Abstract
BackgroundImplementation is proposed to be a multiphase, multilevel process. After a period of exploration, an adoption decision is made, typically at the upper management or policy level. Nevertheless, movement through each of the subsequent phases of the implementation process involves clinicians or providers at the individual level to adopt the innovation and then change their behavior to use/deliver the innovation. Multiple behavioral change theories propose that intentions are a critical determinant of implementation behavior. However, there is a need for the development and testing of pragmatic measures of providers’ intentions to use a specific innovation or evidence-based practice (EBP).MethodsNine items were developed to assess providers’ intentions to use a specific innovation or EBP. Motivational interviewing was the EBP in the study. Items were administered, as part of larger survey, to 179 providers across 38 substance use disorder treatment (SUDT) programs within five agencies in California, USA. Rasch analysis was conducted using RUMM2030 software to assess the items, their overall fit to the Rasch model, the response scale used, individual item fit, differential item functioning (DIF), and person separation.ResultsFollowing a stepwise process, the scale was reduced from nine items to three items to increase the feasibility and acceptability of the scale while maintaining suitable psychometric properties. The three-item unidimensional scale showed good person separation (PSI = .872), no disordering of thresholds, and no evidence of uniform or non-uniform DIF. Rasch analysis supported the viability of the scale as a measure of implementation intentions.ConclusionsThe Measure of Innovation-Specific Implementation Intentions (MISII) is a sound measure of providers’ intentions to use a specific innovation or EBP. Future evaluation of convergent, divergent, and predictive validity are needed. The study also demonstrates the value of Rasch analysis for testing the psychometric properties of pragmatic implementation measures.
Highlights
Implementation is proposed to be a multiphase, multilevel process
We developed and tested a provider-level measure of implementation intention for a specific innovation using Rasch measurement theory (RMT) and methods
Measure The Measure of Innovation-Specific Implementation Intentions (MISII) was developed following the scale development procedure described by DeVellis which consists of (1) defining what is to be measured, (2) generating items and the response format using an expert panel, (3) administering items to a sample, and (4) evaluating items and optimizing the scale length [22]
Summary
Implementation is proposed to be a multiphase, multilevel process. After a period of exploration, an adoption decision is made, typically at the upper management or policy level. Movement through each of the subsequent phases of the implementation process involves clinicians or providers at the individual level to adopt the innovation and change their behavior to use/deliver the innovation. There is a need for the development and testing of pragmatic measures of providers’ intentions to use a specific innovation or evidence-based practice (EBP). Implementation is proposed to be a multilevel, multiphase process that involves policies, organizations, and individual providers. The movement through each of the subsequent phases of the implementation process involves individual providers adopting and using one or more specific innovations or evidence-based practices (EBPs). Because providers may not be involved in the adoption decision, it is critical that, prior to preparation and implementation, organizations understand providers’ attitudes toward the selected innovation and their intentions to use it
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