Abstract
BackgroundLittle is known about factors influencing professionals’ use of wikis.ObjectiveWe developed and validated two questionnaires to assess health care professionals’ intention to use wiki-based reminders for the management of trauma patients.MethodsWe developed questionnaires for emergency physicians (EPs) and allied health professions (AHPs) based on the Theory of Planned Behavior and adapted them to the salient beliefs of each, identified in an earlier study. Items measured demographics and direct and indirect theoretical constructs. We piloted the questionnaires with 2 focus groups (5 EPs and 5 AHPs) to identify problems of wording and length. Based on feedback, we adjusted the wording and combined certain items. A new convenience sample of 25 EPs and 26 AHPs then performed a test-retest of the questionnaires at a 2-week interval. We assessed internal consistency using Cronbach alpha coefficients and temporal stability of items with an agreement intraclass correlation coefficient (ICC).ResultsFive EPs and 5 AHPs (3 nurses, 1 respiratory therapist, and 1 pharmacist) formed 2 focus groups; 25 EPs and 26 AHPs (12 nurses, 7 respiratory therapists, and 7 pharmacists) completed the test and retest. The EP questionnaire test-retest scores for consistency (Cronbach alpha) and stability (ICC) were intention (test: Cronbach alpha=.94; retest: Cronbach alpha=.98; ICC=.89), attitude (.74, .72, .70), subjective norm (.79, .78, .75), perceived behavioral control (.67, .65, .66), attitudinal beliefs (.94, .86, .60), normative beliefs (.83, .87, .79), and control beliefs barriers (.58, .67, .78) and facilitators (.97, .85, .30). The AHP questionnaire scores for consistency and stability were: intention (test Cronbach alpha=.69, retest Cronbach alpha=.81, ICC=.48), attitude (.85, .87, .83), subjective norm (.47, .82, .62), perceived behavioral control (.55, .62, .60), attitudinal beliefs (.92, .91, .82), normative beliefs (.85, .90, .74), and control beliefs barriers (.58, .55, .66) and facilitators (.72, .94, –.05). To improve the psychometric properties of both questionnaires, we reformulated poorly consistent or unstable items.ConclusionsOur new theory-based questionnaires to measure health care professionals’ intention to use wiki-based reminders have adequate validity and reliability for use in large surveys. In the long run, they can be used to develop a theory-based implementation intervention for a wiki promoting best practices in trauma care.
Highlights
Clinical practice does not always reflect best evidence
We developed questionnaires for emergency physicians (EPs) and allied health professions (AHPs) based on the Theory of Planned Behavior and adapted them to the salient beliefs of each, identified in an earlier study
We piloted the questionnaires with 2 focus groups (5 EPs and 5 AHPs) to identify problems of wording and length
Summary
Clinical practice does not always reflect best evidence. High proportions of inappropriate care have been reported in different health care systems and settings [1]. Local initiatives to adapt various ICT solutions seem to be restricted to a small number of hospitals and tools are mostly designed for local use only [11,12,13] Transfer of these local initiatives to the larger health care community is often slow and complex. In emergency departments (EDs), where shift work is prevalent, getting health care professionals to collaborate in creating, using, and updating decision support tools (eg, care protocols, care pathways, and decision aids) is difficult [14]. These decision support tools can be translated into paper-based or computer-based reminders that support clinicians’ or patients’ decision making at the bedside. Little is known about factors influencing professionals’ use of wikis
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