Adaptation of the Texas Christian University Organisational Readiness for Change Short Form (TCU-ORC-SF) for use in primary health facilities in South Africa.

Journal: BMJ open

Volume: 11

Issue: 12

Year of Publication: 2022

Affiliated Institutions:  Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa carrie.brooke-sumner@mrc.ac.za. Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa. Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa. Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa. Department of Psychiatry, University of California, La Jolla, San Diego, California, USA.

Abstract summary 

The Texas Christian University Organisational Readiness for Change Scale (TCU-ORC) assesses factors influencing adoption of evidence-based practices. It has not been validated in low-income and middle-income countries (LMIC). This study assessed its psychometric properties in a South African setting with the aim of adapting it into a shorter measure.This study was conducted in 24 South African primary healthcare clinics in the Western Cape Province. The TCU-ORC and two other measures, the Organisational Readiness to Change Assessment (ORCA) and the Checklist for Assessing Readiness for Implementation (CARI) were administered. The questionnaire was readministered after 2 weeks to obtain data on test-retest reliability. Three hundred and ninety-five surveys were completed: 281 participants completed the first survey, and 118 recompleted the assessments.We used exploratory factor analysis (EFA) to identify latent dimensions represented in the data. Cronbach's alpha for each subscale was assessed and we examined the extent to which the subscales and total scale scores for the first and retest surveys correlated. Convergent validity was assessed by the correlation coefficient between the TCU-ORC, ORCA and CARI total scale scores. EFA resulted in a three-factor solution. The three subscales proposed are Clinic Organisational Climate (8 items), Motivational Readiness for Change (13 items) and Individual Change Efficacy (5 items) (26 items total). Cronbach's alpha for each subscale was >0.80. The overall shortened scale had a test-retest correlation of r0.80, p<0.01, acceptable convergent validity with the ORCA scale (r=0.56, p<0.05), moderate convergence with the CARI (r39, p0.05) and strong correlation with the original scale (r=0.79, p<0.05).This study presents the first psychometric data on the TCU-ORC from an LMIC. The proposed shortened tool may be more feasible for use in LMICs.Results stage. Project MIND trial. Pan-African Clinical Trials Registry. PACTR201610001825405.

Authors & Co-authors:  Brooke-Sumner Carrie C Petersen-Williams Petal P Wagener Emma E Sorsdahl Katherine K Aarons Gregory A GA Myers Bronwyn B

Study Outcome 

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Statistics
Citations :  Department of Health RoSA . National mental health policy framework and strategic plan 2013-2020. Pretoria: Department of Health South Africa, 2013.
Authors :  6
Identifiers
Doi : e047320
SSN : 2044-6055
Study Population
Male,Female
Mesh Terms
Health Facilities
Other Terms
change management;organisational development;primary care
Study Design
Exploratory Study,Cross Sectional Study
Study Approach
Country of Study
South Africa
Publication Country
England