Development and Psychometric Assessment of the Evidence-Informed Decision-Making Competence Measure for Public Health Nursing

Abstract

Background: There are professional expectations for public health nurses to engage in and develop competencies in evidence-informed decision-making (EIDM). The purpose of this research study was to develop and psychometrically test a measure to assess competence in EIDM among public health nurses. Methods: Guided by the Standards for Educational and Psychological Testing (American Educational Research Association, American Psychological Association, & National Council on Measurement in Education, 2014), a three stage study was employed to develop and psychometrically evaluate the new self-report EIDM Competence Measure: 1) Stage one: a systematic review of existing measures assessing four EIDM competence attributes of knowledge, skills, attitudes/beliefs, and behaviours; 2) Stage two: item development for the EIDM Competence Measure comprised of four subscales (knowledge, skills, attitudes/beliefs, and behaviours); and 3) Stage three: psychometric testing (reliability, validity, acceptability) which included item reduction from an original 40-item to a final 27-item tool. Results: The EIDM Competence Measure consists of 27 items aligning with a four-factor model of EIDM knowledge, skills, attitudes/beliefs, and behaviours establishing internal structure validity. Cronbach’s alpha for these four factors was 0.96, 0.93, 0.80, and 0.94, respectively. Significant associations between EIDM competence subscale scores and education, EIDM training/project involvement, and organizational culture established validity based on relationships to other variables. For the original 40-item tool, missing data was minimal as 93% of participants completed all items and mean completion time was 7 minutes and 20 seconds. Conclusions: The EIDM Competence Measure is a conceptually and psychometrically robust instrument that has potential for use in public health nursing practice.