Validity and reliability of the transculturally adapted Spanish version of the Implementation Leadership Scale (ILS)

Marta Llarena; Heather Lynn Rogers; Patricia Macia; Susana Pablo; Marta Gonzalez-Saenz de Tejada; Marta Montejo; Natalia Paniagua; Javier Benito; Mikel Rueda; Borja Santos; Gonzalo Grandes; Alvaro Sanchez

doi:10.1186/s43058-023-00495-3

Validity and reliability of the transculturally adapted Spanish version of the Implementation Leadership Scale (ILS)

Implement Sci Commun. 2023 Sep 12;4(1):112. doi: 10.1186/s43058-023-00495-3.

Authors

Affiliations

¹ Biocruces Bizkaia Health Research Institute, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain.
² Biocruces Bizkaia Health Research Institute, Plaza Cruces s/n, E-48903, Bizkaia, Barakaldo, Spain.
³ Ikerbasque Basque Foundation for Science, Bilbao, Spain.
⁴ Biocruces Bizkaia Health Research Institute, Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain.
⁵ Primary Care Research Unit of Bizkaia, Deputy Directorate of Healthcare Assistance, Biocruces Bizkaia Health Research Institute, Basque Healthcare Service - Osakidetza, Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain.
⁶ Rontegi-Barakaldo Primary Care Center, University of the Basque Country, UPV/EHU, Biocruces Bizkaia Health Research Institute, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Bizkaia, Barakaldo, Spain.
⁷ Pediatric Emergency Department, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain.
⁸ Pediatric Emergency Department, Cruces University Hospital, Biocruces Bizkaia Health Research Institute, University of the Basque Country, UPV/EHU, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain.
⁹ Primary Care Research Unit of Bizkaia, Deputy Directorate of Healthcare Assistance, Biocruces Bizkaia Health Research Institute, Basque Healthcare Service - Osakidetza, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain.
¹⁰ Primary Care Research Unit of Bizkaia, Deputy Directorate of Healthcare Assistance, Biocruces Bizkaia Health Research Institute, Basque Healthcare Service - Osakidetza, Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS), Plaza Cruces s/n, 48903, Bizkaia, Barakaldo, Spain. alvaro.sanchezperez@osakidetza.eus.

Abstract

Background: There is a need for pragmatic and reliable measures of sound factors that affect evidence-based practice (EBP) adoption and implementation in different languages and cultural environments. The Implementation Leadership Scale (ILS) is a brief and efficient measurement tool of strategic leadership for EBP implementation. The objective of this study was to assess the psychometric properties of the Spanish version of the ILS.

Methods: The process of translation of the original ILS into Spanish consisted of forward translation, panel meeting, and back-translation. Scale face and content validity compared to that of the original version were assessed and ensured before agreement on the final version. Psychometric properties were examined in 144 healthcare professionals (family physicians, pediatricians, practice and pediatric nurses) involved in implementation or improvement research projects. ILS factor structure was tested by confirmatory factor analysis (CFA). Reliability was assessed by internal consistency analysis. The Pearson correlation between the ILS and the Organizational Support dimension of the Organizational Readiness for Knowledge Translation (OR4KT) questionnaire in the subsample of pediatricians and pediatric nurses (n = 52) was estimated for convergent validity analysis.

Results: The CFA results indicated that the original four theorized first-order factors with a second-order Implementation Leadership factor fit the data well (χ² = 107.70; df = 45; p < 0.001). All standardized first- and second-order factor loadings were statistically significant. Fit indexes showed acceptable figures (GFI = 0.90; CFI = 0.97; RMSEA = 0.10; SRMR = 0.053). Cronbach's alpha coefficient for the four dimensions of ILS ranged from 0.90 to 0.97, while the reliability estimated for the total scale was 0.95. Results of convergent validity revealed high correlation (r = 0.56) between the ILS and the OR4KT's Organizational Support dimension.

Conclusion: The CFA results demonstrated that the tested first- and second-order factor structure of the 12-item Spanish version of the ILS is consistent with the factor structure of the original tool. The availability of the ILS will allow Spanish-speaking researchers to assess and advance understanding of the implementation leadership construct as a predictor of organizational implementation context.

Keywords: Implementation; Leadership; Primary care; Reliability; Spanish ILS; Validity.

Abstract

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