This research was funded by a “cross-border” initiative from the Northern Ireland Department of Health, Social Services and Public Safety R&D Office and the Republic of Ireland Health Research Board.
Development and Testing of the Context Assessment Index (CAI)
Article first published online: 16 JAN 2009
©2009 Sigma Theta Tau International
Worldviews on Evidence-Based Nursing
Volume 6, Issue 1, pages 27–35, March 2009
How to Cite
McCormack, B., McCarthy, G., Wright, J. and Coffey, A. (2009), Development and Testing of the Context Assessment Index (CAI). Worldviews on Evidence-Based Nursing, 6: 27–35. doi: 10.1111/j.1741-6787.2008.00130.x
- Issue published online: 16 MAR 2009
- Article first published online: 16 JAN 2009
- Accepted 30 April 2008
- instrument development;
- context assessment index [CAI];
- PARIHS framework
Aim: To test the psychometric properties of the Context Assessment Index (CAI).
Background: We used the Promoting Action on Research Implementation in Health Services Framework (PARIHS) as the theoretical framework for the study. The framework shows the successful implementation of evidence in practice as dependent on the inter-relationship of the nature of the evidence, the quality of the context, and expert facilitation. However, a comprehensive method of assessing context has not yet been available.
Methods: A five-stage instrument development and testing methodology was used. Principal components analysis, exploratory factor analysis, and expert panel feedback were used to develop and refine the CAI model. The model was further tested for psychometric properties of internal consistency and test–retest scores. Telephone interviews were conducted with expert nurses to gauge the usability of the instrument. These stages of development and testing resulted in a final 37-item, five-factor CAI model.
Findings: This 37-item model was accepted as a reasonable explanation of the data. The measures of homogeneity were calculated for each of the five factors to measure internal reliability. The Cronbach's alpha score for the complete questionnaire was estimated at 0.93. All five factors achieved a satisfactory estimated level of internal consistency in scoring, ranging from 0.78 to 0.91. Test–retest scores indicate reliability of the findings, and the feedback from focus group participants suggests that the instrument has practical utility.
Conclusions: The CAI provides clinicians with the means to assess and understand the context in which they work and the effect this has on using evidence in practice.