Translation, adaptation, and psychometric assessment of the Alberta Context Tool for use with nurses in adult acute care in Japan

Abstract

Aim

Currently, there is no Japanese tool to measure organizational context factors that influence nurses' implementation of evidence-based practices. This study aimed to translate, culturally adapt, and psychometrically evaluate the Alberta Context Tool (ACT) for nurses in Japan.

Methods

We completed forward translations with reconciliation, expert discussions, back translations with reconciliation, back translation review by tool developers, and semi-structured cognitive interviews with verbal probing. A convenience sample of nurses from five hospitals completed the translated tool. Item descriptives (including missing data), internal structure (confirmatory factor analyses [CFA]), criterion validity (correlations with Team Climate Inventory [TCI] items “support for innovative ideas”), internal consistency reliability (Cronbach's alpha, item–concept correlations), and test–retest reliability (intraclass correlation) were examined.

Results

Cognitive debriefing with nine nurses led to modifying 10 ACT items. A total of 508 nurses completed the survey. CFA showed an acceptable model fit for the seven scale-based concepts ($x^2$ = 1037.28, root mean square error of approximation = 0.054, Comparative Fit Index = 0.913, Tucker–Lewis Index = 0.902, standardized root mean square residual = 0.053). Correlations between the 10 ACT concepts and TCI ranged from .08 to .43, with nine statistically significant (p < .05). Cronbach's alpha ranged from .22 to .91 (exceeding 0.70 for 8/10 concepts), and item–concept correlations ranged from .15 to .96 (exceeding 0.70 for 26/56 items). Retest reliability (N = 65) ranged from 0.45 to 0.81.

Conclusions

The ACT Japanese version demonstrated initial evidence of acceptable validity and reliability for most concepts and items, supporting its use in assessing organizational context.