Method
Ethical approval: This study was approved by Western New South
Wales Local Health District Human Research Ethics Committee (Approval
number 2020/ETH01247)
Design : Cross sectional survey
Survey instrument: A survey tool was developed by the research
team consisting of five elements (Supplementary File A). The responses
were measured on a 7-point Likert scale (from 1- strongly disagree to 7
- strongly agree). The four validated elements were: i) Individual
change readiness scale (4 items) , ii) collective change readiness scale
(4 items), iii) change self-efficacy scale (4 items), and iv) affective
commitment to change scale (3 items).(6, 13) A fifth element contained
purposively developed items to assess participants understanding and
awareness of the change being proposed.
Setting : The study was conducted in partnership between academic
researchers, health agencies and two local health districts (LHDs) in
New South Wales, Australia. Two local health districts (LHDs) in New
South Wales participated in this study, one servicing a metropolitan
region and one servicing a rural/remote region. Within each district the
project partners identified two transformational change projects that
were at a suitable stage to address our aims. This meant that projects
were of a similar scale, at a similar point in their planning, but
implementation had not yet commenced. The four participating projects
were: virtual pharmacy project, in-home monitoring project, emergency
department expansion and an outpatient administration change project.
Recruitment and procedure : Employees in any clinical or
non-clinical role who were directly affected by or involved in the
change/s proposed in each project were eligible to participate: a total
participant pool of 60 participants was available who met the
eligibility criteria in the participating projects. A minimum sample
size of 15 participants per site was sought to enable us to detect
significant changes in individual change readiness between sites.(14)
Participants were recruited via a study invitation email with an
embedded survey link. The email was distributed by the research team to
eligible potential participants at each site through the local study
partners. Written consent was obtained from individuals prior to their
participation.
Analysis : Descriptive and inferential statistics for sample
characteristics and the levels of change readiness, change commitment,
and change self-efficacy were explored using SPSS (IBM Statistics,
Version 25). Pearson correlation coefficients were calculated to examine
the relationships between readiness for change (individual and
collective), change self-efficacy, and affective commitment to change.
Multiple regression analysis using ordinary least square estimation was
conducted to examine the independent effects of the two antecedents
(affective commitment to change and change self-efficacy) on individual
change readiness. Specifically, we conducted a simultaneous regression
in which change readiness was entered as the outcome variable and change
self-efficacy and affective commitment to change were entered as
predictors.