Systems antecedents for dissemination and implementation: a review and analysis of measures

Abstract

There is a growing emphasis on the role of organizations as settings for dissemination and implementation. Only recently has the field begun to consider features of organizations that affect dissemination and implementation of evidence-based interventions. This manuscript identifies and evaluates available measures for five key organizational-level constructs: (a) leadership, (b) vision, (c) managerial relations, (d) climate, and (e) absorptive capacity. Overall the picture was the same across the five constructs--no measure was used in more than one study, many studies did not report the psychometric properties of the measures, some assessments were based on a single response per unit, and the level of the instrument and analysis did not always match. One must seriously consider the development and evaluation of a robust set of measures that will serve as the basis of building the field, allow for comparisons across organizational types and intervention topics, and allow a robust area of dissemination and implementation research to develop.

Figures

Figure 1

Conceptual Model for Considering the Determinants of Diffusion, Dissemination, and Implementation of Innovations in Health Service Delivery and Organization, Based on a Systematic Review of Empirical Research Studies 2004 Wiley. Used with permission from Greenhalgh, Diffusion of Innovations in Service Organizations: Systematic Review and Recommendations, The Milbank Quarterly, Blackwell Publishing.