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. 2023 Jan 27;23(1):93.
doi: 10.1186/s12913-022-09005-y.

Using cognitive interviews to improve a measure of organizational readiness for implementation

Maria McClam  1 , Lauren Workman  2   3 , Emanuelle M Dias  4 , Timothy J Walker  4 , Heather M Brandt  5 , Derek W Craig  4 , Robert Gibson  6 , Andrea Lamont  7 , Bryan J Weiner  8 , Abraham Wandersman  7 , Maria E Fernandez  4
Affiliations

Using cognitive interviews to improve a measure of organizational readiness for implementation

Maria McClam et al. BMC Health Serv Res. .

Abstract

Background: Organizational readiness is a key factor for successful implementation of evidence-based interventions (EBIs), but a valid and reliable measure to assess readiness across contexts and settings is needed. The R = MC2 heuristic posits that organizational readiness stems from an organization's motivation, capacity to implement a specific innovation, and its general capacity. This paper describes a process used to examine the face and content validity of items in a readiness survey developed to assess organizational readiness (based on R = MC2) among federally qualified health centers (FQHC) implementing colorectal cancer screening (CRCS) EBIs.

Methods: We conducted 20 cognitive interviews with FQHC staff (clinical and non-clinical) in South Carolina and Texas. Participants were provided a subset of items from the readiness survey to review. A semi-structured interview guide was developed to elicit feedback from participants using "think aloud" and probing techniques. Participants were recruited using a purposive sampling approach and interviews were conducted virtually using Zoom and WebEx. Participants were asked 1) about the relevancy of items, 2) how they interpreted the meaning of items or specific terms, 3) to identify items that were difficult to understand, and 4) how items could be improved. Interviews were transcribed verbatim and coded in ATLAS.ti. Findings were used to revise the readiness survey.

Results: Key recommendations included reducing the survey length and removing redundant or difficult to understand items. Additionally, participants recommended using consistent terms throughout (e.g., other units/teams vs. departments) the survey and changing pronouns (e.g., people, we) to be more specific (e.g., leadership, staff). Moreover, participants recommended specifying ambiguous terms (e.g., define what "better" means).

Conclusion: Use of cognitive interviews allowed for an engaged process to refine an existing measure of readiness. The improved and finalized readiness survey can be used to support and improve implementation of CRCS EBIs in the clinic setting and thus reduce the cancer burden and cancer-related health disparities.

Keywords: Cognitive interviewing; Evidence-based interventions; Measure development; Organizational readiness; Qualitative methods; cancer prevention.

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Conflict of interest statement

The authors declare that they have no competing interests.

References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. Cancer statistics, 2021. CA Cancer J Clin. 2021;71(1):7–33. - PubMed
    1. Siegel RL, Miller KD, Goding Sauer A, Fedewa SA, Butterly LF, Anderson JC, et al. Colorectal cancer statistics, 2020. CA Cancer J Clin. 2020;70(3):145–164. - PubMed
    1. U.S. Preventative Services Task Force . Final Recommendation Statement: Colorectal Cancer: Screening. 2021.
    1. Harber I, Zeidan D, Aslam MN. Colorectal Cancer screening: impact of COVID-19 pandemic and possible consequences. Life (Basel) 2021;11(12):1297. - PMC - PubMed
    1. Office of Disease Prevention and Health Promotion, Office of the Secretary, U.S. Department of Health and Human Services. Increase the proportion of adults who get screened for colorectal cancer — C-07Available from: https://health.gov/healthypeople/objectives-and-data/browse-objectives/c.... Accessed 22 Dec 2022.