Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial

Frontiers in Public Health

Christian D. Helfrich¹  Austin Stapleton¹  Kristen Elizabeth Hammerback²  K. C. Gary Chan²  Amanda T. Parrish²  Bryan J. Weiner²  Peggy A. Hannon²  Marlana J. Kohn²  Jeffrey R. Harris²  Claire L. Allen²  Daron E. Ryan² 

[1] Department of Health Services, School of Public Health, University of Washington, Seattle, WA, United States;Health Promotion Research Center, A CDC Prevention Research Center, Department of Health Services, University of Washington, Seattle, WA, United States;Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, US Department of Veterans Affairs, Seattle, WA, United States;

关键词: readiness to change;    implementation;    change commitment;    change efficacy;    psychometric validation;    workplace health promotion;   

DOI  :  10.3389/fpubh.2018.00110

来源: DOAJ

【 摘 要 】

IntroductionOrganizational readiness to change may be a key determinant of implementation success and a mediator of the effectiveness of implementation interventions. If organizational readiness can be reliably and validly assessed at the outset of a change initiative, it could be used to assess the effectiveness of implementation-support activities by measuring changes in readiness factors over time.MethodsWe analyzed two waves of readiness-to-change survey data collected as part of a three-arm, randomized controlled trial to implement evidence-based health promotion practices in small worksites in low-wage industries. We measured five readiness factors: context (favorable broader conditions); change valence (valuing health promotion); information assessment (demands and resources to implement health promotion); change commitment (an intention to implement health promotion); and change efficacy (a belief in shared ability to implement health promotion). We expected commitment and efficacy to increase at intervention sites along with their self-reported effort to implement health promotion practices, termed wellness-program effort. We compared means between baseline and 15 months, and between intervention and control sites. We used linear regression to test whether intervention and control sites differed in their change-readiness scores over time.ResultsOnly context and change commitment met reliability thresholds. Change commitment declined significantly for both control (−0.39) and interventions sites (−0.29) from baseline to 15 months, while context did not change for either. Only wellness program effort at 15 months, but not at baseline, differed significantly between control and intervention sites (1.20 controls, 2.02 intervention). Regression analyses resulted in two significant differences between intervention and control sites in changes from baseline to 15 months: (1) intervention sites exhibited significantly smaller change in context scores relative to control sites over time and (2) intervention sites exhibited significantly higher changes in wellness program effort relative to control sites.DiscussionContrary to our hypothesis, change commitment declined significantly at both Healthlinks and control sites, even as wellness-program effort increased significantly at HealthLinks sites. Regression to the mean may explain the decline in change commitment. Future research needs to assess whether baseline commitment is an independent predictor of wellness-program effort or an effect modifier of the HealthLinks intervention.

【 授权许可】

Unknown