Translating and testing the Alberta context tool for use among nurses in Swedish elder care

Abstract

BackgroundThere is emerging evidence that context is important for successful transfer of research knowledge into health care practice. The Alberta Context Tool (ACT) is a Canadian developed research-based instrument that assesses 10 modifiable concepts of organizational context considered important for health care professionals’ use of evidence. Swedish and Canadian health care have similarities in terms of organisational and professional aspects, suggesting that the ACT could be used for measuring context in Sweden. This paper reports on the translation of the ACT to Swedish and a testing of preliminary aspects of its validity, acceptability and reliability in Swedish elder care.MethodsThe ACT was translated into Swedish and back-translated into English before being pilot tested in ten elder care facilities for response processes validity, acceptability and reliability (Cronbach’s alpha). Subsequently, further modification was performed.ResultsIn the pilot test, the nurses found the questions easy to respond to (52%) and relevant (65%), yet the questions’ clarity were mainly considered ‘neither clear nor unclear’ (52%). Missing data varied between 0 (0%) and 19 (12%) per item, the most common being 1 missing case per item (15 items). Internal consistency (Cronbach’s Alpha > .70) was reached for 5 out of 8 contextual concepts. Translation and back translation identified 21 linguistic- and semantic related issues and 3 context related deviations, resolved by developers and translators.ConclusionModifying an instrument is a detailed process, requiring time and consideration of the linguistic and semantic aspects of the instrument, and understanding of the context where the instrument was developed and where it is to be applied. A team, including the instrument’s developers, translators, and researchers is necessary to ensure a valid translation. This study suggests preliminary validity, reliability and acceptability evidence for the ACT when used with nurses in Swedish elder care.

A Multisite Health System Survey to Assess Organizational Context to Support Evidence‐Based Practice

“…The ACT was selected by the R2P committee as the most appropriate measure of the organizational context and organizational environment. The ACT has been used in a variety of countries (e.g., Canada, Sweden, Germany, and Australia), populations (e.g., nurses, physicians, allied health professionals, specialists, healthcare aides, and managers), and settings (e.g., pediatric hospitals, acute care, residential long‐term care facilities, and community and home care settings), making it very applicable for use in this large multisite healthcare organization (Eldh, Ehrenberg, Squires, Estabrooks, & Wallin, ; Estabrooks, Squires, Hayduk, Cummings, & Norton, 2011; Hoben et al., ; Squires et al., ).…”

The psychometric testing of the Nursing Teamwork Survey in Iceland

“…The unit of analysis in this study is the individual participant. Acceptability, an indication of ease of use measured by frequency of missing data, was evaluated with the pilot study data and the national study data. Reliability testing of the NTS‐Icelandic included test–retest of the pilot study data and a Cronbach's alpha coefficient calculation for the total scale, as well as for each of the five subscales for the pilot study and the national study data.…”

Context, complexity and process in the implementation of evidence-based innovation: a realist informed review

“…To achieve optimum innovation adoption establishing a context that values evidence in guiding practice was recommended [12,29,40]. Context was most often conceptualized as a modifiable, although difficult to change [16,38,41,42]. Failure to address context was the most commonly cited consideration in implementations that failed to achieve the desired goals [35,43].…”

“…It has been endorsed as a central construct in conceptual frameworks for implementation such as the PARIHS framework [3]. Context includes the environment or setting in which the proposed innovation is implemented and characteristics associated with that practice setting [1,16]. There is no fully consolidated understanding of how contextual modifies or impacts implementation.…”