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Sustained Implementation Support Scale: Validation of a Measure of Program Characteristics and Workplace Functioning for Sustained Program Implementation

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Abstract

An evaluation measure of enablers and inhibitors to sustained evidence-based program (EBP) implementation may provide a useful tool to enhance organizations’ capacity. This paper outlines preliminary validation of such a measure. An expert informant and consumer feedback approach was used to tailor constructs from two existing measures assessing key domains associated with sustained implementation. Validity and reliability were evaluated for an inventory composed of five subscales: Program benefits, Program burden, Workplace support, Workplace cohesion, and Leadership style. Exploratory and confirmatory factor analysis with a sample of 593 Triple P—Positive Parenting Program—practitioners led to a 28-item scale with good reliability and good convergent, discriminant, and predictive validity. Practitioners sustaining implementation at least 3 years post-training were more likely to have supervision/peer support, reported higher levels of program benefit, workplace support, and positive leadership style, and lower program burden compared to practitioners who were non-sustainers.

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Notes

  1. The CFI, RMSEA, and SRMR fit indices were all affected by the Satorra–Bentler scaling correction for the chi-square statistic.

  2. The AVE estimate represents the average amount of variation that a latent construct is able to explain in the observed variables that theoretically relate to the construct. It is calculated by averaging the sum of squared factor loadings for each latent construct. The squared factor loading represents the amount of variation in each observed variable that the latent construct accounts for. When this variance is averaged across all observed variables that relate theoretically to the latent construct, the authors generate the AVE.

  3. For the chi-square difference test, a constrained model, in which the correlation between the factors is fixed at 1.00, is compared to the original model’s χ 2 where the correlation between the constructs is estimated freely. Significantly lower chi-square value of the unconstrained model implies good discriminant validity.

  4. The supervision/peer support variable was a binary predictor coded 0 if there was no supervision and peer support and 1 if the practitioner received some supervision/peer support. Since it was desirable to estimate the intercept and the slope for the group coded 0, no mean centering was applied for this predictor.103

  5. FIML procedure is not available for logistic regression (FIML can only be used with maximum likelihood estimation).

  6. The Bartlett’s test of sphericity is sensitive to deviations from normality, and, since the first sample was non-normally distributed, the results of this test should be interpreted with caution.

  7. Results based on multiple imputations present a range of Cox and Snell R 2 across five imputed samples.

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Acknowledgments

This research was conducted with funding support from the Australian Research Council (ARC Linkage grant LP110200701: Assessing the effectiveness, acceptability, and sustainability of a culturally adapted evidence-based intervention for Indigenous parents). Many thanks go to the practitioners who completed the survey and to Jenna McWilliam and TPI for arranging the survey distribution.

Author Contributions and Disclosures

The Triple P—Positive Parenting Program—is developed and owned by The University of Queensland. The University, through its main technology transfer company, UniQuest Pty Ltd, has licensed Triple P International (TPI) Pty Ltd to publish and disseminate Triple P worldwide. Royalties stemming from published Triple P resources are distributed to the Faculty of Health and Behavioural Sciences; School of Psychology; Parenting and Family Support Centre; and contributory authors. TPI is a private company, and no author has any share or ownership in it. TPI had no involvement in the study design, collection, analysis or interpretation of data, or writing of this report. Matthew Sanders and Karen Turner are contributory authors and receive royalties from TPI. TPI engages the services of Matthew Sanders and Lauren Hodge as consultants to support program integrity and dissemination. Project design and data collection was managed by Lauren Hodge as part of her doctoral research. Data analysis and interpretation was led by Ania Filus. All authors approved the final manuscript.

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Authors and Affiliations

  1. Parenting and Family Support Centre, School of Psychology, The University of Queensland, St Lucia, QLD, 4072, Australia

    Lauren M. Hodge BSc, Karen M. T. Turner PhD & Matthew R. Sanders PhD

  2. Center for Self-Report Science, University of Southern California, 635 Downey Way, Los Angeles, CA, 90089-3332, USA

    Ania Filus PhD

Authors
  1. Lauren M. Hodge BSc
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  2. Karen M. T. Turner PhD
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  3. Matthew R. Sanders PhD
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  4. Ania Filus PhD
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Corresponding author

Correspondence to Lauren M. Hodge BSc.

Appendices

Appendix A

Table 8 Original 40-item Implementation and Sustainment Support Scale (SISS)
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Appendix B

Table 9 Descriptive statistics for the original 40 SISS items analyzed via EFA
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Table 10 Descriptive statistics for the final 28 SISS items analyzed via CFA
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Hodge, L.M., Turner, K.M.T., Sanders, M.R. et al. Sustained Implementation Support Scale: Validation of a Measure of Program Characteristics and Workplace Functioning for Sustained Program Implementation. J Behav Health Serv Res 44, 442–464 (2017). https://doi.org/10.1007/s11414-016-9505-z

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