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Development of an Instrument to Assess the Perceived Effectiveness of Academic Detailing
Mary H Smart1, Andrea L Monteiro, Christopher D Saffore
1Dr. Smart, Ms. Monteiro, Dr. Saffore, Ms. Ruseva, Dr. Lee, Dr. Pickard: Department of Pharmacy Systems, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, Chicago, IL; and Dr. Fischer: Division of Pharmacoepidemiology and Pharmacoeconomics, National Resource Center for Academic Detailing, Brigham and Women's Hospital, Boston, MA.
Introduction:
Academic detailing (AD) is an effective, evidence-based education outreach method of promoting clinician behavior change. Detailer feedback is important for program evaluation but is rarely systematically collected. The study's objective was to develop a measure capturing the detailer's perception of the effectiveness of an AD program.
Methods:
A six-item measure with a five-level scale was initially developed from the literature review and expert panel consultation. Item constructs were usefulness, acceptability, feasibility, relevance, effectiveness of communication, and readiness to change. The measure was piloted, refined, and tested during an opioid-focused AD program that included two visits. The instrument structure was evaluated using exploratory factor analysis, measure reliability was assessed using item-item correlation (rho), corrected item-total correlation, Cronbach alpha (α), and item response theory.
Results:
The initial six-item instrument demonstrated unidimensionality. The Cronbach α for the measure was 0.74 (visit 1) and 0.79 (visit 2); one item (relevance) was redundant (α = 0.73 and 0.79 when deleted) and therefore dropped. Items related to usefulness, acceptability, and readiness to change displayed high item-item correlation (rho ≥ 0.50) and contributed the most information and seemed to operate as a single scale (ie, "likelihood to change") based on item response theory analysis. Items related to feasibility and communication were slightly different constructs and should be reported separately.
Discussion:
The five-item detailer assessment of visit effectiveness (the "DAVE") instrument provides a standardized approach to assess AD. Further study of its validity and broader use in other programs and educational outreach activities is encouraged.
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