Development and testing of the Context Assessment Index (CAI)

Area of Science:

• Health Services Research
• Nursing Research
• Psychometrics

Background:

• The Promoting Action on Research Implementation in Health Services (PARIHS) framework highlights context as crucial for evidence implementation.
• A comprehensive tool for assessing healthcare context quality was previously unavailable.
• Understanding context is vital for bridging the gap between research evidence and clinical practice.

Purpose of the Study:

• To develop and validate the psychometric properties of the Context Assessment Index (CAI).
• To create a reliable instrument for evaluating the contextual factors influencing evidence-based practice.

Main Methods:

• A five-stage methodology including principal components analysis, exploratory factor analysis, and expert feedback was employed.
• The Context Assessment Index (CAI) was refined into a 37-item, five-factor model.
• Psychometric testing included internal consistency (Cronbach's alpha) and test-retest reliability, alongside usability assessments via interviews with expert nurses.

Main Results:

• The 37-item, five-factor CAI model demonstrated a good fit with the data.
• High internal consistency was found, with a Cronbach's alpha of 0.93 for the total scale and scores ranging from 0.78 to 0.91 for individual factors.
• Test-retest scores confirmed the reliability of the CAI, and expert feedback indicated practical utility for clinical settings.

Conclusions:

• The Context Assessment Index (CAI) is a psychometrically sound instrument for assessing healthcare contexts.
• The CAI empowers clinicians to evaluate their work environment and its impact on the utilization of evidence in practice.
• This tool facilitates a deeper understanding of contextual facilitators and barriers to implementing evidence-based practices.