Jones Salene M W, Shrey Aditya, Weiner Bryan J
Fred Hutchinson Cancer Center, Seattle, WA, USA.
School of Public Health, University of Washington, Seattle, WA, USA.
Implement Res Pract. 2023 May 16;4:26334895231175527. doi: 10.1177/26334895231175527. eCollection 2023 Jan-Dec.
Barriers and facilitators, collectively called determinants, of evidence-based practice implementation are key to identifying the best strategies for promoting implementation. Assessing determinants before implementation can help tailor strategies to those that would be most effective. Current measures of determinants are not comparable across implementation settings and implementation scientists and practitioners often have to create their own measures. This study was the first step in creating determinants item banks that are usable across settings and focused on intervention characteristics. We aimed to establish the content validity of the item bank.
This study used a concurrent mixed methods approach. Items for assessing intervention characteristic determinants were first identified through systematic reviews. Implementation scientists then completed a survey where they provided both quantitative and qualitative feedback on the items. Finally, three experts with both clinical and implementation experience provided feedback on redundancy and representativeness.
The systematic reviews identified over 1,959 items so subsequent steps were limited to focus on intervention characteristic determinants (271 items) such as adaptability of the practice. Based on feedback from thirty implementation scientists, the items were reduced to 92 but an additional 53 were added, most due to qualitative feedback. Items were also rewritten based on qualitative results. Three experts reviewed the remaining 145 items. Based on their feedback, the number of items was reduced to 109.
Creating a determinants item bank was feasible and the final items had content validity. The next steps include testing reliability and validity in a larger sample of clinicians implementing evidence-based practices.
循证实践实施的障碍和促进因素,统称为决定因素,是确定促进实施的最佳策略的关键。在实施前评估决定因素有助于使策略适合最有效的那些因素。目前对决定因素的衡量在不同的实施环境中不可比,实施科学家和从业者常常不得不自行创建衡量方法。本研究是创建可在不同环境中使用且侧重于干预特征的决定因素项目库的第一步。我们旨在确立该项目库的内容效度。
本研究采用同步混合方法。首先通过系统评价确定评估干预特征决定因素的项目。然后实施科学家完成一项调查,他们对这些项目提供定量和定性反馈。最后,三位具有临床和实施经验的专家对冗余性和代表性提供反馈。
系统评价确定了超过1959个项目,因此后续步骤限于关注干预特征决定因素(271个项目),如实践的适应性。根据30位实施科学家的反馈,项目减少到92个,但又增加了53个,大多是由于定性反馈。还根据定性结果对项目进行了改写。三位专家审查了其余的145个项目。根据他们的反馈,项目数量减少到109个。
创建决定因素项目库是可行的,最终项目具有内容效度。下一步包括在实施循证实践的更大规模临床医生样本中测试信度和效度。