Research and Models for Measuring Readiness

Scales to Measure Readiness

Some researchers are developing scales to measure “readiness” of practitioners. For example, Aarons (2004) has developed the “Evidence-based Practice Attitude Scale” to measure mental health provider attitudes toward adopting evidence-based practices and programs. The 18-item scale was developed from the literature, consultation with providers, and researchers with experience implementing evidence-based practices and programs. The items assess the appeal of evidence-based programs, requirements for using evidence-based practices and programs, openness to innovation, and perceived divergence of evidence-based practices and programs from usual practice. Clinical and case management service providers from 51 programs were surveyed and the results demonstrated good internal consistency and reliability.

Scales to measure organizational readiness also are being developed (Lehman, Greener, & Simpson, 2002; Simpson, 2002). Items on the Organizational Readiness to Change scale ask questions about motivational readiness (need for improvement, training needs, pressure to change), institutional resources (space, staffing, training, computers, e-communication), staff attributes (growth, efficacy, influence, adaptability), and organizational climate (clarity of mission and goals, cohesiveness, autonomy, openness to communication, stress, openness to change). Data collected from treatment staff in over 100 organizations support the construct validity of the scales.

Measuring Readiness at the Community Level

A model for measuring readiness at the community level also has been developed. Many of the readiness concepts found in the literature were included in a Community Readiness Model developed by Edwards, Jumper-Thurman, Plested, Oetting, & Swanson (2000). In this model, assessment of the stage of readiness is done through key informant interviews, with questions on six different dimensions related to a community’s readiness to mobilize to address a specific issue. Based on experiences in working directly with communities, strategies for improving community readiness have been developed for each stage. Teams of community members can use the strategies as a guide to develop specific, culturally appropriate efforts that use local resources to help the community to more advanced levels of readiness. Edwards et al. (2000) identified several stages of community readiness (some actions recommended by the authors to improve community readiness are provided in parentheses):

  • No awareness: not a problem, just the way it is. (Actions: Raise awareness of the issue via one-on-one visits with community leaders and members, visits with existing and established small groups to inform them of the issue, and one-on-one phone calls to friends and potential supporters.)
  • Denial: some recognition of the problem but it is confined to a small group, we are helpless anyway.
  • Vague awareness: some recognition, some notion of doing something, no clarity.
  • Preplanning: clear recognition of a problem, something needs to be done, leaders emerge, but no specifics yet. (Actions: Raise awareness with concrete ideas to combat the problem by introducing information about the issue through presentations and media, visiting and developing support in the cause by community leaders, reviewing existing efforts in community (programs, activities, etc.) to determine who benefits and what the degree of success has been, and conducting local focus groups to discuss issues and develop strategies).
  • Preparation: active planning with a focus on details, leadership is active, resources are being assessed and expanded.
  • Initiation: enough preparation has been done to justify efforts, policies and actions are underway and still seen as new, enthusiasm is high and problems (so far) are few.
  • Stabilization: programs are up and running with support from administrators and community leaders, staff have been trained and are experienced, limitations have been encountered and resistance overcome.
  • The Community Readiness Model has been used by researchers to help match communities in preparation for experimental analyses of prevention programs (Edwards et al., 2000). However, no psychometric testing was reported.

Summary

In summary, community obviously is important to implementation and researchers are beginning the process of developing measures of community involvement in planning and implementing programs and practices. Advice from those engaged in implementation efforts emphasize the need for members of a community to recognize its assets and needs, select interventions and services, build support and buy in, retain a monitoring function, and help to assure long-term sustainability of useful services. “Readiness” to implement new practices and programs has intuitive appeal but there is scant research evidence to support the idea of “readiness” at any level (practitioner, organization, community).

While the developers of the various scales have assessed the reliability and construct validity of their measures of readiness, so far there has been no assessment of predictive validity. Thus, the relationship between measures of readiness and later implementation success is unknown. However, future research should be aided by including measures of readiness. The next step is to conduct research to determine the ways in which aspects of community or organizational preparation are related to later implementation success.