Climate for evidence-based mental health care implementation in Germany: psychometric investigation of the Implementation Climate Scale (ICS)

Abstract

Organizational implementation climate is an important construct in implementation research to describe to what extent implementation is expected, supported, and rewarded. Efforts in bridging the research-practice gap by implementing evidence-based practice (EBP) can benefit from consideration of implementation climate. The Implementation Climate Scale (ICS) is a psychometrically strong measure assessing employees’ perceptions of the implementation climate. The present cross-sectional study aimed at providing a German translation and investigating its psychometric properties. The translation followed standard procedures for adapting psychometric instruments. German psychotherapists (N = 425) recruited online completed the ICS, the Evidence Based Practice Attitudes Scale (EBPAS-36D) and the Intention Scale for Providers (ISP). We conducted standard item and reliability analyses. Factorial validity was assessed by comparing an independent cluster model of Confirmatory Factorial Analysis (ICM-CFA), a Bifactor CFA, a Second-order CFA and an (Bifactor) Exploratory Structural Equation Model (ESEM). Measurement invariance was tested using multiple-group CFA and ESEM, convergent validity with correlation analysis between the ICS and the ISP subjective norms subscale (ISP-D-SN). The mean item difficulty was pi = .47, mean inter-item correlation r = .34, and mean item-total correlation ritc = .55. The total scale (ω = 0.91) and the subscales (ω = .79–.92) showed acceptable to high internal consistencies. The model fit indices were comparable and acceptable (Second-order CFA: RMSEA [90% CI] = .077 [.069; .085], SRMR = .078, CFI = .93). Multiple-group CFA and ESEM indicated scalar measurement invariance across gender and presence of a psychotherapy license. Psychotherapists in training reported higher educational support for EBP than licensed psychotherapists (T = 2.09, p = .037, d = 0.25). The expected high correlation between the ICS and the ISP-D-SN was found (r = .59, p < .001). Results for the German ICS confirm good psychometric properties including validity.

Climates and associated factors for evidence-based practice implementation among nurses: a cross-sectional study

“…Considering the limited availability of research results on ICS scores, conducting multiple comparisons becomes challenging. Indeed, higher scores indicate a more favorable rating of the organizations’ implementation climate [ 17 ]. From the present research findings of this study, it can be inferred that the participating nurses exhibit a strong sense of climate and organizational identity when it comes to evidence-based nursing practice.…”

“…This can be achieved by actively enhancing key internal factors influencing EBP implementation (i.e., the organizational implementation environment) [ 8 ], such as resources and policy support (performance incentives, training policies, etc.). Consequently, this can further enhance the implementation and compliance of clinical nurses with EBP [ 26 , 27 ], provide them with a more positive implementation attitude [ 17 , 28 ], and perpetuate a positive incentive.…”

Climates and associated factors for evidence-based practice implementation among nurses: A cross-sectional study

“…Given the limited availability of research results on ICS scores, conducting multiple comparisons becomes challenging. Indeed, Higher scores indicate a more favorable rating of the organizations' implementation climate [17] . Based on the current research results of this study, it can be inferred that the nurses involved in this study possess a strong sense of climate and organizational identity when it comes to evidence-based nursing practice.…”

“…The results of this study emphasized that the organizational level should pay attention to employees' perceptions of the importance of innovation implementation within the organization, and pay attention to and continuously meet nurses' expectations, rewards and support for the organization in the application and implementation of EBP by actively improving the key internal factors that affect the implementation of EBP ( i.e., the organizational implementation environment ) [8] , such as resources and policy support (performance incentives, training policies, etc.). Thus, further improve the implementation and compliance of clinical nurses for EBP [26,27] , and can provide them with a more positive implementation attitude [17,28] , and continue to form a positive incentive.…”