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

Carrie Brooke-Sumner; Petal Petersen-Williams; Emma Wagener; Katherine Sorsdahl; Gregory A Aarons; Bronwyn Myers

doi:10.1136/bmjopen-2020-047320

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. 2021 Dec 17;11(12):e047320. doi: 10.1136/bmjopen-2020-047320.

Authors

Carrie Brooke-Sumner^{1

2}, Petal Petersen-Williams^{3

4}, Emma Wagener⁵, Katherine Sorsdahl², Gregory A Aarons^{6

7}, Bronwyn Myers^{3

4}

Affiliations

¹ Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa carrie.brooke-sumner@mrc.ac.za.
² Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
³ Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council, Tygerberg, South Africa.
⁴ Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
⁵ Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa.
⁶ Department of Psychiatry, University of California, La Jolla, San Diego, California, USA.
⁷ Child and Adolescent Services Research Center, San Diego, California, USA.

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. PACTR201610001825405.

Keywords: change management; organisational development; primary care.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Health Facilities*
Humans
Psychometrics
Reproducibility of Results
South Africa
Surveys and Questionnaires
Texas
Universities*

Abstract

Publication types

MeSH terms

Grants and funding