Measuring Organizational Readiness for Change in Michigan’s Home and Community-based Services Program: Instrument Adaptation and Psychometric Testing

ABSTRACT

Short, valid, and reliable tools that measure organizational readiness are needed in practice. This study adapted and tested a previously developed instrument for measuring organizational readiness in a Medicaid Home and Community-Based Services (HCBS) program. The Texas Christian University Organizational Readiness for Change (TCU-ORC) scale was adapted and tested for validity and reliability in a sample of 522 registered nurses and social workers employed at 18 program sites. Structural validity was established using the exploratory factor analysis. Convergent validity was evaluated via correlations with the Implementation Leadership Scale (ILS) score. The adapted ORC scale consisted of 23 items. Cronbach’s alphas for 5 subscales, Climate, Culture, Training, Motivation, and Pressure to Change exceeded .70. Convergent validity was supported by significant moderate correlations with the ILS. The adapted 23-item TCU-ORC scale is a valid and reliable instrument for measuring the organizational readiness for change in the Medicaid Home and Community-Based Services programs.

KEYWORDS:

• Certification
• clinician
• factor analysis
• home and community based waiver
• implementation
• training

Disclosure statement

No potential conflict of interest was reported by the author(s).

Trial registration

ClinicalTrials.gov NCT03634033. Registered 16 August 2018. https://clinicaltrials.gov/ct2/show/NCT03634033

Additional information

Funding

The study is funded by National Institutes of Aging 1 R15 AG058193-01A1 (9/1/2018 to 8/30/2021). MI-Community Aging in Place, Advancing Better Living for Elders Agreement# E20200657-00; to Delaying or Preventing Nursing Home Placement in the Home and Community Based Waiver Program in the State of Michigan, A Medicaid Demonstration Match Grant.