{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T12:26:27Z","timestamp":1765887987696,"version":"3.48.0"},"reference-count":52,"publisher":"BMJ","issue":"4","funder":[{"name":"British Medical Research Council, Wellcome Trust and DFID"},{"DOI":"10.13039\/501100001322","name":"South African Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001322","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,3,14]]},"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>A large treatment gap for common mental disorders (such as depression) exists in South Africa. Comorbidity with other chronic diseases, including HIV and diseases of lifestyle, is an increasing public health concern globally. Currently, primary health facilities as points of care for those with chronic disease provide limited services for common mental disorders. Assessing organisational readiness for change (ORC) towards adopting health innovations (such as mental health services) using contextually appropriate measures is needed to facilitate implementation of these services. This study aims to investigate the validity of the Texas Christian University Organisational Readiness for Change (TCU-ORC) scale in the South African context. Subsequently, we will develop a shortened version of this scale. This study is nested within Project MIND, a multiyear randomised controlled trial that is testing two different approaches for integrating counselling for common mental disorders into chronic disease care. Although the modified, contextually appropriate ORC measure resulting from the proposed study will be developed in the context of integrating mental health into primary healthcare services, the potential for the tool to be generalised to further understanding barriers to any change being implemented in primary care settings is high.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will establish internal consistency (Cronbach\u2019s alpha coefficients), test-retest reliability (intraclass correlation coefficient) and construct validity of the long-form TCU-ORC questionnaire. Survey data will be collected from 288 clinical, management and operational staff from 24 primary health facilities where the Project MIND trial is implemented. A modified Delphi approach will assess the content validity of the TCU-ORC items and identify areas for potential adaptation and item reduction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval has been granted by the South African Medical Research Council (Protocol ID EC004-2-2015, amendment of 20 August 2017). Results will be submitted to peer-reviewed journals relevant to implementation and health systems strengthening.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-020539","type":"journal-article","created":{"date-parts":[[2018,4,9]],"date-time":"2018-04-09T09:50:26Z","timestamp":1523267426000},"page":"e020539","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Protocol for development and validation of a context-appropriate tool for assessing organisational readiness for change in primary health clinics in South Africa"],"prefix":"10.1136","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9489-8717","authenticated-orcid":false,"given":"Carrie","family":"Brooke-Sumner","sequence":"first","affiliation":[{"name":"Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Sorsdahl","sequence":"additional","affiliation":[{"name":"Alan J Flisher Centre for Public Mental Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carl","family":"Lombard","sequence":"additional","affiliation":[{"name":"Biostatistics Unit, South African Medical Research Council, Cape Town, South Africa"},{"name":"School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petal","family":"Petersen-Williams","sequence":"additional","affiliation":[{"name":"Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa"},{"name":"Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bronwyn","family":"Myers","sequence":"additional","affiliation":[{"name":"Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa"},{"name":"Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,4,9]]},"reference":[{"key":"2025121401115785000_8.4.e020539.1","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.1016\/S0140-6736(16)00208-7","article-title":"Sustainable development and global mental health--a Lancet Commission","volume":"387","author":"Patel","year":"2016","journal-title":"Lancet"},{"key":"2025121401115785000_8.4.e020539.2","first-page":"40","article-title":"A clarion call for action based on refined DALY estimates for South Africa","volume":"97","author":"Bradshaw","year":"2007","journal-title":"S Afr Med J"},{"doi-asserted-by":"publisher","key":"2025121401115785000_8.4.e020539.3","DOI":"10.1016\/S0140-6736(13)61611-6"},{"doi-asserted-by":"publisher","key":"2025121401115785000_8.4.e020539.4","DOI":"10.1016\/S0140-6736(07)61238-0"},{"doi-asserted-by":"publisher","key":"2025121401115785000_8.4.e020539.5","DOI":"10.1192\/bjp.bp.106.029280"},{"key":"2025121401115785000_8.4.e020539.6","first-page":"751","article-title":"Mental health service delivery in South Africa from 2000 to 2010: one step forward, one step back","volume":"101","author":"Petersen","year":"2011","journal-title":"S Afr Med J"},{"doi-asserted-by":"publisher","key":"2025121401115785000_8.4.e020539.7","DOI":"10.1590\/S0042-96862004001100011"},{"key":"2025121401115785000_8.4.e020539.8","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1007\/s11920-017-0780-z","article-title":"Challenges and opportunities in global mental health: a research-to-practice perspective","volume":"19","author":"Wainberg","year":"2017","journal-title":"Curr Psychiatry Rep"},{"key":"2025121401115785000_8.4.e020539.9","doi-asserted-by":"crossref","first-page":"1723","DOI":"10.1353\/hpu.2014.0176","article-title":"An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa","volume":"25","author":"Mahomed","year":"2014","journal-title":"J Health Care Poor Underserved"},{"unstructured":"Doh SA . 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