TY - JOUR
T1 - Development and validation of an organizational readiness to change instrument focused on cultural competency
AU - McAlearney, Ann Scheck
AU - Gregory, Megan
AU - Walker, Daniel M.
AU - Edwards, Michael
N1 - Publisher Copyright:
© 2020 Health Research and Educational Trust
PY - 2021/2
Y1 - 2021/2
N2 - Objective: To validate a brief survey developed to be used in hospitals nationwide to assess organizational readiness to change to increase cultural competency. Data Sources/Study Setting: Analysis of primary data collected as part of a 125-item Organizational Assessment Survey conducted in the ten US hospitals participating in the Robert Wood Johnson Foundation Expecting Success program in 2005-2006. Study Design: The study utilized a cross-sectional survey. Data Collection: Surveys were distributed to participants in the ten hospitals based on job title and role within the organization (including clinicians, clinical administrators, other clinical professionals, and those in relevant nonclinical roles; respondents = 513; response rate = 31%). Missing data were deleted listwise. We computed internal consistency reliability via Cronbach's alpha and interrater agreement using the rwg(j) index, and conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine validity of the survey. We subsequently conducted ANOVAs to examine whether the instrument adequately distinguished between hospitals. Principal Findings: Across 408 complete responses, a scree plot generated by the EFA and a follow-up CFA indicated a 2-factor solution (RMSEA = 0.06; CFI = 0.96; GFI = 0.96; RMSR = 0.08). We identified these primary factors as two scales, a 12-item Readiness to Address Quality scale (α = 0.85; rwg(j) = 0.93) and an 11-item Readiness to Address Disparities scale (α = 0.65; rwg(j) = 0.89). ANOVAs suggested that these scales distinguished between hospitals (RTAQ: F[9, 428] = 3.70, P <.001; RTAD: F[9, 435] = 3.02, P =.002). Conclusions: This survey can help identify an organization's readiness to change to increase cultural competency.
AB - Objective: To validate a brief survey developed to be used in hospitals nationwide to assess organizational readiness to change to increase cultural competency. Data Sources/Study Setting: Analysis of primary data collected as part of a 125-item Organizational Assessment Survey conducted in the ten US hospitals participating in the Robert Wood Johnson Foundation Expecting Success program in 2005-2006. Study Design: The study utilized a cross-sectional survey. Data Collection: Surveys were distributed to participants in the ten hospitals based on job title and role within the organization (including clinicians, clinical administrators, other clinical professionals, and those in relevant nonclinical roles; respondents = 513; response rate = 31%). Missing data were deleted listwise. We computed internal consistency reliability via Cronbach's alpha and interrater agreement using the rwg(j) index, and conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to examine validity of the survey. We subsequently conducted ANOVAs to examine whether the instrument adequately distinguished between hospitals. Principal Findings: Across 408 complete responses, a scree plot generated by the EFA and a follow-up CFA indicated a 2-factor solution (RMSEA = 0.06; CFI = 0.96; GFI = 0.96; RMSR = 0.08). We identified these primary factors as two scales, a 12-item Readiness to Address Quality scale (α = 0.85; rwg(j) = 0.93) and an 11-item Readiness to Address Disparities scale (α = 0.65; rwg(j) = 0.89). ANOVAs suggested that these scales distinguished between hospitals (RTAQ: F[9, 428] = 3.70, P <.001; RTAD: F[9, 435] = 3.02, P =.002). Conclusions: This survey can help identify an organization's readiness to change to increase cultural competency.
KW - cultural competency
KW - disparities
KW - organizational readiness to change
KW - quality improvement
KW - survey development
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U2 - 10.1111/1475-6773.13563
DO - 10.1111/1475-6773.13563
M3 - Article
C2 - 33025602
AN - SCOPUS:85092116032
SN - 0017-9124
VL - 56
SP - 145
EP - 153
JO - Health Services Research
JF - Health Services Research
IS - 1
ER -