Table 3 Means (standard deviations), ICCs, and standardized factor loadings (standard error) for level 1 and level 2
Item | N | M (SD) | ICC | Adjusted loadings | L1 | L2 | |
|---|---|---|---|---|---|---|---|
Culture | |||||||
 A03 | People at all levels openly talk about what is and isn’t working | 327 | 3.66 (1.02) | 0.15 | 0.668 (0.052) | 0.666 (0.069) | 0.728 (0.284) |
 A05 | Most people in this clinic are willing to change how they do things in response to feedback from others | 327 | 3.57 (0.98) | 0.09 | 0.735 (0.036) | 0.705 (0.048) | 0.967 (0.092) |
 A16* | It is hard to get things to change in our clinic | 322 | 3.11 (1.08) | 0.10 | 0.521 (0.083) | 0.452 (0.108) | 0.994 (2.54) |
 A07 | I can rely on the other people in this clinic to do their jobs well | 323 | 3.62 (0.92) | 0.10 | 0.671 (0.038) | 0.626 (0.044) | 0.983 (0.253) |
 A22 | Most of the people who work in our clinic seem to enjoy their work | 323 | 3.68 (0.86) | 0.17 | 0.705 (0.046) | 0.636 (0.051) | 0.996 (0.177) |
 A08 | Difficult problems are solved through face-to-face discussions | 323 | 3.54 (0.96) | 0.11 | 0.686 (0.048) | 0.720 (0.044) | 0.572 (0.418) |
 A09 | We regularly take time to reflect on who we do things | 323 | 3.64 (0.91) | 0.11 | 0.723 (0.032) | 0.731 (0.043) | 0.992 (0.542) |
 A10 | After trying something new, we take time to think about how it worked | 323 | 3.65 (0.92) | 0.10 | 0.729 (0.040) | 0.777 (0.040) | 0.870 (0.306) |
 A21 | People in this clinic operate as a real team | 322 | 3.57 (1.02) | 0.15 | 0.762 (0.033) | 0.700 (0.029) | 0.997 (0.274) |
Culture Stress | |||||||
 A36 | I am under too many pressures to do my job effectively | 317 | 2.84 (1.08) | 0.06 | 0.626 (0.087) | 0.635 (0.102) | 0.999 (0.001) |
 A37 | Staff members often show signs of stress and strain | 317 | 3.57 (0.99) | 0.07 | 0.767 (0.041) | 0.833 (0.038) | 0.150 (12.36) |
 A38 | The heavy workload here reduces program effectiveness | 317 | 3.19 (1.03) | 0.10 | 0.847 (0.072) | 0.813 (0.042) | 0.988 (1.573) |
 A39 | Staff frustration is common here | 317 | 3.44 (1.06) | 0.12 | 0.765 (0.052) | 0.859 (0.020) | −0.771 (4.552) |
Culture Effort | |||||||
 A40 | People in this clinic always want to preform to the best of their abilities | 317 | 4.02 (0.86) | 0.12 | 0.695 (0.053) | 0.637 (0.061) | 0.999 (0.166) |
 A41 | People are enthusiastic about their work | 317 | 3.51 (0.83) | 0.11 | 0.563 (0.060) | 0.495 (0.061) | 0.964 (0.123) |
 A42* | People in our clinic get by with doing as little as possible | 317 | 3.57 (1.05) | 0.24 | 0.546 (0.062) | 0.434 (0.078) | 0.916 (0.088) |
 A43 | People are prepared to make a special effort to do a good job | 317 | 3.85 (0.76) | 0.18 | 0.858 (0.041) | 0.839 (0.048) | 0.981 (0.087) |
 A44* | People in this clinic do no put more effort into their work than they have to | 317 | 3.38 (1.02) | 0.12 | 0.560 (0.058) | 0.500 (0.078) | 0.896 (0.099) |
Implementation Climate | |||||||
 C11 | Clinic staff are expected to help the <EBA> meet its goal (i.e., increase colorectal cancer screening rates) | 259 | 3.85 (0.81) | 0.28 | 0.535 (0.072) | 0.473 (0.083) | 0.754 (0.103) |
 C12 | Clinic staff gets the support they need to implement <EBA> | 259 | 3.40 (0.89) | 0.20 | 0.879 (0.047) | 0.844 (0.064) | 0.982 (0.088) |
 C13 | Clinic staff gets recognition for implementing <EBA> to increase colorectal cancer screening rates | 259 | 2.98 (1.01) | 0.09 | 0.708 (0.045) | 0.685 (0.050) | 0.992 (0.292) |
 C05 | <EBA> to increase colorectal cancer screening rates is a top priority of the clinic | 260 | 3.51 (0.91) | 0.09 | 0.408 (0.088) | 0.331 (0.091) | 0.959 (0.491) |
Learning Climate | |||||||
 A01 | We regularly take time to consider ways to improve how we do things | 327 | 4.09 (0.88) | 0.14 | 0.799 (0.045) | 0.864 (0.030) | 1.000 (0.000) |
 A02 | People in our clinic actively seek new ways to improve how we do things | 327 | 4.00 (0.89) | 0.12 | 0.752 (0.043) | 0.822 (0.040) | 0.982 (0.082) |
 A06 | This clinic encourages everyone to share ideas | 327 | 3.86 (1.00) | 0.17 | 0.829 (0.038) | 0.722 (0.042) | 0.946 (0.067) |
 A15 | This clinic learns from its mistakes | 322 | 3.71 (0.97) | 0.16 | 0.600 (0.059) | 0.501 (0.070) | 0.804 (0.107) |
 A19 | When we experience a problem in the clinic, we make a serious effort to figure out what’s really going on | 322 | 3.86 (0.90) | 0.13 | 0.610 (0.064) | 0.530 (0.061) | 0.908 (0.101) |
Leadership Engagement | |||||||
 A11 | The clinic leadership makes sure that we have the time and space necessary to discuss changes to improve care | 323 | 3.44 (1.12) | 0.17 | 0.788 (0.033) | 0.791 (0.038) | 0.983 (0.039) |
 A12 | Leadership in this clinic creates an environment where things can be accomplished | 323 | 3.54 (1.08) | 0.11 | 0.894 (0.020) | 0.918 (0.019) | 0.996 (0.108) |
 A13 | Clinic leadership promotes an environment that is an enjoyable place to work | 322 | 3.59 (1.06) | 0.18 | 0.851 (0.034) | 0.800 (0.042) | 0.997 (0.062) |
 A14 | Leadership strongly supports clinic change efforts | 322 | 3.68 (1.01) | 0.17 | 0.882 (0.023) | 0.847 (0.029) | 0.928 (0.067) |
Available Resources | |||||||
 A35a | In general, when there is agreement that change needs to happen in the clinic we have the necessary support in terms of: budget or financial resources | 317 | 3.13 (1.02) | 0.09 | 0.330 (0.072) | 0.340 (0.080) | 0.310 (0.156) |
 A35b | In general, when there is agreement that change needs to happen in the clinic we have the necessary support in terms of: training | 317 | 3.39 (0.99) | 0.13 | 0.421 (0.069) | 0.424 (0.074) | 0.407 (0.214) |
 A35c | In general, when there is agreement that change needs to happen in the clinic we have the necessary support in terms of: staffing | 317 | 3.13 (1.04) | 0.11 | 0.452 (0.067) | 0.451 (0.068) | 0.502 (0.263) |
 C20a | The following are available to make <EBA> work in our clinic: equipment and materials | 258 | 3.67 (0.88) | 0.12 | 0.698 (0.049) | 0.690 (0.054) | 0.882 (0.239) |
 C20b | The following are available to make <EBA> work in our clinic: patient awareness/need | 258 | 3.56 (0.87) | 0.04 | 0.805 (0.041) | 0.803 (0.052) | 0.857 (0.199) |
 C20c | The following are available to make <EBA> work in our clinic: provider buy-in | 258 | 3.40 (0.90) | 0.07 | 0.645 (0.073) | 0.634 (0.076) | 0.915 (0.558) |
 C20d | The following are available to make <EBA> work in our clinic: intervention team | 258 | 3.16 (0.96) | 0.10 | 0.711 (0.057) | 0.699 (0.056) | 0.947 (0.470) |