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Table 3 Quantitative clinician measures: potential contextual mediators

From: Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol

Construct Description Time point (month)
0 5 15
Demographics An adapted 16-item version of the one developed by Lewis & Simons (2011) to assess clinician demographic information (e.g., age, gender, ethnicity) as well as training (e.g., degree level, measurement-based care training) and treatment (e.g., theoretical orientation, caseload) information X   
Norms A 6-item measure of subjective (3 items) and descriptive (3 items) norms developed based on the guidelines and considerations put forth by theory of planned behavior measurement development manuals (Azjen, 2006; Francis et al., 2004) X X X
Attitudes Monitoring and Feedback Attitudes Scale (MFA; Jensen-Doss, Becker, Smith, Lyon, Lewis, Stanick, & Hawley, in prep) is a 17-item measure of clinician’s attitudes about “‘routine’ progress monitoring and providing feedback to clients about treatment progress.” It has demonstrated good internal consistency and consists of three scales: MFA Benefit, MFA Harm, and MFA Trust X X X
Evidence-based practices attitudes scale (EBPAS; Aarons, 2004) is a 15-item measure of clinician’s attitudes toward adopting evidence-based practices, consisting of one total score and four scales: Appeal, Requirements, Openness, and Divergence. It has demonstrated good psychometrics, displaying good internal consistency (Aarons, 2004; Aarons et al., 2007) and construct and convergent validity (e.g., Aarons et al., 2007; Aarons, 2004; Aarons & Sawitzkey, 2006; Aarons, 2006) X X X
Culture & Climate Survey of Organizational Functioning (TCU SOF; Broome et al., 2007) is 162-item measure of an organization’s resources, job attitudes, readiness to change, workplace practices, climate, and training exposure and utilization. The SOF is comprised of 32 scales, which includes 23 scales from the Organizational Readiness for Change (ORC; Lehman et al., 2002) measure and nine additional scales measuring workplace practice and job attitudes, with all of these scales demonstrating acceptable psychometrics (e.g., Broome et al., 2007; Broome et al., 2009; Lehman et al., 2002). X X X
Implementation Climate Scale (ICS; Ehrhart, Aarons, & Farahnak, 2014) is an 18-item measure assessing a clinician’s perception of the strategic climate of the organization, specifically the facets of the organizational climate that are essential for successful implementation of EBPs. It consists of a total score and six factors: Selection for openness, Recognition for EBP, Selection for EBP, Focus on EBP, Educational Support for EBP, and Rewards for EBP. It has displayed sound psychometrics, including good to excellent internal consistency and construct-based evidence of validity (Ehrhart et al., 2014) X X X
Structure and process Barriers and Facilitators to Implementing survey (Salyers, Rollins, McGuire, & Gearhart, 2009) is a 21-item measure of the potential barriers and facilitators to implementing an innovation. It contains a total facilitator score and three subscales: Agency leadership support, Program-level structures, and Job-related structural supports with two open-ended questions: “What facilitated/helped you provide MBC?” and “What were the challenges/barriers to providing MBC?” The measure has demonstrated excellent internal consistency across the three subscales (Salyers et al., 2009) X X X
Clinic Systems Project (CSP) Director Survey (Schoenwald, Kelleher, Hoagwood, Landsverk, & Glisson, 2003) is a structured interview that will be reduced and adapted for relevance to the study and conducted with the clinic directors of each site and the executive director. This survey assesses the infrastructure of the organization and sites, such as staffing, turnover, supervision, services, and previous implementation practices, and financing. The CSP Director Survey interview also includes 21-items from the Dimensions of Organizational Readiness-Revised (DOOR-R; K. Hoagwood et al., 2003), which asks the director to rate the domains or factors (e.g., management support, treatment fit or match with the organization’s mission) s/he perceives to be critical for successful implementation of new treatments and services X   
Policies and incentives Qualitative Focus Groups will be used to explore the domain of Policies and Incentives (see Additional file 2), as no quantitative measures exist X X X
Resources Survey of Organizational Functioning (TCU SOF; Broome et al., 2007)’s Resources scale is a 25-item scale from the SOF. The scale has five subscales: Offices, Staffing, Training, Computer Access, and e-Communications X X X
Networks and linkages Sociometric Questionnaire (Valente et al., 2007) is a 3-item sociometric questionnaire that will be given to identify professional, personal, and advice relations among staff (Valente, Chou, & Pentz, 2007) and calculate the density and centrality of the network. The three questions will include: a) “Which clinician is a colleague you go to as a source of information on client care-related matters;” b) “Which clinician is a colleague with whom you discuss you clinical work;” and c) “Which clinician is a colleague with whom you are friends?” The questionnaire will be paired with an alphabetized roster of all of the clinicians at each site, in which the respondent designates his or her relationship with each individual. An adjacency matrix will be used to record information about the relationships or ties between each pair of clinicians (Wasserman & Faust, 1994). This information will then be entered into social network analysis software , which will allow for measurement of network metrics, in particular centrality and density X X X
Media and change agents Opinion Leadership Scale (OLS; Childers, 1986) is a 6-item opinion leader self-identification scale that will be employed to identify clinician opinion leaders who may serve as influential change agents. The six items were adapted for relevance to clinical work and rated by clinicians. It has demonstrated good internal consistency and validity (Childers, 1986) X X X
Qualitative Focus Groups will be used to collect information on internal and external media influence since no quantitative measures currently exits to examine these constructs X X X