Good soldiers in implementation: validation of the Implementation Citizenship Behavior Scale and its relation to implementation leadership and intentions to use evidence-based practices

Randi Hovden Borge, Ane-Marthe Solheim Skar, Mathilde Endsjø, Karina M Egeland, Randi Hovden Borge, Ane-Marthe Solheim Skar, Mathilde Endsjø, Karina M Egeland

Abstract

Background: Implementation citizenship behavior (ICB) describes extra-role behaviors performed by employees to support evidence-based practice (EBP) implementation. Such behaviors can be measured using the Implementation Citizenship Behavior Scale (ICBS), which divides ICB into two dimensions, namely helping others and keeping informed. The current study extends the use of the ICBS to a context outside the USA and adds to the literature by investigating how leader-perceived ICB relates to practitioner-perceived implementation leadership and practitioners' intentions to use EBPs.

Methods: Participants were 42 leaders and 152 practitioners in Norwegian mental health services implementing EBPs for post-traumatic stress disorder. Leaders rated each practitioner on ICB, and each practitioner rated their leader on implementation leadership and reported on their own intentions to use EBPs. The psychometric properties of the ICBS were assessed using confirmatory factor analysis and internal consistency reliabilities. The relationships between ICB, implementation leadership and intentions to use EBPs, were investigated through a series of bivariate correlation analyses and a path analysis of the total scales.

Results: The ICBS showed excellent psychometric properties. The hypothesized two-factor model provided an excellent fit to the data, and both subscales and the total scale were internally reliable. Leader-perceived ICB was positively and significantly correlated with both practitioner-perceived implementation leadership and practitioners' intentions to use EBPs. Correlations with intentions to use EBPs were stronger for the subscale of keeping informed than for the subscale of helping others.

Conclusions: Results indicated that practitioners who rated their leader higher on implementation leadership received higher ICB ratings from their leader and reported higher intentions to use EBPs. The results provide evidence of a reciprocal social exchange relationship between leaders and practitioners during EBP implementation and a link to an important proximal implementation outcome (i.e., intentions to use EBPs). Results also suggest cultural differences in how ICB is perceived and relates to other phenomena. Scientific and practical implications are discussed.

Trial registration: Retrospectively registered in ClinicalTrials with ID NCT03719651 .

Keywords: Evidence-based practice; Implementation citizenship behavior; Implementation leadership; Mental health services.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2021. The Author(s).

Figures

Fig. 1
Fig. 1
Path analysis. Note. N=109. **p < .01; *p < .05; †p < .10

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