Choy-Brown Mimi, Williams Nathaniel J, Ramirez Nallely, Esp Susan
University of Minnesota, Twin Cities, 1404 Gortner Avenue, St. Paul, MN, 55108, USA.
Boise State University, 1910 University Drive, Education Suite 717, Boise, ID, 83725-1940, USA.
Implement Sci Commun. 2023 Apr 6;4(1):39. doi: 10.1186/s43058-023-00419-1.
Valid and reliable measurement of implementation strategies is essential to advancing implementation science; however, this area lags behind the measurement of implementation outcomes and determinants. Clinical supervision is a promising and highly feasible implementation strategy in behavioral healthcare for which pragmatic measures are lacking. This research aimed to develop and psychometrically evaluate a pragmatic measure of clinical supervision conceptualized in terms of two broadly applicable, discrete clinical supervision techniques shown to improve providers' implementation of evidence-based psychosocial interventions-(1) audit and feedback and (2) active learning.
Items were generated based on a systematic review of the literature and administered to a sample of 154 outpatient mental health clinicians serving youth and 181 community-based mental health providers serving adults. Scores were evaluated for evidence of reliability, structural validity, construct-related validity, and measurement invariance across the two samples.
In sample 1, confirmatory factor analysis (CFA) supported the hypothesized two-factor structure of scores on the Evidence-Based Clinical Supervision Strategies (EBCSS) scale (χ=5.89, df=4, p=0.208; RMSEA=0.055, CFI=0.988, SRMR=0.033). In sample 2, CFA replicated the EBCSS factor structure and provided discriminant validity evidence relative to an established supervisory alliance measure (χ=36.12, df=30, p=0.204; RMSEA=0.034; CFI=0.990; SRMR=0.031). Construct-related validity evidence was provided by theoretically concordant associations between EBCSS subscale scores and agency climate for evidence-based practice implementation in sample 1 (d= .47 and .55) as well as measures of the supervision process in sample 2. Multiple group CFA supported the configural, metric, and partial scalar invariance of scores on the EBCSS across the two samples.
Scores on the EBCSS provide a valid basis for inferences regarding the extent to which behavioral health providers experience audit and feedback and active learning as part of their clinical supervision in both clinic- and community-based behavioral health settings.
ClinicalTrials.gov NCT04096274 . Registered on 19 September 2019.
对实施策略进行有效且可靠的测量对于推进实施科学至关重要；然而，这一领域在测量实施结果和决定因素方面相对滞后。临床督导是行为健康护理中一种有前景且高度可行的实施策略，但缺乏实用的测量方法。本研究旨在开发并从心理测量学角度评估一种实用的临床督导测量方法，该方法依据两种广泛适用的、离散的临床督导技术进行概念化，这两种技术已被证明可提高提供者对循证心理社会干预措施的实施效果，即（1）审核与反馈以及（2）主动学习。
基于对文献的系统回顾生成条目，并将其施测于154名服务青少年的门诊心理健康临床医生样本以及181名服务成年人的社区心理健康提供者样本。对分数进行评估，以获取关于可靠性、结构效度、构想效度以及两个样本间测量不变性的证据。
在样本1中，验证性因子分析（CFA）支持了基于循证临床督导策略（EBCSS）量表得分的假设双因子结构（χ=5.89，自由度=4，p=0.208；RMSEA=0.055，CFI=0.988，SRMR=0.033）。在样本2中，CFA复制了EBCSS因子结构，并提供了相对于一种既定督导联盟测量方法的区分效度证据（χ=36.12，自由度=30，p=0.204；RMSEA=0.034；CFI=0.990；SRMR=0.031）。样本1中EBCSS子量表得分与基于证据的实践实施的机构氛围之间理论上一致的关联（d =.47和.55）以及样本2中督导过程的测量指标提供了构想效度证据。多组CFA支持了EBCSS得分在两个样本间的构型、度量和部分标量不变性。
EBCSS得分提供了一个有效依据，可据此推断行为健康提供者在基于诊所和社区的行为健康环境中，将审核与反馈以及主动学习体验为其临床督导一部分的程度。
ClinicalTrials.gov NCT04096274。于2019年9月19日注册。
