Development of a pragmatic measure for the Practical, Robust Implementation and Sustainability Model

Area of Science:

• Implementation Science
• Health Services Research
• Psychometrics

Background:

• The Practical, Robust Implementation and Sustainability Model (PRISM) is a framework for program planning, implementation, and sustainment.
• Existing tools for assessing PRISM's contextual determinants are limited, necessitating new assessment methods.
• Effective implementation and sustainment of health programs require understanding multilevel contextual factors.

Purpose of the Study:

• To develop and evaluate the PRISM Contextual Survey Instrument (PCSI) for assessing implementation.
• To determine the psychometric and pragmatic properties of the PCSI.
• To demonstrate the PCSI's utility in informing healthcare implementation and sustainment strategies.

Main Methods:

• A 29-item survey (PCSI) was developed using existing questions, expert feedback, and pilot testing.
• The PCSI includes 3-6 items per PRISM context domain, rated on a 5-point Likert scale.
• Concurrent validity was established by correlating PCSI scores with implementation outcomes (acceptability, feasibility, appropriateness).

Main Results:

• The PCSI demonstrated good psychometric properties, with internal consistency for subscales ranging from 0.53 to 0.82.
• Concurrent validity was strong, with correlations for feasibility (r=0.70) and appropriateness (r=0.80).
• The survey averaged 14 minutes to complete, with pragmatic ratings indicating practical utility.

Conclusions:

• The PCSI is a psychometrically sound and pragmatic tool for assessing contextual determinants in implementation science.
• The PCSI can be used to tailor implementation efforts and improve program sustainment in healthcare settings.
• This instrument supports the application of the PRISM framework in diverse health contexts.