Assessing mental health clinicians' intentions to adopt evidence-based treatments: reliability and validity testing of the evidence-based treatment intentions scale.

Nathaniel J Williams

doi:10.1186/s13012-016-0417-3

Abstract

BackgroundIntentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. Despite this, few measures of mental health clinicians’ EBT intentions exist and available measures have not been subject to thorough psychometric evaluation or testing. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians’ intentions to adopt EBTs.MethodsThe study evaluates the reliability and validity of inferences made with the EBTI using multi-method, multi-informant criterion variables collected over 12 months from a sample of 197 mental health clinicians delivering services in 13 mental health agencies. Structural, predictive, and discriminant validity evidence is assessed.ResultsFindings support the EBTI’s factor structure (χ 2 = 3.96, df = 5, p = .556) and internal consistency reliability (α = .80). Predictive validity evidence was provided by robust and significant associations between EBTI scores and clinicians’ observer-reported attendance at a voluntary EBT workshop at a 1-month follow-up (OR = 1.92, p < .05), self-reported EBT adoption at a 12-month follow-up (R 2 = .17, p < .001), and self-reported use of EBTs with clients at a 12-month follow-up (R 2 = .25, p < .001). Discriminant validity evidence was provided by small associations with clinicians’ concurrently measured psychological work climate perceptions of functionality (R 2 = .06, p < .05), engagement (R 2 = .06, p < .05), and stress (R 2 = .00, ns).ConclusionsThe EBTI is a practical and theoretically grounded measure of mental health clinicians’ EBT intentions. Scores on the EBTI provide a basis for valid inferences regarding mental health clinicians’ intentions to adopt EBTs. Discussion focuses on research and practice applications.Electronic supplementary materialThe online version of this article (doi:10.1186/s13012-016-0417-3) contains supplementary material, which is available to authorized users.

Highlights

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation
Research on evidence-based treatment (EBT) implementation in mental health settings is limited by a lack of reliable, valid, and practical measures to assess constructs likely to influence clinicians’ practice behaviors [1, 2]
Few measures of mental health clinicians’ EBT intentions exist and the measures that have been used in individual studies have not been subject to thorough psychometric evaluation or testing [1, 12, 13]

Summary

Introduction

Intentions play a central role in numerous empirically supported theories of behavior and behavior change and have been identified as a potentially important antecedent to successful evidence-based treatment (EBT) implementation. This paper evaluates the psychometric properties of the evidence-based treatment intentions (EBTI) scale, a new measure of mental health clinicians’ intentions to adopt EBTs. Intentions represent self-instructions to engage in a targeted behavior or to obtain specific outcomes and as such capture the motivational factors that influence behavioral performance [9, 14]. Several empirically supported theories of behavior and behavior change, including theories of attitude-behavior relations [6, 7], social cognitive theory [8], goal theory [10], and organizational behavior theories [15, 16], incorporate intentions as a primary determinant of behavior These theories argue that intention represents the most proximal cause of behavior such that other influencing variables are either mediated by intention or serve as moderators of the intention-behavior relationship [17]. Many factors likely influence clinicians’ practice behaviors, these studies suggest that an understanding of mental health clinicians’ EBT adoption will be aided by the reliable and valid assessment of their EBT intentions [20]

Objectives

Methods

Results

Discussion

Conclusion