Construcción y Análisis Psicométrico de una Escala para Evaluar la Tensión por el Cambio en una Intervención de Educación Sexual

  1. Betzabé Torres-Cortés 1
  2. Andrés Antivilo-Bruna 2
  3. Loreto Leiva
  1. 1 Pontificia Universidad Católica de Chile
    info

    Pontificia Universidad Católica de Chile

    Santiago de Chile, Chile

    ROR https://ror.org/04teye511

  2. 2 Universidad de Chile
    info

    Universidad de Chile

    Santiago de Chile, Chile

    ROR https://ror.org/047gc3g35

Revista:
Revista iberoamericana de diagnóstico y evaluación psicológica

ISSN: 1135-3848 2183-6051

Año de publicación: 2024

Volumen: 1

Número: 71

Páginas: 199-216

Tipo: Artículo

DOI: 10.21865/RIDEP71.1.14 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Revista iberoamericana de diagnóstico y evaluación psicológica

Resumen

Uno de los elementos claves en la implementación de intervenciones en educación sexual es la Tensión por el Cambio (TC). Esta refiere al nivel en que una situación es intolerable o requiere cambios, implicando una apertura hacia la intervención. Este estudio evaluó psicométricamente las propiedades de un instrumento para medir la TC hacia un programa de educación sexual en estudiantes; y midió su nivel en dicho grupo. Se diseñó, identificó y confirmó la estructura factorial de una escala ad hoc para evaluar la TC. El AFE estableció una estructura de dos factores: “deseo de cambio” y “necesidad de la intervención”; confirmada mediante un AFC con adecuados indicadores de ajuste (CFI=.962, TLI=.945, RMSEA=.080, SMRS=.040) y apropiados índices de fiabilidad (ω=.91). A partir de estos resultados, es posible inferir que el instrumento es bidimensional y presenta propiedades psicométricas satisfactorias, lo que respalda su uso para medir la TC frente a intervenciones en educación sexual.

Referencias bibliográficas

  • Aarons, G. A., Ehrhart, M. G., & Farahnak, L. R. (2014). The Implementation Leadership Scale (ILS): Development of a brief measure of unit level implementation leadership. Implementation Science, 9(1), 45. https://doi.org/10.1186/1748-5908-9-45
  • Abad-Villaverde (2022). Consumo de alcohol y otras sustancias psicoactivas en adolescentes Dominicanos. Revista Iberoamericana de Diagnóstico y Evaluación Psicológica – e Avaliação Psicológica, 65 (4),5-18. https://doi.org/10.21865/RIDEP65.4.01
  • Allen, M., Wilhelm, A., Ortega, L. E., Pergament, S., Bates, N., & Cunningham, B. (2021). Applying a Race(ism)-Conscious Adaptation of the CFIR Framework to understand implementation of a school-based equityoriented intervention. Ethnicity & Disease, 31 (Suppl 1), 375–388. https://doi.org/10.18865/ed.31.S1.375
  • Anderson, R. M. (2013). Positive sexuality and its impact on overall well-being. Bundesgesundheitsblatt - Gesundheitsforschung - Gesundheitsschutz, 56(2), 208–214. https://doi.org/10.1007/s00103-012-1607-z
  • Ato, M., López-García, J. J., & Benavente, A. (2013). Un sistema de clasificación de los diseños de investigación en psicología. Anales de Psicología, 29(3). https://doi.org/10.6018/analesps.29.3.178511
  • Barwick, M., Dubrowski, R., & Damschroder, L. (2020). Factors associated with effective implementation: Research and practical implications. In B. Albers, A. Shlonsky, & R. Mildon (Eds.), Implementation Science 3.0 (pp. 81–100). Springer International Publishing. https://doi.org/10.1007/978-3-030-03874-8_4
  • Becker, K. (2010). Facilitating unlearning during implementation of new technology. Journal of Organizational Change Management, 23(3), 251–268. https://doi.org/10.1108/09534811011049590
  • Bonjour, M., & van der Vlugt, I. (2018). Comprehensive sexuality education knowledge file. Rutgers International.
  • Breimaier, H. E., Heckemann, B., Halfens, R. J. G., & Lohrmann, C. (2015). The Consolidated Framework for Implementation Research (CFIR): A useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice. BMC Nursing, 14(1), 43. https://doi.org/10.1186/s12912-015-0088-4
  • Breland, J. Y., Asch, S. M., Slightam, C., Wong, A., & Zulman, D. M. (2016). Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis. Healthcare, 4(1), 22–29. https://doi.org/10.1016/j.hjdsi.2015.12.005
  • Broome, K. M., Flynn, P. M., Knight, D. K., & Simpson, D. D. (2007). Program structure, staff perceptions, and client engagement in treatment. Journal of Substance Abuse Treatment, 33(2), 149–158. https://doi.org/10.1016/j.jsat.2006.12.030
  • Brown, T. A. (2006). Confirmatory factor analysis for applied research. In D. A. Kenny (Ed.), Methodology in the Social Sciences Series. The Guilford Press.
  • Browne, M. W., & Cudek, R. (2003). Alternate ways of assessing model fit. In A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136– 162). Sage.
  • Cea, M. A. (2003). Análisis multivariable. Teoría y práctica en la investigación social (2nd ed.). Síntesis.
  • CEPAL. (2008). Juventud y cohesión social en Iberoamérica. Un modelo para armar. Santiago de Chile: Naciones Unidas. Comisión Económica para América Latina y el Caribe.
  • Clary, A. S., Perry, K. R., Edwards-Orr, M., Miech, E. J., VanHoutven, C., Rudolph, J. L., Thomas, K. S., & Sperber, N. (2020). Interorganizational context when implementing multisector partnered programs: A qualitative analysis of veteran directed care. Journal of Gerontological Social Work, 63(8), 822–836. https://doi.org/10.1080/01634372.2020.1817828
  • Clinton-McHarg, T., Yoong, S. L., Tzelepis, F., Regan, T., Fielding, A., Skelton, E., Kingsland, M., Ooi, J. Y., & Wolfenden, L. (2016). Psychometric properties of implementation measures for public health and community settings and mapping of constructs against the Consolidated Framework for Implementation Research: A systematic review. Implementation Science, 11(1), 148. https://doi.org/10.1186/s13012-016-0512-5
  • Crutzen, R., & Kuntsche, E. (2013). Validation of the four-dimensional structure of drinking motives among adults. European Addiction Research, 19, 222–226.
  • Cupani, M. (2012). Análisis de ecuaciones estructurales: Conceptos, etapas de desarrollo y un ejemplo de aplicación. Revista Tesis, 1, 186–199.
  • Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C. (2009). Fostering implementation of health services research findings into practice: A consolidated framework for advancing implementation science. Implementation Science, 4(1), 50. https://doi.org/10.1186/1748-5908-4-50
  • Damschroder, L. J., & Lowery, J. C. (2013). Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR). Implementation Science, 8(1), 51. https://doi.org/10.1186/1748-5908-8-51
  • Declaración de Helsinki (2013). Principios éticos para las investigaciones médicas en seres humanos. Asociación Médica Mundial, 59.
  • Declaración de Singapur. 2nd World Conference on Research Integrity, Julio 21-24 2010, Singapur.
  • Desveaux, L., Saragosa, M., Rogers, J., Bevan, L., Loshak, H., Moser, A., Feldman, S., Regier, L., Jeffs, L., & Ivers, N. M. (2017). Improving the appropriateness of antipsychotic prescribing in nursing homes: A mixed-methods process evaluation of an academic detailing intervention. Implementation Science, 12(1), 71. https://doi.org/10.1186/s13012-017-0602-z
  • Dixon-Mueller, R. (2011). The sexual and reproductive health of younger adolescents: Research issues in developing countries. World Health Organisation.
  • Durlak, J. A.,& DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41(3–4), 327–350. https://doi.org/10.1007/s10464-008-9165-0
  • Elosua, P. (2005). Evaluación progresiva de la invarianza factorial entre las versiones original y adaptada de una escala de autoconcepto. Psicothema, 17(2), 356–362.
  • Emanuel, E., Wendler, D., & Grady, C. (2000). What makes clinical research ethical? JAMA, 283(20), 2701. https://doi.org/10.1001/jama.283.20.2701
  • Fernandes, D., & Junnarkar, M. (2019). Comprehensive sex education: Holistic approach to biological, psychological and social development of adolescents. International Journal of School Health, 6(2). https://doi.org/10.5812/intjsh.63959
  • Field, A., Miles, J., & Field, Z. (2012). Discovering statistics using R. SAGE Publications.
  • Finch, W. H., & French, B. F. (2015). Latent variable modeling with R. Routledge.
  • Fonner, V. A., Kennedy, S., Desai, R., Eichberg, C., Martin, L., & Meissner, E. G. (2021). Patient-provider text messaging and video calling among case-managed patients living with HIV: Formative acceptability and feasibility study. JMIR Formative Research, 5(5), e22513. https://doi.org/10.2196/22513
  • Girard, A., Roberge, P., Ellefsen, É., BernardHamel, J., Carrier, J.-D., & Hudon, C. (2021). The influence of contextual factors on the process of formulating strategies to improve the adoption of care manager activities by primary care nurses. International Journal of Integrated Care, 21(2), 20. https://doi.org/10.5334/ijic.5556
  • Greenhalgh, T., Stramer, K., Bratan, T., Byrne, E., Mohammad, Y., & Russell, J. (2008). Introduction of shared electronic records: Multi-site case study using diffusion of innovation theory. BMJ, 337(oct23 1), a1786– a1786. https://doi.org/10.1136/bmj.a1786
  • Greenhalgh, Trisha, Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. The Milbank Quarterly, 82(4), 581–629. https://doi.org/10.1111/j.0887-378X.2004.00325.x
  • Gustafson, D. H., Sainfort, F., Eichler, M., Adams, L., Bisognano, M., & Steudel, H. (2003). Developing and testing a model to predict outcomes of organizational change. Health Services Research, 38(2), 751–776. https://doi.org/10.1111/1475-6773.00143
  • Henry, D., Wood, S., Moshashane, N., Ramontshonyana, K., Amutah, C., Maleki, P., Howlett, C., Brooks, M. J., Mussa, A., Joel, D., Steenhoff, A. P., Akers, A. Y., & Morroni, C. (2021). Facilitators and barriers to implementation of long-acting reversible contraceptive services for adolescent girls and young women in Gaborone, Botswana. Journal of Pediatric and Adolescent Gynecology, 34(4), 504–513. https://doi.org/10.1016/j.jpag.2021.03.005
  • Holt, D. T., & Vardaman, J. M. (2013). Toward a comprehensive understanding of readiness for change: The case for an expanded conceptualization. Journal of Change Management, 13(1), 9–18. https://doi.org/10.1080/14697017.2013.768426
  • Jebara, T., Cunningham, S., MacLure, K., Pallivalapila, A., Awaisu, A., Al Hail, M., & Stewart, D. (2020). Key stakeholders’ views on the potential implementation of pharmacist prescribing: A qualitative investigation. Research in Social and Administrative Pharmacy, 16(3), 405–414. https://doi.org/10.1016/j.sapharm.2019.06.009
  • Johnson, B. T., Scott-Sheldon, L. A. J., HuedoMedina, T. B., & Carey, M. P. (2011). Interventions to reduce sexual risk for human immunodeficiency virus in adolescents. Archives of Pediatrics & Adolescent Medicine, 165(1). https://doi.org/10.1001/archpediatrics.2010.251
  • Kalkbrenner, M. (2021). Alpha, Omega, and H internal consistency reliability estimates: Reviewing these options and when to use them. Counseling Outcome Research and Evaluation, 14(3),1-12. https://doi.org/10.1080/21501378.2021.1940118
  • Krebbekx, W. (2019). What else can sex education do? Logics and effects in classroom practices. Sexualities, 22(7–8), 1325–1341. https://doi.org/10.1177/1363460718779967
  • Kyomuhangi, T., Naggayi, B., Turyakira, E. T., Khan, S., Murembe, N., Kemigisha, E., Mutatina, R., Muhumuza, J., Kyokushaba, C. K., Kabakyenga, J., & Brenner, J. (2021). Understanding complex community structures to improve sexual reproductive health for adolescents in Uganda. Paediatrics & Child Health, 26(Supplement_1), e60–e60. https://doi.org/10.1093/pch/pxab061.065
  • Lehman, W. E. ., Greener, J. M., & Simpson, D. D. (2002). Assessing organizational readiness for change. Journal of Substance Abuse Treatment, 22(4), 197–209. https://doi.org/10.1016/S0740-5472(02)00233-7
  • Leiva, L., Zavala‐Villalón, G., Antivilo‐Bruna, A., Torres, B., & Ganga‐León, C. (2021). Implementation of a national mental health intervention in educational communities: What do successful teams do differently? Journal of Community Psychology, 49(1), 133–151. https://doi.org/10.1002/jcop.22370
  • Liang, S., Kegler, M. C., Cotter, M., Phillips, E., Beasley, D., Hermstad, A., Morton, R., Martinez, J., & Riehman, K. (2015). Integrating evidence-based practices for increasing cancer screenings in safety net health systems: A multiple case study using the Consolidated Framework for Implementation Research. Implementation Science, 11(1), 109. https://doi.org/10.1186/s13012-016-0477-4
  • Lindberg, L. D., Maddow-Zimet, I., & Boonstra, H. (2016). Changes in adolescents’ receipt of sex education, 2006–2013. Journal of Adolescent Health, 58(6), 621–627. https://doi.org/10.1016/j.jadohealth.2016.02.004
  • Macintyre, A. K.-J., Montero Vega, A. R., & Sagbakken, M. (2015). From disease to desire, pleasure to the pill: A qualitative study of adolescent learning about sexual health and sexuality in Chile. BMC Public Health, 15(1), 945. https://doi.org/10.1186/s12889-015-2253-9
  • McNeish D. (2018). Thanks coefficient alpha, we’ll take it from here. Psychological Methods, 23(3), 412–433. https://doi.org/10.1037/met0000144PMID: 28557467
  • Michielsen, K., De Meyer, S., Ivanova, O., Anderson, R., Decat, P., Herbiet, C., Kabiru, C. W., Ketting, E., Lees, J., Moreau, C., Tolman, D. L., Vanwesenbeeck, I., Vega, B., Verhetsel, E., & Chandra-Mouli, V. (2015). Reorienting adolescent sexual and reproductive health research: Reflections from an international conference. Reproductive Health, 13(1), 3. https://doi.org/10.1186/s12978-016-0117-0
  • Miake-Lye, I. M., Delevan, D. M., Ganz, D. A., Mittman, B. S., & Finley, E. P. (2020). Unpacking organizational readiness for change: An updated systematic review and content analysis of assessments. BMC Health Services Research, 20(1), 106. https://doi.org/10.1186/s12913-020-4926-z
  • Montero, A. (2011). Educación sexual: Un pilar fundamental en la sexualidad de la adolescencia. Revista Médica de Chile, 139(10), 1249–1252. https://doi.org/10.4067/S0034-98872011001000001
  • Ndejjo, R., Wanyenze, R. K., Nuwaha, F., Bastiaens, H., & Musinguzi, G. (2020). Barriers and facilitators of implementation of a community cardiovascular disease prevention programme in Mukono and Buikwe districts in Uganda using the Consolidated Framework for Implementation Research. Implementation Science, 15(1), 106. https://doi.org/10.1186/s13012-020-01065-0
  • Nilsen, P. (2015). Making sense of implementation theories, models and frameworks. Implementation Science, 10(1), 53. https://doi.org/10.1186/s13012-015-0242-0
  • Ninsiima, A. B., Coene, G., Michielsen, K., Najjuka, S., Kemigisha, E., Ruzaaza, G. N., Nyakato, V. N., & Leye, E. (2019). Institutional and contextual obstacles to sexuality education policy implementation in Uganda. Sex Education, 1–16. https://doi.org/10.1080/14681811.2019.1609437
  • OMS (2021) World Health Statistics 2021: Monitoring Health for the SDGs, Sustainable Development Goals. Organización Mundial de la Salud
  • Pantelides, E. (2014). Maternidad temprana en la Argentina. Las madres menores de 15 años. Centro de Estudios de Población – CENEP - Dirección de Estadísticas e Información de Salud, Ministerio de Salud.
  • Powell, B. J., Mettert, K. D., Dorsey, C. N., Weiner, B. J., Stanick, C. F., Lengnick-Hall, R., Ehrhart, M. G., Aarons, G. A., Barwick, M. A., Damschroder, L. J., & Lewis, C. C. (2021). Measures of organizational culture, organizational climate, and implementation climate in behavioral health: A systematic review. Implementation Research and Practice, 2, 263348952110188. https://doi.org/10.1177/26334895211018862
  • Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health, 36(1), 24–34. https://doi.org/10.1007/s10488-008-0197-4
  • Ralefala, T., Mokokwe, L., Jammalamadugu, S., Legobere, D., Motlhwa, W., Oyekunle, A., Grover, S., Barg, F., Shulman, L., Martei, Y. (2021). Provider barriers and facilitators of breast cancer guideline-concordant therapy delivery in Botswana: A consolidated framework for implementation research analysis. The Oncologist, 26(12), e2200–e220. https://doi.org/10.1002/onco.13935
  • Rohrbach, L. A., Berglas, N. F., Jerman, P., Angulo-Olaiz, F., Chou, C.-P., & Constantine, N. A. (2015). A rights-based sexuality education curriculum for adolescents: 1-year outcomes from a cluster-randomized trial. Journal of Adolescent Health, 57(4), 399–406. https://doi.org/10.1016/j.jadohealth.2015.07.004
  • Roos, M., Roy, J. S., & Lamontagne, M. E. (2021). A qualitative study exploring the implementation determinants of rehabilitation and global wellness programs for orchestral musicians. Clinical Rehabilitation, 35(10), 1488–1499. https://doi.org/10.1177 Sandín, B., Chorot, P.,
  • Santed, M., y Valiente, R. (2002). Análisis factorial confirmatorio del Índice de Sensibilidad a la Ansiedad para Niños. Psicothema, 14(2), 333-339. http://www.psicothema.com/pdf/728.pdf
  • Sepúlveda-Páez, G., Mena-Chamorro, P. & FerrerUrbina, R. (2021). Desarrollo de una escala para valorar conocimiento sobre situaciones y conductas de riesgo de contagio de VIH, en jóvenes y adultos jóvenes en un contexto latinoamericano. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica, 60(3), 157-167. https://doi.org/10.21865/RIDEP60.3.13
  • Steinman, L., van Pelt, M., Hen, H., Chhorvann, C., Lan, C. S., Te, V., LoGerfo, J., & Fitzpatrick, A. L. (2020). Can mHealth and eHealth improve management of diabetes and hypertension in a hard-to-reach population? — lessons learned from a process evaluation of digital health to support a peer educator model in Cambodia using the RE-AIM framework. MHealth, 6, 40–40. https://doi.org/10.21037/mhealth-19-249
  • Turner, D., Lockhart, E., Wang, W., Shore, R., Daley, E., & Marhefka, S. L. (2021). Examining the factors affecting prep implementation within community-based HIV testing sites in Florida: A mixed methods study applying the consolidated framework for implementation research. AIDS and Behavior, 25(7), 2240–2251. https://doi.org/10.1007/s10461-020-03152-1
  • UNAIDS. (2004). Seen but not heard … Very young adolescents aged 10–14 years. Joint United Nations Programme on HIV/AIDS.
  • UNICEF (2023). Adolescent HIV Prevention. United Nations Children's Fund
  • Vasilenko, S. A., Lefkowitz, E. S., & Welsh, D. P. (2014). Is sexual behavior healthy for adolescents? A conceptual framework for research on adolescent sexual behavior and physical, mental, and social health. New Directions for Child and Adolescent Development, 2014(144), 3–19. https://doi.org/10.1002/cad.20057
  • Weiner, B. J., Belden, C. M., Bergmire, D. M., & Johnston, M. (2011). The meaning and measurement of implementation climate. Implementation Science, 6(1), 78. https://doi.org/10.1186/1748-5908-6-78
  • Weisz, J. R., & Kazdin, A. E. (Eds.). (2010). Evidence-based psychotherapies for children and adolescents (Second Edition). The Guildford Press.
  • Zinbarg, R., Revelle, W., Yovel, I., & Li, W. (2005). Cronbach’s, Revelle’s and Mcdonald’s: Their relations with each other and two alternative conceptualizations of reliability. Psychometrika, 70, 123-133. https://doi.org/10.1007/s11336-003-0974-7.
  • Zoila, H., & Alma, C. (2007). La sexualidad en jóvenes universitarios: Factores de riesgo. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica, 2(24), 121–137.
  • Zúñiga, A., Teva, I., & Bermúdez, M. P. (2017). Conocimiento y fuentes de información sobre las ITS/VIH, comunicación sobre sexo y actitud hacia el uso del preservativo en adolescentes y padres/madres salvadoreños. Revista Iberoamericana de Diagnóstico y Evaluación – e Avaliação Psicológica, 45(3), 97–107. https://doi.org/10.21865/RIDEP45.3.08