The Measure of Evidence-Based Practice in Occupational Health<\/strong> (EBP-OHS) is a specialized psychometric assessment instrument engineered to rigorously evaluate the operationalization, assimilation, and institutionalization of evidence-based practice<\/a> (EBP) within multidisciplinary occupational health settings. While conventional psychometric inventories in healthcare primarily gauge solitary clinical competencies, critical appraisal skills, or isolated academic knowledge\u2014such as basic literature appraisal measured by legacy tools\u2014the EBP-OHS captures a holistic, ecological perspective of evidence-informed healthcare. It measures both micro-level individual characteristics (competence and professional attitudes) and macro-level systemic dimensions (organizational support<\/a>, managerial leadership, educational facilitation, and operational workflow alignment).<\/p>\n Developed and empirically validated in Finland among occupational healthcare professionals, the instrument operationalizes core phases of the updated Joanna Briggs Institute<\/a> (JBI) Model of Evidence-Based Healthcare, with particular theoretical emphasis on evidence transfer and evidence implementation. Structurally, the EBP-OHS is composed of 15 self-report items distributed across three psychometrically validated dimensions: Organisational Support (7 items), Practitioners’ Competence (6 items), and Practitioners’ Attitudes (2 items). All items are appraised on a standardized 5-point Likert response scale ranging from “Fully agree” to “Fully disagree,” alongside an explicit domain-specific option: “I cannot say.” In structural validation studies utilizing Principal Component Analysis<\/a> (PCA), the three-factor model demonstrated strong structural construct validity, explaining 60.3% of the total cumulative variance with factor loadings ranging from 0.51 to 0.84. Furthermore, the instrument displays excellent internal consistency reliability, demonstrated by an overall scale Cronbach’s alpha<\/a> of 0.88, with content validity verified through rigorous evaluation by multidisciplinary panels. The EBP-OHS stands as an indispensable diagnostic and evaluative tool for healthcare researchers, medical directors, and occupational health managers seeking to identify systemic barriers, audit institutional readiness, benchmark quality metrics, and design targeted developmental interventions.<\/p>\n evidence-based practice, occupational health services, psychometrics, organizational support, clinical competence, scale validation, Joanna Briggs Institute, implementation science, occupational medicine, professional attitudes<\/p>\n The Measure of Evidence-Based Practice in Occupational Health was conceptualized, developed, and empirically validated by a team of leading scholars and clinical experts in occupational health, nursing science, and health economics based in Finland:<\/p>\n The central objective of the Measure of Evidence-Based Practice in Occupational Health (EBP-OHS) is to furnish a psychometrically sound, contextually sensitive, and practically actionable diagnostic instrument tailored to the structural and clinical complexities of occupational health services (OHS). In contemporary healthcare systems, occupational health<\/a> occupies a unique nexus between clinical medicine, preventive public health, industrial hygiene, labor economics, and enterprise management. Practitioners within this sphere\u2014principally occupational physicians, occupational health nurses, occupational physiotherapists, and enterprise psychologists\u2014do not merely administer episodic bedside care to isolated patients. Rather, they formulate strategic enterprise-level workplace interventions, conduct preventative risk assessments, navigate legal and compensatory frameworks, and deliver clinical consultations intended to preserve sustained work ability and prevent premature labor market exit.<\/p>\n Despite the immense socio-economic ramifications of occupational health decisions, the uptake of high-quality scientific evidence in routine occupational healthcare has historically lagged behind acute clinical specialties. Systematic investigations reveal that occupational health practitioners frequently encounter pervasive challenges when attempting to translate research evidence into everyday clinical practice. These challenges include excessive workloads, fragmented workflows, ambiguous enterprise demands, deficits in critical appraisal training, and, most crucially, a widespread absence of supportive organizational architectures. Prior to the development of the EBP-OHS, investigators seeking to quantify evidence-based practice relied on generalized clinical instruments, such as the Fresno Test of Competence in Evidence-Based Medicine<\/a>, or specialized instruments designed strictly for acute-care inpatient hospital nursing, such as the Evidence-Based Practice Questionnaire (EBPQ) or the Quick-EBP-VIK. However, these legacy instruments present pronounced ecological validity deficits when deployed in occupational settings. They measure academic literature retrieval skills or hospital-centric nursing rituals while entirely overlooking corporate stakeholder negotiations, preventive service selection, workplace guideline alignment, and executive administrative backing.<\/p>\n The EBP-OHS resolves this methodological void by capturing both micro-level individual cognitive\/affective factors and macro-level organizational support systems. In research applications, the scale facilitates sophisticated multi-level investigations into implementation science, enabling researchers to map structural antecedents that drive evidence translation across private and public occupational healthcare enterprises. In clinical and administrative settings, the tool serves as a strategic diagnostic audit. Clinical directors and practice supervisors can utilize the EBP-OHS to pinpoint whether shortfalls in clinical guideline compliance originate from employee training deficits (competence), institutional skepticism (attitudes), or systemic structural neglect (such as lack of continuous professional education, absent managerial encouragement, or poor electronic knowledge infrastructures). By distinguishing between these domains, organizations can strategically deploy educational interventions, restructure managerial priorities, allocate capital to information resources, and track organizational development longitudinally.<\/p>\n The psychological, behavioral, and organizational construct operationalized by the EBP-OHS is conceptualized as an integrated, triadic ecosystem encompassing organizational infrastructure, cognitive capability, and professional value alignment. Rather than treating evidence-based practice as a static technical competence held solely in the mind of the clinician, the construct reflects the dynamic interplay between the practitioner’s behavioral execution and the workplace climate in which they operate. The 15 items of the scale cleanly partition into three distinct, interconnected subscales:<\/p>\n This subscale captures the employee’s perception of the institution’s environmental, administrative, and cultural commitment to facilitating evidence-based practice. Grounded in the principles of organizational psychology and perceived organizational support theory, this dimension posits that individual healthcare professionals cannot systematically deliver evidence-informed interventions if their operational ecosystem does not furnish structural facilitation. The subscale evaluates:<\/p>\n The competence dimension evaluates the practitioner’s self-efficacy and perceived behavioral capability to operationalize scientific evidence across diverse professional interactions. Drawing from social cognitive theory and self-efficacy frameworks, this subscale does not measure abstract statistical theory; instead, it measures applied behavioral capability within occupational health practice. Key facets include:<\/p>\n The attitudes dimension measures the intrinsic affective evaluation and professional value system of the occupational health clinician regarding scientific empiricism. While parsimonious in item count, this construct represents an essential affective filter: even within highly supportive organizations, practitioners who harbor skepticism toward scientific guidelines or view empirical research as subordinate to personal clinical intuition will exhibit substantial implementation friction. This subscale measures:<\/p>\n The conceptual architecture of the Measure of Evidence-Based Practice in Occupational Health is anchored in the internationally recognized Joanna Briggs Institute (JBI) Model of Evidence-Based Healthcare<\/a>, originally articulated by Pearson, Wiechula, Court, and Lockwood (2005) and substantially updated by Jordan, Lockwood, Munn, and Aromataris (2019). The JBI Model is widely acknowledged as one of the most comprehensive theoretical models in implementation science, delineating evidence-based healthcare across four pivotal, cyclical phases:<\/p>\n The EBP-OHS specifically operationalizes and contextualizes the latter two phases\u2014Evidence Transfer<\/strong> and Evidence Implementation<\/strong>\u2014within occupational healthcare delivery systems. In the context of occupational health, evidence transfer cannot be understood merely as passive publication reading; it requires active organizational translation mechanisms. The theoretical model posits that for synthesized evidence (such as clinical practice guidelines on work-related musculoskeletal rehabilitation or toxicological exposure limits) to reach the front line, occupational health units must construct viable transfer conduits. These conduits are embodied in the Organisational Support<\/em> subscale, reflecting supervisory backing, structured continuing education, and workflow-embedded guidelines.<\/p>\n Furthermore, the JBI Model stresses that sustainable Evidence Implementation<\/em> is fundamentally a dual phenomenon of culture and agency. Structural transfer provides the necessary context, but individual professional agency\u2014operationalized through the Competence<\/em> and Attitudes<\/em> subscales\u2014governs whether evidence-based recommendations are realized during client encounters. Drawing additionally upon Kurt Lewin<\/a>‘s field theory ($B = f(P, E)$<\/span>, where behavior is a function of the person and their environment) and Bandura’s Social Cognitive Theory<\/a>, the EBP-OHS framework asserts that evidence-informed clinical behavior emerges only when environmental facilitation intersects with personal competence and internal affective valuation. Thus, the EBP-OHS translates abstract implementation science into an operational, empirical psychometric framework perfectly suited for the multidisciplinary occupational health milieu.<\/p>\n The psychometric validation of the EBP-OHS followed rigorous academic and methodological standards established in contemporary psychometric literature (e.g., Polit & Hungler, 1999; Nunnally & Bernstein, 1994; Mikkonen et al., 2022). Validation encompassed content, construct, and structural verification across multiple developmental phases.<\/p>\n Content validity was evaluated using a structured expert panel consisting of 12 distinguished specialists representing occupational medicine, occupational health nursing, implementation science, and evidence-based clinical methodologies. Panel members independently quantified the clarity, relevance, and representativeness of each candidate item relative to the JBI theoretical framework. Quantification was conducted using the Item-Level Content Validity Index (I-CVI<\/a>). In accordance with strict psychometric thresholds, only items achieving an I-CVI value of 0.78 or higher were retained. Items exhibiting semantic ambiguity, conceptual redundancy, or clinical mismatch were systematically revised or eliminated, resulting in a refined, highly targeted 15-item instrument displaying comprehensive content coverage of the target domain.<\/p>\n Construct validity was subsequently verified through empirical testing on a nationwide opportunity sample of 524 occupational healthcare professionals in Finland. To evaluate sampling adequacy and data suitability for structural factor extraction, the Kaiser-Meyer-Olkin (KMO) measure and Bartlett’s Test of Sphericity were computed:<\/p>\n The instrument exhibited robust sensitivity to professional demographic variations within occupational health teams. Statistical comparisons across professional strata\u2014occupational health nurses ($n = 289$<\/span>, 55%), occupational health physicians ($n = 166$<\/span>, 32%), and executive supervisors\/experts ($n = 69$<\/span>, 13%)\u2014revealed meaningful distinctions in subscale profiles. Executive supervisors and medical directors scored significantly higher on perceived organizational support than frontline clinicians, reflecting known administrative perception patterns documented in health services research. Furthermore, practitioners who had completed recent formal coursework in evidence-based medicine scored substantially higher on the Competence subscale, providing robust known-groups construct validity evidence.<\/p>\n The reliability of the Measure of Evidence-Based Practice in Occupational Health was comprehensively evaluated through internal consistency analyses utilizing classical test theory metrics across the full validation dataset ($N = 524$<\/span>).<\/p>\n The total 15-item EBP-OHS demonstrated strong internal consistency reliability, yielding an overall scale Cronbach’s alpha<\/a> ($\u0007lpha$<\/span>) of 0.88<\/strong>. In psychometric scale development, an alpha coefficient surpassing 0.80 is standardly recognized as indicative of excellent internal consistency, demonstrating that the constituent items form a cohesive operational measure without exhibiting excessive collinearity or item redundancy ($\u0007lpha > 0.95$<\/span>).<\/p>\n Analyses of the three extracted dimensions demonstrated robust internal reliability profiles consistent with their respective item lengths and conceptual breadths:<\/p>\n Item-total correlations across the battery remained consistently above the conventional 0.30 cutoff, with item communalities ($h^2$<\/span>) ranging from 0.37 to 0.79. These findings substantiate that each item contributes substantive, unique, and reliable variance to its designated theoretical domain, rendering the EBP-OHS highly dependable for both cross-sectional institutional audits and longitudinal impact assessments.<\/p>\n To establish the empirical dimensionality and underlying factor structure of the 15-item instrument, the developers conducted an exploratory factor analysis via Principal Component Analysis<\/a> (PCA). Given the theoretical assumption that organizational support, clinician competence, and professional attitudes share meaningful real-world relationships, an oblique rotation method was utilized to optimize factor interpretability while permitting inter-factor correlations.<\/p>\n The PCA extracted a clean, robust three-factor solution that accounted for 60.3% of the total cumulative variance<\/strong> across the dataset. All three extracted factors satisfied Kaiser’s classic eigenvalue retention criterion ($lambda > 1.0$<\/span>), with each retained factor demonstrating an initial eigenvalue of 1.3 or greater<\/strong>. Scree plot inspection corroborated the retention of three primary dimensions, displaying a distinct point of inflection (elbow) following the third component.<\/p>\n The structural matrix revealed clean, highly interpretable item factor loadings without significant cross-loadings, perfectly aligning with the triadic conceptual model:<\/p>\n The communalities of the individual items ranged from 0.37 to 0.79<\/strong>, confirming that the three-factor solution captured a substantial proportion of each item’s baseline variance. This structural clarity confirms that the EBP-OHS accurately operationalizes the dual macro- and micro-level framework of evidence implementation.<\/p>\n The Measure of Evidence-Based Practice in Occupational Health was finalized and formally published in 2024<\/strong> in the peer-reviewed journal La Medicina del Lavoro<\/em> (Work, Environment and Health). The scale development was conducted in Finland under the academic auspices of the Oulu University of Applied Sciences, the University of Eastern Finland, and Ilmarinen Mutual Pension Insurance Company, adhering strictly to the ethical standards codified by the Finnish National Board on Research Integrity (TENK, 2019).<\/p>\n Licensing and Accessibility:<\/strong> The conceptual framework, validation metrics, and psychometric structure of the EBP-OHS are published under academic fair-use and open-science conventions. While the structural methodology is published openly, the complete verbatim questionnaire items in Finnish (and authorized translations) remain under the academic copyright of the original investigative authors (Jani Ruotsalainen, Kati P\u00e4\u00e4talo, Kari-Pekka Martimo, and Tuula Oksanen). The instrument is made accessible free of charge for non-commercial academic research, institutional audits, and non-profit healthcare quality improvement initiatives. Researchers and occupational health directors wishing to obtain the authoritative, unabridged item inventory, Finnish master version, or translation clearance must submit a formal written request to the corresponding author, Jani Ruotsalainen, via email at j.h.ruotsalainen@gmail.com<\/a>.<\/p>\n Bianchi, M., Bagnasco, A., Bressan, V., Barisone, M., Timmins, F., Pellegrini, R., Aleo, G., & Sasso, L. (2018). A review of the role of nurse leadership in promoting and sustaining evidence-based practice. Journal of Nursing Management<\/em>, 26(8), 918\u2013932. https:\/\/doi.org\/10.1111\/jonm.12638<\/a><\/p>\n Br\u00e4mberg, E. B., Nyman, T., Kwak, L., Almin, G., & Bergstr\u00f6m, G. (2017). Development of evidence-based practice in occupational health services in Sweden: A 3-year follow-up of attitudes, barriers and facilitators. International Archives of Occupational and Environmental Health<\/em>, 90(4), 335\u2013348. https:\/\/doi.org\/10.1007\/s00420-017-1200-8<\/a><\/p>\n da Silva, A. M., Valentim, D. P., Martins, A. L., & Padula, R. S. (2023). Instruments to assess evidence-based practice among health care professionals: A systematic review. Health Education & Behavior<\/em>, 50(5), 682\u2013695. https:\/\/doi.org\/10.1177\/10901981231170154<\/a><\/p>\n Finnish National Board on Research Integrity. (2019). The ethical principles of research with human participants and ethical review in the human sciences in Finland<\/em>. Finnish Advisory Board on Research Integrity (TENK) Publications. https:\/\/tenk.fi\/sites\/default\/files\/2021-01\/Ethical_review_in_human_sciences_2020.pdf<\/a><\/p>\n Heselmans, A., Donceel, P., Aertgeerts, B., Van de Velde, S., & Ramaekers, D. (2010). The attitude of Flemish occupational health physicians toward evidence-based occupational health and clinical practice guidelines. International Archives of Occupational and Environmental Health<\/em>, 83(2), 201\u2013208. https:\/\/doi.org\/10.1007\/s00420-009-0449-y<\/a><\/p>\n Jordan, Z., Lockwood, C., Munn, Z., & Aromataris, E. (2019). The updated Joanna Briggs Institute Model of Evidence-Based Healthcare. International Journal of Evidence-Based Healthcare<\/em>, 17(1), 58\u201371. https:\/\/doi.org\/10.1097\/XEB.0000000000000155<\/a><\/p>\n Kinnunen-Amoroso, M. (2013). How occupational health care professionals experience evidence-based guidelines in Finland: A qualitative study. Journal of Evaluation in Clinical Practice<\/em>, 19(4), 612\u2013616. https:\/\/doi.org\/10.1111\/j.1365-2753.2012.01850.x<\/a><\/p>\n Korhonen, T., Siltanen, H., Hahtela, N., & Holopainen, A. (2018). Toteutuuko n\u00e4ytt\u00f6\u00f6n perustuva toiminta Suomessa? Raportti nykytilasta hoitoty\u00f6n edustajien kuvaamana<\/em>. Suomen Sairaanhoitajaliitto ry & Hotus.<\/p>\n Lockwood, C. (2017). Applying theory informed global trends in a collaborative model for organizational evidence-based healthcare. Journal of Korean Academy of Nursing Administration<\/em>, 23(2), 111\u2013115. https:\/\/doi.org\/10.11111\/jkana.2017.23.2.111<\/a><\/p>\n Mikkonen, K., Tomietto, M., & Watson, R. (2022). Instrument development and psychometric testing in nursing education research. Nurse Education Today<\/em>, 119, Article 105603. https:\/\/doi.org\/10.1016\/j.nedt.2022.105603<\/a><\/p>\n Nunnally, J. C., & Bernstein, I. H. (1994). Psychometric theory<\/em> (3rd ed.). McGraw-Hill.<\/p>\n Paul, F., Connor, L., McCabe, M., & Ziniel, S. (2016). The development and content validity testing of the Quick-EBP-VIK: A survey instrument measuring nurses’ values, knowledge and implementation of evidence-based practice. Journal of Nursing Education and Practice<\/em>, 6(5), 118\u2013127. https:\/\/doi.org\/10.5430\/jnep.v6n5p118<\/a><\/p>\n Pearson, A., Wiechula, R., Court, A., & Lockwood, C. (2005). The JBI model of evidence-based healthcare. International Journal of Evidence-Based Healthcare<\/em>, 3(8), 207\u2013215. https:\/\/doi.org\/10.1111\/j.1479-6988.2005.00026.x<\/a><\/p>\n Polit, D. F., & Hungler, B. P. (1999). Nursing research: Principles and methods<\/em> (6th ed.). Lippincott Williams & Wilkins.<\/p>\n Ramos, K. D., Schafer, S., & Tracz, S. M. (2003). Validation of the Fresno test of competence in evidence based medicine. BMJ<\/em>, 326(7384), 319\u2013321. https:\/\/doi.org\/10.1136\/bmj.326.7384.319<\/a><\/p>\n Ruotsalainen, J., P\u00e4\u00e4talo, K., Martimo, K.-P., & Oksanen, T. (2024). Measure of Evidence-Based Practice in Occupational Health. La Medicina del Lavoro<\/em>, 115(5), Article e2024041. https:\/\/doi.org\/10.23749\/mdl.v115i5.16286<\/a><\/p>\n Shaneyfelt, T., Baum, K. D., Bell, D., Feldstein, D., Hershberger, P. J., Baumann, P. C., & Sinsky, C. (2006). Instruments for evaluating education in evidence-based practice: A systematic review. JAMA<\/em>, 296(9), 1116\u20131127. https:\/\/doi.org\/10.1001\/jama.296.9.1116<\/a><\/p>\n2. Keywords<\/h2>\n
3. Authors<\/h2>\n
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4. Purpose<\/h2>\n
5. Psychological Construct<\/h2>\n
1. Organisational Support (7 Items)<\/h3>\n
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2. OHS Practitioners’ Competence (6 Items)<\/h3>\n
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3. OHS Practitioners’ Attitudes (2 Items)<\/h3>\n
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6. Theoretical Framework<\/h2>\n
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7. Validity<\/h2>\n
Content Validity<\/h3>\n
Construct and Structural Validity<\/h3>\n
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Known-Groups and Practical Validity Evidence<\/h3>\n
8. Reliability<\/h2>\n
Internal Consistency Reliability<\/h3>\n
Subscale Reliability Properties<\/h3>\n
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Item Homogeneity and Communalities<\/h3>\n
9. Factor Analysis<\/h2>\n
Factor Extraction and Variance Explained<\/h3>\n
Factor Loadings and Structural Alignment<\/h3>\n
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10. Instrument \/ Measurement Tool<\/h2>\n
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11. Permissions, Fee, and Test Year<\/h2>\n
12. References<\/h2>\n