australia
| | - Nathalie Rheault
- VITAM - Centre de recherche en santé durable, Université Laval, Quebec City, QC, Canada.,Unité de soutien SSA Québec, Université Laval, Quebec City, QC, Canada
| | | | - Jennifer Salerno
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Maureen Markle-Reid
- Aging, Community and Health Research Unit, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada.,Canada Research Chair in Person Centred Interventions for Older Adults with Multimorbidity and their Caregivers, McMaster University, Hamilton, ON, Canada
| | - France Légaré
- VITAM - Centre de recherche en santé durable, Université Laval, Quebec City, QC, Canada. .,Tier 1 Canada Research Chair in Shared Decision Making and Knowledge Translation, Université Laval, Quebec City, QC, Canada. .,Department of Family Medicine and Emergency Medicine, Université Laval, Quebec City, QC, Canada. .,Unité de soutien SSA Québec, Université Laval, Quebec City, QC, Canada. .,Population Health and Practice-Changing Research Group, CHU de Québec Research Centre, Quebec City, QC, Canada.
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11
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Braathu N, Laukvik EH, Egeland KM, Skar AMS. Validation of the Norwegian versions of the Implementation Leadership Scale (ILS) and Multifactor Leadership Questionnaire (MLQ) in a mental health care setting. BMC Psychol 2022; 10:25. [PMID: 35135616 PMCID: PMC8822706 DOI: 10.1186/s40359-022-00725-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 01/24/2022] [Indexed: 12/25/2022] Open
Abstract
Background The implementation of evidence-based practices (EBPs) is of crucial importance in health care institutions and requires effective management from leaders. However, there is a lack of assessment tools sufficient to evaluate the degree to which the employees´ rate how well their leaders are at implementing EBPs. This emphasises the need for validated and widely used scales relevant for EBPs. Methods The current study evaluated the psychometric properties of the Multifactor Leadership Questionnaire (MLQ) and Implementation Leadership Scale (ILS) in a Norwegian mental health care setting. Results Results from confirmatory factor analyses indicate that the MLQ and ILS are valid instruments for measuring general and implementation leadership. The scales demonstrate good convergent validity. In addition, attitudes towards EBPs did not seem to be associated with the ILS and MLQ, further supporting the applicability of the instruments. Conclusions The two scales demonstrate good psychometric properties in a Norwegian mental health care setting, which suggests that the MLQ and ILS are valid and reliable tools for measuring leadership in an implementation setting. More research is greatly needed to disentangle the link between perceived leadership and objective measures of successful implementation of EBPs. Trial registration NSD 690,133, NSD 60,059/3/OOS.
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Affiliation(s)
- Nora Braathu
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1-3, 0484, Oslo, Norway.
| | - Erlend Høen Laukvik
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Karina M Egeland
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1-3, 0484, Oslo, Norway
| | - Ane-Marthe Solheim Skar
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Gullhaugveien 1-3, 0484, Oslo, Norway
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12
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Ayhan Başer D, Ağadayi E, Gönderen Çakmak S, Kahveci R. Adaptation of the evidence-based practices attitude scale-15 in Turkish family medicine residents. Int J Clin Pract 2021; 75:e14354. [PMID: 33974348 DOI: 10.1111/ijcp.14354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/04/2021] [Accepted: 05/07/2021] [Indexed: 11/28/2022] Open
Abstract
AIMS Aim of this study is to translate and apply a cross-cultural adaptation of the Evidence-Based Practice Attitude Scale (EBPAS) in Turkish and investigate its validity and reliability. METHODS The original EBPAS-15 (a questionnaire assessing health professionals' attitudes to implementation of evidence-based practice) was translated into Turkish. To assess its validity and reliability, 151 family medicine residents answered the EBPAS-15 by web-based survey. In addition, relationships of family medicine residents' characteristics with EBPAS-15 total scores are examined. RESULTS The results showed that the EBPAS-15 has good internal consistency and reliability. The Cronbach's alpha value for EBPAS-15 was 0.828. The scores of the two scales were highly correlated (ρ = 0.72). In the scale, there was no item with a total correlation value of less than 0.40. For this reason, no item was removed due to the high reliability value of all 15 items. CONCLUSION The Turkish version of the EBPAS-15 shows mainly good validity and reliability.
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Affiliation(s)
- Duygu Ayhan Başer
- Department of Family Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ezgi Ağadayi
- Department of Medical Education, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | | | - Rabia Kahveci
- Department of Family Medicine, Ankara City Hospital, Ankara, Turkey
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13
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Szota K, Thielemann JFB, Christiansen H, Rye M, Aarons GA, Barke A. Cross-cultural adaption and psychometric investigation of the German version of the Evidence Based Practice Attitude Scale (EBPAS-36D). Health Res Policy Syst 2021; 19:90. [PMID: 34078387 PMCID: PMC8173815 DOI: 10.1186/s12961-021-00736-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 05/12/2021] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The implementation of evidence-based practice (EBP) in mental health care confers many benefits to patients, and research into factors facilitating the implementation of EBP is needed. As an important factor affecting the implementation of EBP, service providers' attitudes toward EBP emerged. The Evidence-Based Practice Attitude Scale (EBPAS-36) is an instrument with good psychometric characteristics that measures positive and ambivalent attitudes toward EBP. However, a German version is missing. The present study therefore aims to provide a validated German translation of the EBPAS-36. METHODS The scale was translated and back-translated as recommended by standard procedures. German psychotherapists were recruited to participate in an online survey. They provided demographic and professional information, completed the EBPAS-36, the Implementation Climate Scale (ICS) and the Intention Scale for Providers (ISP). Standard item and reliability analyses were conducted. Construct validity was evaluated with exploratory (EFA) and confirmatory factor analyses (CFA) in two subsamples (random split). Convergent validity was tested by predicting a high positive correlation of the EBPAS-36D with two scores of attitudes of the ISP and an interest in EBP score. It was tested whether the EBPAS-36D predicts the intention to use EBP. RESULTS N = 599 psychotherapists participated in the study. The item analyses showed a mean item difficulty of pi = 0.64, a mean inter-item correlation of r = 0.18, and a mean item-total correlation of ritc = 0.40. The internal consistency was very good for the total scale (α = 0.89) and ranged from adequate to very good for the subscales (0.65-0.89), indicating high reliability. The original factor structure showed an acceptable model fit (RMSEA = 0.064 (90% CI = 0.059-0.068); SRMR = 0.0922; AIC = 1400.77), confirming the 12-factor structure of the EBPAS-36. However, a second-order factor structure derived by the EFA had an even better model fit (RMSEA = 0.057 (90% CI = 0.052-0.062); SRMR = 0.0822; AIC = 1274.56). When the EBPAS-36D was entered in a hierarchical regression model with the criterion Intention to use EBP, the EBPAS-36D contributed significantly to the prediction (Change in R2 = 0.28, p < 0.001) over and above gender, age and participants' report of ever having worked in a university context. CONCLUSIONS The present study confirms good psychometric properties and validity of a German version of the EBPAS-36 in a sample of psychotherapists.
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Affiliation(s)
- Katharina Szota
- Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany.
| | - Jonathan F B Thielemann
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049, Ingolstadt, Germany
| | - Hanna Christiansen
- Department of Psychology, Philipps-University of Marburg, Gutenbergstr. 18, 35032, Marburg, Germany
| | - Marte Rye
- Faculty of Health Sciences, UiT The Arctic University of Norway, Regional Centre for Child and Youth Mental Health and Child Welfare, 9037, Tromsø, Norway
| | - Gregory A Aarons
- Department of Psychiatry, University of California, 9500 Gilman Drive (0812), La Jolla, San Diego, CA, 92093-0812, USA
| | - Antonia Barke
- Department of Clinical and Biological Psychology, Catholic University of Eichstätt-Ingolstadt, Levelingstr. 7, 85049, Ingolstadt, Germany
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14
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Finne J, Malmberg-Heimonen I. Norwegian Social Work and Child Welfare Students' Attitudes Toward Research-Supported Treatments. JOURNAL OF EVIDENCE-BASED SOCIAL WORK (2019) 2021; 18:340-352. [PMID: 33393451 DOI: 10.1080/26408066.2020.1865227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Purpose: Evidence-based practice (EBP) has increasingly become a part of social work education, but there is a lack of knowledge about students' attitudes toward it. This study evaluated Norwegian social work students' attitudes toward research-supported treatments (RSTs).Method: Attitudes were measured with the Evidence-Based Practice Attitude Scale-36 (EBPAS-36), a validated measure including 12 subscales.Results: The findings suggest that master's students are more positive toward RSTs compared to bachelor's students. Having less educational training in EBP was associated with more skepticism toward the concept, suggesting that educational training in EBP contributes to facilitating a positive attitude toward RSTs.Discussion: These findings indicate a need to emphasize EBP in social work education. To enable EBP engagement in practice, we argue that emphasis should be put on teaching students to critically appraise research.
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Affiliation(s)
- Joakim Finne
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
| | - Ira Malmberg-Heimonen
- Department of Social Work, Child Welfare and Social Policy, Oslo Metropolitan University, Oslo, Norway
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15
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Santesson AHE, Bäckström M, Holmberg R, Perrin S, Jarbin H. Confirmatory factor analysis of the Evidence-Based Practice Attitude Scale (EBPAS) in a large and representative Swedish sample: is the use of the total scale and subscale scores justified? BMC Med Res Methodol 2020; 20:254. [PMID: 33054717 PMCID: PMC7557010 DOI: 10.1186/s12874-020-01126-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 09/18/2020] [Indexed: 11/24/2022] Open
Abstract
Background There is a call for valid and reliable instruments to evaluate implementation of evidence-based practices (EBP). The 15-item Evidence-Based Practice Attitude Scale (EBPAS) measures attitude toward EBP, incorporating four lower-order factor subscales (Appeal, Requirements, Openness, and Divergence) and a Total scale (General Attitudes). It is one of a few measures of EBP attitudes evaluated for its psychometric properties. The reliability of the Total scale has been repeatedly supported, but also the multidimensionality of the inventory. However, whether all of the items contribute to the EBPAS Total beyond their subscales has yet to be demonstrated. In addition, the Divergence subscale has been questioned because of its low correlation with the other subscales and low inter-item correlations. The EBPAS is widely used to tailor and evaluate implementation efforts, but a Swedish version has not yet been validated. This study aimed to contribute to the development and cross-validation of the EBPAS by examining the factor structure of t a Swedish-language version in a large sample of mental health professionals. Methods The EBPAS was translated into Swedish and completed by 570 mental health professionals working in child and adolescent psychiatry settings spread across Sweden. The factor structure was examined using first-order, second-order and bifactor confirmatory factor analytic (CFA) models. Results Results suggested adequate fit for all CFA models. The EBPAS Total was strongly supported in the Swedish version. Support for the hierarchical second-order model was also strong, while the bifactor model gave mixed support for the subscales. The Openness and Requirements subscales came out best, while there were problems with both the Appeal (e.g. not different from the General Attitudes factor) and the Divergence subscales (e.g. low reliability). Conclusions Overall, the psychometric properties were on par with the English version and the total score appears to be a valid measure of general attitudes towards EBP. This is the first study supporting this General Attitudes factor based on a bifactor model. Although comparatively better supported in this Swedish sample, we conclude that the use of the EBPAS subscale scores may result in misleading conclusions. Practical implications and future directions are discussed.
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Affiliation(s)
| | - Martin Bäckström
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Robert Holmberg
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Sean Perrin
- Department of Psychology, Faculty of Social Sciences, Lund University, Lund, Sweden
| | - Håkan Jarbin
- Department of Clinical Sciences, Faculty of Medicine, Lund University, BMC F12, S-, 221 84, Lund, Sweden
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16
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Van Giang N, Lin SY, Thai DH. A psychometric evaluation of the Vietnamese version of the Evidence-Based Practice Attitudes and Beliefs Scales. Int J Nurs Pract 2020; 27:e12896. [PMID: 33058371 DOI: 10.1111/ijn.12896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/06/2020] [Accepted: 09/19/2020] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study is to develop and to test the construct validity and reliability of the Vietnamese versions of the Evidence-Based Practice Attitude and Evidence-Based Practice Beliefs scales. METHODS This is a psychometric evaluation study. Three hundred and fifty-three nurses and midwives were recruited from a national hospital in Vietnam from September to December 2018. Data were obtained from two scales. Content validity, face validity and construct validity measures were all conducted, whereas exploratory and confirmatory factor analyses were performed from data collected from two cohorts of participants. Cronbach's alpha coefficient represented reliability, and data were analysed in SPSS 20 and AMOS 24. RESULTS The four-factor model developed with openness, requirements, appeal and divergence factors accounted for 55% of total variance in the Attitude scale. A three-factor model labelled as value beliefs, knowledge beliefs and resource beliefs with 59% of total variance was explained in the Beliefs scale. Cronbach's α coefficients were .72 for the Attitude scale and .81 for the Beliefs scale. CONCLUSIONS The two scales could be used to assess Vietnamese nurses' attitudes and beliefs to adopt evidence-based practice enabling hospitals to align individual and organizational goals for developing evidence-based practice and enable comparison of the results with international samples.
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Affiliation(s)
- Nguyen Van Giang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Faculty of Nursing, Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - Shu-Yuan Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Duong Hong Thai
- Thai Nguyen National Hospital, Thai Nguyen, Vietnam.,Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
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17
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Skavberg Roaldsen K, Halvarsson A. Reliability of the Swedish version of the Evidence-Based Practice Attitude Scale assessing physiotherapist's attitudes to implementation of evidence-based practice. PLoS One 2019; 14:e0225467. [PMID: 31765410 PMCID: PMC6876878 DOI: 10.1371/journal.pone.0225467] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 11/05/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To translate and apply a cross-cultural adaptation of the Evidence-Based Practice Attitude Scale (EBPAS) in Swedish and investigate its absolute and relative reliability. Methods The original EBPAS (a questionnaire assessing health professionals’ attitudes to implementation of evidence-based practice) was translated into Swedish using a forward and backward procedure, including a group discussion and expert committee. To assess reliability, 55 physiotherapists (48 women) aged 23–64 years from different clinical settings in the Stockholm region answered the EBPAS by postal survey twice within an interval of 2 weeks. Results The Cronbach’s alpha values for EBPAS were >0.721. The intraclass correlation (ICC) between test and retest (relative reliability) was moderate to good for the four subscales, with ICC(A.1) and ICC(C.1) values approximately equal and in the range 0.56–0.89. Values for the absolute reliability of the mean score were a standard error of measurement of about 7% and a smallest real difference of about 19%. Conclusion The Swedish version of the EBPAS shows mainly good reliability.
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Affiliation(s)
- Kirsti Skavberg Roaldsen
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Department of Research, Sunnaas Rehabilitation Hospital, Nesoddtangen, Norway
- Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Alexandra Halvarsson
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
- Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden
- * E-mail:
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18
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Skogøy BE, Ogden T, Weimand B, Ruud T, Sørgaard K, Maybery D. Predictors of family focused practice: organisation, profession, or the role as child responsible personnel? BMC Health Serv Res 2019; 19:793. [PMID: 31684933 PMCID: PMC6829823 DOI: 10.1186/s12913-019-4553-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 09/23/2019] [Indexed: 01/15/2023] Open
Abstract
Background Health professionals in Norway are required by law to help safeguard information and follow-up with children of parents with mental or physical illness, or who have substance abuse problems, to reduce their higher risk of psychosocial problems. Knowledge is lacking regarding whether organisation and/or worker-related factors can explain the differences in health professionals’ ability to support the families when patients are parents. Methods Employing a translated, generic version of the Family Focused Mental Health Practice Questionnaire (FFPQ), this cross-sectional study examines family focused practice (FFP) differences in relation to health professionals’ background and role (N = 280) along with exploring predictors of parent, child, and family support. Results While most health professions had begun to have conversations with parents on children’s needs, under one-third have had conversations with children. There were significant differences between nurses, social workers, psychologists, physicians, and others on seven of the FFP subscales, with physicians scoring lowest on five subscales and psychologists providing the least family support. Controlling for confounders, there were significant differences between child responsible personnel (CRP) and other clinicians (C), with CRP scoring significantly higher on knowledge and skills, confidence, and referrals. Predictors of FFP varied between less complex practices (talking with parents) and more complex practices (family support and referrals). Conclusion The type of profession was a key predictor of delivering family support, suggesting that social workers have more undergraduate training to support families, followed by nurses; alternately, the results could suggest that that social workers and nurses have been more willing or able than physicians and psychologists to follow the new legal requirements. The findings highlight the importance of multidisciplinary teams and of tailoring training strategies to health professionals’ needs in order to strengthen their ability to better support children and families when a parent is ill.
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Affiliation(s)
- Bjørg Eva Skogøy
- Nordland Hospital Trust, Kløveråsveien 1, 8076, Bodø, Norway. .,The Faculty of Health Science, UiT, The Arctic University of Norway, Box 6050, 9037, Tromsø, Norway.
| | - Terje Ogden
- Norwegian Center for Child Behavioral Development, Unirand, Box 7053, Majorstuen, 0368, Oslo, Norway.,Institute of Psychology, University of Oslo, Box 1171, Blindern, 0318, Oslo, Norway
| | - Bente Weimand
- Department for Research and Development, Mental Health Services, Akershus University Hospital, Box 1000, 1478, Lørenskog, Norway.,Faculty of Health Sciences, Department of Nursing and Health Promotion, OsloMet - Oslo Metropolitan University, P.O. Box 4, St. Olavs plass, 0130, Oslo, Norway
| | - Torleif Ruud
- Department for Research and Development, Mental Health Services, Akershus University Hospital, Box 1000, 1478, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Box 1171, Blindern, 0318, Oslo, Norway
| | - Knut Sørgaard
- Nordland Hospital Trust, Kløveråsveien 1, 8076, Bodø, Norway.,The Faculty of Health Science, UiT, The Arctic University of Norway, Box 6050, 9037, Tromsø, Norway
| | - Darryl Maybery
- Monash University Department of Rural Health, Box 973, Moe, Victoria, 3825, Australia
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19
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Hartveit M, Hovlid E, Nordin MHA, Øvretveit J, Bond GR, Biringer E, Assmus J, Mariniusson GH, Ruud T. Measuring implementation: development of the implementation process assessment tool (IPAT). BMC Health Serv Res 2019; 19:721. [PMID: 31638967 PMCID: PMC6805659 DOI: 10.1186/s12913-019-4496-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 08/30/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Implementation science comprises a large set of theories suggesting interacting factors at different organisational levels. Development of literature syntheses and frameworks for implementation have contributed to comprehensive descriptions of implementation. However, corresponding instruments for measuring these comprehensive descriptions are currently lacking. The present study aimed to develop an instrument measuring care providers' perceptions of an implementation effort, and to explore the instrument's psychometric properties. METHODS Based on existing implementation literature, a questionnaire was designed with items on individual and team factors and on stages of change in an implementation process. The instrument was tested in a Norwegian study on implementation of evidence based practices for psychosis. Item analysis, factor structure, and internal consistency at baseline were examined. RESULTS The 27-item Implementation Process Assessment Tool (IPAT) revealed large variation between mean score of the items. The total scale scores were widely dispersed across respondents. Internal consistency for the total scale was high (Cronbach's alpha: .962), and all but one item contributed positively to the construct. The results indicated four underlying constructs: individual stages for behavioural change, individual activities and perceived support, collective readiness and support, and individual perceptions of the intervention. CONCLUSIONS The IPAT appears to be a feasible instrument for investigating the implementation process from the perspective of those making the change. It can enable examination of the relative importance of factors thought to be essential for implementation outcomes. It may also provide ongoing feedback for leaders tailoring support for teams to improve implementation. However, further research is needed to detect the instrument's properties later in the implementation process and in different contexts. TRIAL REGISTRATION ClinicalTrials.gov code NCT03271242 (retrospective registered September 5, 2017).
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Affiliation(s)
- M Hartveit
- Department of Research and Innovation, Helse Fonna Local Health Authority, Haugesund, Norway. .,Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.
| | - E Hovlid
- Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.,Department of Social Science, Western Norway University of Applied Sciences, Sogndal and Norwegian Board of Health Supervision, Oslo, Norway
| | - M H A Nordin
- Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - J Øvretveit
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - G R Bond
- IPS Employment Center, Westat, Rivermill Commercial Center, Lebanon, USA
| | - E Biringer
- Department of Research and Innovation, Helse Fonna Local Health Authority, Haugesund, Norway
| | - J Assmus
- Haukeland University Hospital, Centre for Clinical Research, Bergen, Norway
| | - G H Mariniusson
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway
| | - T Ruud
- Division Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Rye M, Torres EM, Friborg O, Skre I, Aarons GA. The Evidence-based Practice Attitude Scale-36 (EBPAS-36): a brief and pragmatic measure of attitudes to evidence-based practice validated in US and Norwegian samples. Implement Sci 2017; 12:44. [PMID: 28372587 PMCID: PMC5379724 DOI: 10.1186/s13012-017-0573-0] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 03/16/2017] [Indexed: 11/30/2022] Open
Abstract
Background Short and valid instruments for measuring factors facilitating or hindering implementation efforts are called for. This article describes (1) the adaptation of a shorter version of the Evidence-based Practice Attitude Scale (EBPAS-50 items), and (2) the psychometric properties of the shortened version in both US and Norwegian data. Methods The US participants were mental health service providers (N = 418) recruited from clinics providing mental health services in San Diego County, California. The Norwegian participants were psychologists, psychiatric nurses, and psychology students (N = 838) recruited from the Norwegian Psychological Association and the Norwegian Nurses Organization. A confirmatory factor analysis (CFA) approach was used. Results The reduction resulted in 36 items named EBPAS-36, and the original 12 factor model was maintained. The EBPAS-36 had acceptable model fit, as indicated by a low degree of misspecification errors in both the US (RMSEA = .045 (CI90% .040–.049); SRMR = .05) and the Norwegian data (RMSEA = .052 (CI90% .047–.056, SRMR = .07). Incremental model fit was fair in the US (CFI = .93, TLI = .91) and in the Norwegian samples (CFI = .91, TLI = .89). The internal consistency (Cronbach’s α) in the US and the Norwegian samples were good for the total EBPAS-36 score (.79 and .86, respectively) and were ranged from adequate to excellent for the subscales (US .60–.91 and Norway .61–.92). Conclusions The EBPAS-36 has adequate psychometric properties both in US and Norwegian samples, hence indicating cross-cultural validity. It is a brief, pragmatic, and more user-friendly instrument than the EBPAS-50, yet maintains a broad scope by retaining the original 12 measurement domains. Electronic supplementary material The online version of this article (doi:10.1186/s13012-017-0573-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marte Rye
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway. .,Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway.
| | - Elisa M Torres
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Oddgeir Friborg
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway
| | - Ingunn Skre
- Department of Psychology, Faculty of Health Sciences, UiT The Arctic University of Norway, N-9037, Tromsø, Norway.,Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway
| | - Gregory A Aarons
- Department of Psychiatry, University of California, San Diego, CA, USA
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