Factor Structure, Reliability and Measurement Invariance of the Alberta Context Tool and the Conceptual Research Utilization Scale, for German Residential Long Term Care

Abstract

We translated the Canadian residential long term care versions of the Alberta Context Tool (ACT) and the Conceptual Research Utilization (CRU) Scale into German, to study the association between organizational context factors and research utilization in German nursing homes. The rigorous translation process was based on best practice guidelines for tool translation, and we previously published methods and results of this process in two papers. Both instruments are self-report questionnaires used with care providers working in nursing homes. The aim of this study was to assess the factor structure, reliability, and measurement invariance (MI) between care provider groups responding to these instruments. In a stratified random sample of 38 nursing homes in one German region (Metropolregion Rhein-Neckar), we collected questionnaires from 273 care aides, 196 regulated nurses, 152 allied health providers, 6 quality improvement specialists, 129 clinical leaders, and 65 nursing students. The factor structure was assessed using confirmatory factor models. The first model included all 10 ACT concepts. We also decided a priori to run two separate models for the scale-based and the count-based ACT concepts as suggested by the instrument developers. The fourth model included the five CRU Scale items. Reliability scores were calculated based on the parameters of the best-fitting factor models. Multiple-group confirmatory factor models were used to assess MI between provider groups. Rather than the hypothesized ten-factor structure of the ACT, confirmatory factor models suggested 13 factors. The one-factor solution of the CRU Scale was confirmed. The reliability was acceptable (>0.7 in the entire sample and in all provider groups) for 10 of 13 ACT concepts, and high (0.90–0.96) for the CRU Scale. We could demonstrate partial strong MI for both ACT models and partial strict MI for the CRU Scale. Our results suggest that the scores of the German ACT and the CRU Scale for nursing homes are acceptably reliable and valid. However, as the ACT lacked strict MI, observed variables (or scale scores based on them) cannot be compared between provider groups. Rather, group comparisons should be based on latent variable models, which consider the different residual variances of each group.

A Structured Process Description of a Pragmatic Implementation Project: Improving Integrated Care for Older Persons in Residential Care Homes

“…Examples of recent work are the assessment of context in care homes and the possibilities that feedback to stakeholders offer (reported by Estabrooks et al), and the realist approach in general and the realist review of effective health care in homes in particular (as presented by Goodman et al). 21 , 35 , 36 …”

The use of the PARIHS framework in implementation research and practice—a citation analysis of the literature

“…About 35 studies applied PARIHS for quantitative analysis, (e.g., [69,168,174,190,211]). In half of these, the Alberta Context Tool (e.g., [155,165,180,195,229]) and the Organizational Readiness to Change Assessment Tool (e.g., [74,159,219,240]) were used; both these tools being derived from PARIHS. Empirical studies using the PARIHS framework in the analysis encompassed primarily all three main elements of PARIHS (e.g., [166,181,193,221]) and the context domain (e.g., [78,152,153,207]), and in lesser extent the evidence (e.g., [185,208,214]) and the facilitation domain (e.g., [58,67,79,182]).…”

Využívání kurikulárních dokumentů učiteli ZŠ: aplikace Johnsonovy typologie

“…Koncept využívání se v odborné literatuře nejčastěji spojuje s užíváním výzkumných poznatků či inovací v praxi (Hoben, Estabrooks, Squires, & Behrens, 2016;Rich, 1991, s. 320;Squires, Estabrooks, Newburn-Cook, & Gierl, 2011;Stetler, 2001 Využívání poznatků jako výzkumné téma vzniklo v průběhu zemědělské inovativní vlny v USA kolem roku 1900. V tomto období se pojem využívání ještě neužíval, ale jeho klíčové myšlenky zde již byly obsaženy -více o rozvoji myšlenky Rogers (1988).…”

“…Johnson (1998, s. 93-94) uvedenou typologii rozšířil o procesuální typ využívání. Přestože lze typologii využívání považovat za nadoborovou, aktuálně nachází uplatnění zejména ve zdravotnictví (Estabrooks, 1999;Hoben et al, 2016;Stetler, 2001) a veřejné správě (Rissi & Sager, 2013). Dohledali jsme nicméně výzkumy, které koncept využívání rozpracovávají také pro oblast vzdělávání (Cain, 2015;Cain & Allan, 2017;Landry, Amara, & Lamari, 2001;Squires et al, 2011).…”