Measuring implementation climate: psychometric properties of the Implementation Climate Scale (ICS) in Norwegian mental health care services

BackgroundEmployees’ perceptions of organizational climate for implementation of new methods are important in assessing and planning for implementation efforts. More specifically, feedback from employees’ points to which implementation strategies to select, adopt, and tailor in building positive climate for implementation of new evidence-based practices within the organization. Implementation climate can be measured with the Implementation Climate Scale (ICS). The purpose of this study was to investigate the psychometric properties of the Norwegian version of the ICS in outpatient mental health clinics.MethodsThe ICS was administered to 383 clinicians within 47 different child and adult mental health clinics across the country. We conducted confirmatory factor analysis to assess the psychometric functioning of the ICS. Cronbach’s alpha was examined to assess internal consistency. We also examined criterion related validity of the scale by comparing it with an alternative measure of implementation climate (concurrent validity) and by examining correlations with clinicians’ intentions to use evidence-based practices.ResultsResults supported the 6-factor structure and the internal consistency reliability of the ICS. One exception was poor functioning of the Reward scale. Concurrent validity was stronger at the group than at the individual level, and assessment of associations with clinicians’ intentions to use evidence- based practices showed positive correlations.ConclusionsThe Norwegian version of the ICS is a promising tool for assessing implementation climate which can provide organizations with specific feedback concerning which aspects of the implementation climate to attend to. Due to poor functioning of the Reward scale, adaptations and further testing of this is recommended.

Psychometric Properties of a Norwegian Version of the Social Emotional Assets and Resilience Scales–Child–Short Form

Norwegian schools are obliged to develop students’ social competences. Programs used are School-Wide Positive Behavioral Interventions and Supports (PBIS) or classroom-based aimed to teach students social-emotional ( Social and Emotional Learning [SEL]) skills in a broad sense. Some rating scales have been used to assess the effect of SEL programs on SEL skills. We explored the Norwegian version of the 12-item Social Emotional Assets and Resilience Scales–Child–Short Form (SEARS-C-SF). An exploratory factor analysis (EFA) was performed, proposing a one-factor solution which was confirmed by a confirmatory factor analysis (CFA). The scale reliability of .84 (λ2), means and standard deviations, as well as Tier levels were compared with the original short form. Finally, concurrent, discriminant, and convergent validity with different Strengths and Difficulties Questionnaire (SDQ) subscales were shown.

Translation and validation of the Alberta Context Tool for use in Norwegian nursing homes

Purpose Organizational context is recognized as important for facilitating evidence-based practice and improving patient outcomes. Organizational context is a complex construct to measure and appropriate instruments that can quantify and measure context are needed. The aim of this study was to translate and cross-culturally adapt the Alberta Context Tool (ACT) to Norwegian, and to test the reliability and structural validity among registered nurses (RNs) and licenced practice nurses (LPNs) working in nursing homes. Methods This study was a validation study utilizing a cross-sectional design. The sample consisted of n = 956 healthcare personnel from 28 nursing homes from a municipality in Norway. In the first stage, the ACT was translated before being administered in 28 nursing homes. In the second stage, internal consistency and structural validity were explored using Cronbach’s alpha and confirmatory factor analysis. Results A rigorous forward-and-back translation process was performed including a team of academics, experts, professional translators and the copyright holders, before an acceptable version of the ACT was piloted and finalized. The Norwegian version of the ACT showed good internal consistency with Chronbachs alpha above .75 for all concepts except for Formal interactions where the alpha was .69. Structural validity was acceptable for both RNs and LPNs with factors loadings more than .4 for most items. Conclusions The Norwegian version of the ACT is a valid measure of organizational context in Norwegian nursing homes among RNs and LPNs.

Validity and reliability of the Norwegian version of the Musculoskeletal Health Questionnaire in people on sick leave

Background The Musculoskeletal Health Questionnaire (MSK-HQ) is a recently developed generic questionnaire that consists of 14 items assessing health status in people with musculoskeletal disorders. The objective was to translate and cross-culturally adapt the MSK-HQ into Norwegian and to examine its construct validity and reliability in people on sick leave with musculoskeletal disorders. Methods A prospective cohort study was carried out in Norway on people between 18 and 67 years of age and sick leave due to a musculoskeletal disorder. The participants were recruited through the Norwegian Labour and Welfare Administration during November 2018–January 2019 and responded to the MSK-HQ at inclusion and after four weeks. Internal consistency was assessed by Cronbach’s alpha, and structural validity with a factor analysis. Construct validity was assessed by eight “a priori” defined hypotheses regarding correlations between the MSK-HQ and other reference scales. Correlations were analyzed by Spearman’s- or Pearson’s correlation coefficient and interpreted as high with values ≥ 0.50, moderate between 0.30–0.49, and low < 0.29. Reliability was tested with test–retest, standard error of measurement (SEM) and smallest detectable change (SDC). Results A total of 549 patients, mean age (SD) 48.6 (10.7), 309 women (56.3%), were included. The mean (SD) MSK-HQ sum scores (min–max 3–56) were 27.7 (8.2). Internal consistency was 0.86 and a three-factor structure was determined by factor analysis. Construct validity was supported by the confirmation of all hypotheses; high correlation with HRQOL, psychosocial risk profile, and self-perceived health; moderate correlation with physical activity, self-perceived work ability, and work presenteeism; and low correlation with the number of sick days. The test–retest reliability was good with an intraclass correlation coefficient of 0.83 (95% CI, 0.74–0.89), SEM was 2.3 and SDC 6.5. Conclusions The Norwegian version of the MSK-HQ demonstrated high internal consistency, a three-factor structure, good construct validity and good test–retest reliability when used among people on sick leave due to musculoskeletal disorders.

Psychometric properties of the PROMIS-57 questionnaire, Norwegian version

Purpose The aims of this cross-sectional study were to explore reliability and validity of the Norwegian version of the Patient-Reported Outcome Measurement System®—Profile 57 (PROMIS-57) questionnaire in a general population sample, n = 408, and to examine Item Response properties and factor structure. Methods Reliability measures were obtained from factor analysis and item response theory (IRT) methods. Correlations between PROMIS-57 and RAND-36-item health survey (RAND36) were examined for concurrent and discriminant validity. Factor structure and IRT assumptions were examined with factor analysis methods. IRT Item and model fit and graphic plots were inspected, and differential item functioning (DIF) for language, age, gender, and education level were examined. Results PROMIS-57 demonstrated excellent reliability and satisfactory concurrent and discriminant validity. Factor structure of seven domains was supported. IRT assumptions were met for unidimensionality, local independence, monotonicity, and invariance with no DIF of consequence for language or age groups. Estimated common variance (ECV) per domain and confirmatory factor analysis (CFA) model fit supported unidimensionality for all seven domains. The GRM IRT Model demonstrates acceptable model fit. Conclusions The psychometric properties and factor structure of Norwegian PROMIS-57 were satisfactory. Hence, the 57-item questionnaire along with PROMIS-29, and the corresponding 8 and 4 item short forms for physical function, anxiety, depression, fatigue, sleep disturbance, social participation ability and pain interference, are considered suitable for use in research and clinical care in Norwegian populations. Further studies on longitudinal reliability and sensitivity in patient populations and for Norwegian item calibration and/or reference scores are needed.

‘Northern, not Nordic noir’: A Norwegian case study on crime series and strategies for transnational television

This article discusses transnational television and what strategies public service broadcaster NRK Drama has pursued to make the Norwegian crime series Monster: Brutally Far North travel. Monster was the first Norwegian-language television series bought by a major American cable network, Starz. Using the concept of production values, we argue that NRK has made a series that is able to ride the Nordic noir wave of success while also offering a new northern Norwegian version of the western. These two factors made Monster a good fit for the American market. The series is a result of strategic changes within NRK Drama and a commitment to the private and regional film business. Furthermore, NRK views drama productions as key for reaching audiences and has increased their budgets significantly. The analysis encompasses the industry context, media articles, the ‘North’ as location, the series itself and interviews with important stakeholders.

Traumeinstrumentet Maltreatment and Abuse Chronology of Exposure scale (MACE)

The Maltreatment and Abuse Chronology of Exposure scale (MACE) trauma questionnaire Background: A 55-item Norwegian version of the Maltreatment and Abuse Chronology of Exposure (MACE) scale was recently developed. For clinicians to apply MACE, they need to perceive the instrument as acceptable to patients and useful. We investigated clinicians’ experiences and views of the acceptability, usefulness and application of MACE. Method: Twenty-three clinicians recorded their perceptions of how unpleasant it was for 84 adult patients to complete MACE, 20 clinicians answered a survey about MACE, and eight clinicians attended focus group interviews to detail their experiences and views. Results: According to the clinicians, the MACE form was sufficiently self-explanatory to function as a questionnaire. Clinicians considered MACE as emotionally tolerable for most patients. They reported that some patients had strong negative reactions but that these patients did not regret participating. The majority of clinicians found MACE to be useful. Based on their experiences, they proposed ways of utilising MACE in clinical practice. Conclusion: MACE appears applicable and useful to clinicians in an outpatient setting. Possible negative patient reactions should be taken into account when administering the instrument. Keywords: MACE; trauma instrument; clinicians’ perceptions; acceptability, usefulness, application

Rasch Analysis of the Norwegian Version of the Occupational Balance Questionnaire in a Sample of Occupational Therapy Students

Background. Recently, the Occupational Balance Questionnaire developed in Sweden was translated into Norwegian. No studies to date have examined the measurement properties of the Norwegian version of this questionnaire. Aim. The study is aimed at examining the psychometric properties of the Norwegian version of the Occupational Balance Questionnaire, the OBQ11-N. Methods. Along with sociodemographic data, 180 occupational therapy students enrolled at two Norwegian universities completed the OBQ11-N as well as one question each related to health and quality of life and some sociodemographic variables. Rasch analysis was employed for examining rating scale functioning, item and person validity, dimensionality, and differential item functioning. Results. Item categories were ordered, but there were potential gaps in the measurement of the construct. Person reliability was fair, whereas item reliability was low. Point biserial correlations were positive, indicating that all items contributed to the construct. Factor loadings were low for two items, and there were indices of a second underlying dimension and item redundancy. Many people were not aligned with the items, and some items functioned differently across various demographic variables. Conclusion and Significance. The OBQ11-N did not function as an adequate measure of occupational balance in a sample of students. Potentially, the detected measurement problems may be solved by adding more relevant items to a larger item pool, from which the best fitting items should be selected.