Adaptation of the Texas Christian University organisational readiness for change short form (TCU-ORC-SF) for use in primary health facilities in South Africa
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Date
2022
Journal Title
Journal ISSN
Volume Title
Publisher
BMJ publishing group
Abstract
Objectives 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.
Methods 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.
Results 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 r=0.80, p<0.01, acceptable
convergent validity with the ORCA scale (r=0.56,
p<0.05), moderate convergence with the CARI (r=39,
p<0.05) and strong correlation with the original scale
(r=0.79, p<0.05).
Conclusions 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.
Trial registration number Results stage. Project
MIND trial. Pan-African
Clinical Trials Registry.
Description
Keywords
Health, Human resource, Mental health, Treatment, South Africa
Citation
Brooke-Sumner, C. et al. (2021). Adaptation of the texas christian university organisational readiness for change short form (TCU-ORC-SF) for use in primary health facilities in south africa. BMJ Open, 11(12) doi:10.1136/bmjopen-2020-047320