DOI: 10.5061/dryad.w6m905qqm
title: Adaptation of the Texas Christian University Organisational Readiness for Change Short Form (TCU-ORC-SF) for use in primary health facilities in South Africa

description: 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- 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 health care 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 re-administered 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 re-completed 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 &gt;.80. The overall shortened
 scale had a test-retest correlation of r = .80, p &lt; 0.01,
 acceptable convergent validity with the ORCA scale (r = .56, p &lt;
 .05), moderate convergence with the CARI (r = 39, p&lt;.05) and strong
 correlation with the original scale (r = 0.79, p &lt; .05).
 Conclusions: This study presents the first psychometric data on the
 TCU-ORC from a LMIC.  The proposed shortened tool may be more
 feasible for use in LMICs.
description: Data
 collection took place from July to December 2018 at the 24 facilities that
 participated in the MIND trial. Following a workshop that introduced the
 study in the facilities, health service employees (managers and staff)
 were requested to complete a paper-based, English language self-report
 survey, after granting written informed consent. English is the official
 language of business of the South African health system. Participants at
 workshops included facility managers, operational managers, medical
 officers, psychiatric nurses, general nursing staff from the chronic
 disease care team, and lay counsellors.  Between one
 and two weeks after the workshop, Project MIND fieldworkers asked a
 sub-sample of participants (convenience sample) from each facility to
 re-complete the paper-based survey comprising the ORC measures to enable
 assessment of test-retest reliability. These fieldworkers also approached
 nursing staff directly to fill in the questionnaire to gain enough
 responses for the first survey.  In total, 395 surveys were completed: 281
 participants completed the first survey and 118 participants completed
 both the first and test-retest survey. Data was
 collected via pen-and-paper surveys and captured electronically by a
 trained data manager. Cases with more than 50% of data missing were
 removed, resulting in 275 participants who completed the first survey.
 This was the data used for the Exploratory Factor Analysis.
description: There are missing values in the T2 (time 2) data, as not all
 participants completed both questionnaires. This data can be excluded
 listwise when running any analyses.