Adaptation of the Texas Christian University Organisational Readiness for Change Short Form (TCU-ORC-SF) for use in primary health facilities in South Africa.

OBJECTIVES: The Texas Christian University Organisational Readiness for Change Scale (TCU-ORC) assesses factors influencing adoption of evidence-based practices. It has not been validated in low-income and middle-income countries (LMIC). This study assessed its psychometric properties in a South African setting with the aim of adapting it into a shorter measure. METHODS: This study was conducted in 24 South African primary healthcare clinics in the Western Cape Province. The TCU-ORC and two other measures, the Organisational Readiness to Change Assessment (ORCA) and the Checklist for Assessing Readiness for Implementation (CARI) were administered. The questionnaire was readministered after 2 weeks to obtain data on test-retest reliability. Three hundred and ninety-five surveys were completed: 281 participants completed the first survey, and 118 recompleted the assessments. RESULTS: We used exploratory factor analysis (EFA) to identify latent dimensions represented in the data. Cronbach's alpha for each subscale was assessed and we examined the extent to which the subscales and total scale scores for the first and retest surveys correlated. Convergent validity was assessed by the correlation coefficient between the TCU-ORC, ORCA and CARI total scale scores. EFA resulted in a three-factor solution. The three subscales proposed are Clinic Organisational Climate (8 items), Motivational Readiness for Change (13 items) and Individual Change Efficacy (5 items) (26 items total). Cronbach's alpha for each subscale was >0.80. The overall shortened scale had a test-retest correlation of r=0.80, p<0.01, acceptable convergent validity with the ORCA scale (r=0.56, p<0.05), moderate convergence with the CARI (r=39, p<0.05) and strong correlation with the original scale (r=0.79, p<0.05). CONCLUSIONS: This study presents the first psychometric data on the TCU-ORC from an LMIC. The proposed shortened tool may be more feasible for use in LMICs. TRIAL REGISTRATION NUMBER: Results stage. Project MIND trial. Pan-African Clinical Trials Registry. PACTR201610001825405.

Achievements and Challenges for Higher Education during the COVID-19 Pandemic: A Rapid Review of Media in Africa.

The coronavirus (COVID-19) pandemic struck globally and has affected higher education institutions (HEIs) and their operations, indirectly impacting the progress of the Sustainable Development Goal 4 achieved thus far. This article addresses HEIs achievements and challenges experienced in the wake of the pandemic. Online news media reports played a facilitative role in providing information to the HEI communities. A rapid review exploring online news media messages relating to higher education at the onset of the COVID-19 pandemic in Africa was utilised. Narrative synthesis was used to analyse the data. The results highlight HEIs achievements, which aim to ensure that all students receive the same level of education and provision in terms of devices and mental health support. However, challenges were also experienced at HEIs and include students feeling uncertainty and fear regarding completing their education. Furthermore, the results also show that not all students received the same level of education due to contextual factors, thus deepening the existing social disparities in Africa. The pandemic provides an opportunity for HEIs to embed the components of global citizenship education into the curriculum and to work in an innovative way to promote Sustainable Development Goal 4.