Work

Measuring constructs from the Consolidated Framework for Implementation Research in the context of increasing colorectal cancer screening at community health centers

Year: 2015

Type: article

Abstract: The Consolidated Framework for Implementation Research (CFIR) is a comprehensive meta-framework widely applied to implementation related studies. Yet, few have used validated measures to operationalize constructs in CFIR in real-life settings. In this study, we operationalized selected CFIR constructs in an assessment to identify factors influencing implementation of evidence-based practices for increasing colorectal cancer screening in Community Health Centers (CHC). We selected 16 constructs from all five domains of CFIR. Measures were developed and tested in a cross-sectional survey with CHCs' clinical staff and leaders respectively. We performed a separate confirmatory factor analysis (CFA) for measures with three or more items, computed inter-item consistency (Cronbach's alpha), inter-rater reliability (ICC) and agreement (rWG(J)) statistics, and assessed construct validity via inter-correlations among constructs at individual and organizational levels. A total of 277 individuals and 59 CHC clinics were included in the analysis. CFA showed satisfactory structural validity (CFI>0.90, TLI>0.90, SRMR<0.08, RMSEA<0.08); all measures showed reasonable reliability (alpha>0.70). The ICCs (>0.1) and rWG(J) (>0.75) suggest it appropriate to aggregate individual responses by computing clinic means. Results also suggest good construct validity at both individual and clinic levels. Inner setting and process-related constructs are correlated with most variables across domains; correlations between outer setting and intervention characteristics and other domains vary more noticeably by construct.

Source: Implementation Science

DOI: 10.1186/1748-5908-10-s1-a10