Hannah H. Leslie - Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA
Rebecca West - Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
Rhian Twine - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Nkosinathi Masilela - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Wayne T. Steward - Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
Kathleen Kahn - MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
Sheri A. Lippman - Division of Prevention Science, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA

Meaningful gains in health outcomes require successful implementation of evidence-based interventions. Organizations such as health facilities must be ready to implement efficacious interventions, but tools to measure organizational readiness have rarely been validated outside of high-income settings. We conducted a pilot study of the organizational readiness to implement change (ORIC) measure in public primary care facilities serving Bushbuckridge Municipality in South Africa in early ۲۰۱۹. We administered the ۱۰-item ORIC to ۵۴ nurses and lay counsellors in ۹ facilities to gauge readiness to implement the national Central Chronic Medicine Dispensing and Distribution (CCMDD) programme intended to declutter busy health facilities. We used exploratory factor analysis (EFA) to identify factor structure. We used Cronbach alpha and intraclass correlation (ICC) to assess reliability at the individual and facility levels. To assess validity, we drew on existing data from routine clinic monitoring and a ۲۰۱۸ quality assessment to test the correlation of ORIC with facility resources, value of CCMDD programme, and better programme uptake and service quality. Six items from the ORIC loaded onto a single factor with Cronbach’s alpha of ۰.۸۲ and ICC of ۰.۲۳. While facility ORIC score was not correlated with implementation of CCMDD, higher scores were correlated with facility resources, perceived value of the CCMDD program, patient satisfaction with wait time, and greater linkage to care following positive HIV testing. The study is limited by measuring ORIC after programme implementation. The findings support the relevance of ORIC, but identify a need for greater adaptation and validation of the measure.

South Africa, Organizational Readiness, HIV Treatment, Implementation Science, Quality of Care