Development and Validation of Questionnaires Exploring Health Care Professionals' Intention to Use Wiki-Based Reminders to Promote Best Practices in Trauma

Background Little is known about factors influencing professionals’ use of wikis. Objective We developed and validated two questionnaires to assess health care professionals’ intention to use wiki-based reminders for the management of trauma patients. Methods We developed questionnaires for emergency physicians (EPs) and allied health professions (AHPs) based on the Theory of Planned Behavior and adapted them to the salient beliefs of each, identified in an earlier study. Items measured demographics and direct and indirect theoretical constructs. We piloted the questionnaires with 2 focus groups (5 EPs and 5 AHPs) to identify problems of wording and length. Based on feedback, we adjusted the wording and combined certain items. A new convenience sample of 25 EPs and 26 AHPs then performed a test-retest of the questionnaires at a 2-week interval. We assessed internal consistency using Cronbach alpha coefficients and temporal stability of items with an agreement intraclass correlation coefficient (ICC). Results Five EPs and 5 AHPs (3 nurses, 1 respiratory therapist, and 1 pharmacist) formed 2 focus groups; 25 EPs and 26 AHPs (12 nurses, 7 respiratory therapists, and 7 pharmacists) completed the test and retest. The EP questionnaire test-retest scores for consistency (Cronbach alpha) and stability (ICC) were intention (test: Cronbach alpha=.94; retest: Cronbach alpha=.98; ICC=.89), attitude (.74, .72, .70), subjective norm (.79, .78, .75), perceived behavioral control (.67, .65, .66), attitudinal beliefs (.94, .86, .60), normative beliefs (.83, .87, .79), and control beliefs barriers (.58, .67, .78) and facilitators (.97, .85, .30). The AHP questionnaire scores for consistency and stability were: intention (test Cronbach alpha=.69, retest Cronbach alpha=.81, ICC=.48), attitude (.85, .87, .83), subjective norm (.47, .82, .62), perceived behavioral control (.55, .62, .60), attitudinal beliefs (.92, .91, .82), normative beliefs (.85, .90, .74), and control beliefs barriers (.58, .55, .66) and facilitators (.72, .94, –.05). To improve the psychometric properties of both questionnaires, we reformulated poorly consistent or unstable items. Conclusions Our new theory-based questionnaires to measure health care professionals’ intention to use wiki-based reminders have adequate validity and reliability for use in large surveys. In the long run, they can be used to develop a theory-based implementation intervention for a wiki promoting best practices in trauma care.

1. This questionnaire is about the use of wikibased reminders that promote best practice in the management of severe cranial trauma in emergency rooms in the province of Quebec. 2. Although some of the questions may seem repetitive, it is very important that you answer them all anyway. 3. Your choice of answers should best reflect your opinion or your situation. 4. There are no right and wrong answers. 5. Your answers will remain confidential. 6. The questionnaire should take about 10 minutes. Your participation in this survey is voluntary and your data will remain confidential. Returning the completed questionnaire will be considered an expression of your consent to participate in the project.

For any comments or questions about this research project please contact Susie Gagnon, Research
Professional, at 4188357121 ext. 6267.

Consent:
I understand that the data collected by this questionnaire will be anonymous. I understand that it will be treated with confidentiality and in no circumstances will be associated with my institution when the results are made public. I have noted the above information and I freely consent to participate in this study. I understand that I may stop answering the questionnaire at any moment without prejudice.

Yes
No Before you begin, please watch the following video depending on your profession:

Definition of a wiki
• A wiki is a website programmed to allow anyone who has access to it to edit (change) its content. It is thus a collaborative work tool, and could contain treatment protocols, for example, or decision algorithms. In the healthcare context, a wiki could enable doctors and other professionals to share, update and edit reminders based on the most recent evidence. Healthcare professionals who had access to a wiki in their hospital could consult it directly in their workplace.
• For example, in the case of a severe cranial trauma, a wikibased reminder could be brought up online on a computer and the team could use the information in their response.
This questionnaire seeks your opinion on the possible use of a wiki-based reminder that promotes best practices in managing severe cranial trauma in emergency rooms in the province of Quebec.
1. I see no obstacles to using a wiki-based reminder that promotes best practice for managing severe cranial trauma in emergency rooms in the province of Quebec. Strongly disagree Strongly agree 2. If I wanted to, I feel confident that I could use a wiki-based reminder that promotes best practice for managing severe cranial trauma in emergency rooms in the province of Quebec. Strongly disagree Strongly agree 3. I feel social pressure to use a wiki-based reminder that promotes best practice for managing severe cranial trauma in emergency rooms in the province of Quebec. Strongly disagree Strongly agree 6. I intend to use a wiki-based reminder that promotes best practice for managing severe cranial trauma in emergency rooms in the province of Quebec. Very low Very high 9. In the future I will use a wiki-based reminder that promotes best practice for managing severe cranial trauma in emergency rooms in the province of Quebec. Strongly disagree Strongly agree 11. The following people would approve of my use of a wiki-based reminder that promotes best practice for managing severe cranial trauma in emergency rooms in the province of Quebec: The doctors at my hospital The respiratory therapists at my hospital The nurses at my hospital The hospital staff in regional/remote hospitals who are less exposed to severe cranial trauma 1 2 3 4 5 6 7 The younger generation of staff at my hospital The trauma team at my hospital The people responsible for quality of care at my hospital The administration at my hospital  Yes → Which one? ____________________________  No 24. Are you a member of a traumatology committee (local or regional)?
 Yes  No The questionnaire is over! Please make sure you have answered all the questions.

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