Abstract
Although organizational context is central to evidence-based practice, underdeveloped measurement hindersitsassessment. The Alberta Context Tool, comprised of 59 items that tap10 modifiable contextual concepts, was developed to address this gap. The purpose of this study to examine the reliability and validity of scores obtained when the Alberta Context Tool is completed by professional nurses across different healthcare settings. Five separate studies (N = 2361 nurses across different care settings) comprised the study sample. Reliability and validity were assessed. Cronbach’s alpha exceeded 0.70 for9/10 Alberta Context Tool concepts. Item-total correlations exceeded acceptable standards for 56/59items. Confirmatory Factor Analysescoordinated acceptably with the Alberta Context Tool’s proposed latent structure. The mean values for each Alberta Context Tool concept increased from low to high levels of research utilization(as hypothesized) further supporting its validity. This study provides robust evidence forreliability and validity of scores obtained with the Alberta Context Tool when administered to professional nurses.
Highlights
International awareness and acceptance of the importance of organizational context to evidence-based practice and to better patient outcomes is growing
Item-total statistics were calculated for the items in each of the 10 Alberta Context Tool (ACT) concepts; we considered items for reassessment if (a) they correlated with their scale score at 0.3 or lower, and (b) they caused a substantial rise or fall in the Cronbach’s alphavalues that were observed when we recalculated alpha on a reduced set of items [28,31]
We report common ‘close-fit’ indices: (1) the root mean square of approximation (RMSEA); (2) the standardized root mean square residual (SRMSR); and, (3) the comparative fit index (CFI)
Summary
International awareness and acceptance of the importance of organizational context to evidence-based practice and to better patient outcomes is growing. Several instruments measure selected aspects of context, for example organizational culture [1,2], organizational climate[3,4], and the practice environment[5,6]. These tend to be lengthy (potentially increasing respondent burden) and do not capture a broad conceptualization of context, making them often not feasible for use in the busy, resource-stretched healthcare settings where healthcare providers frequently practice. PLOS ONE | DOI:10.1371/journal.pone.0127405 June 22, 2015
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