Smoking Cessation and Reduction in Pregnancy Treatment (SCRIPT) Adoption Scale (SAS): Evaluating the Diffusion of an Tobacco Treatment Innovation to a Prenatal Care Program and Providers

When a new patient education program is adopted by a health agency, it is essential to determine the perceptions of providers about its acceptability for routine use. In 2007 the WV Right From The Start (RFTS) Project adopted the Smoking Cessation and Reduction In Pregnancy Treatment (SCRIPT) Program. RFTS is a state-wide perinatal home visitation initiative delivered by Designated Care Coordinators (DCCs). In the absence of a valid instrument to assess the perceived attributes of a tobacco treatment innovation among the RFTS-DCC population, the SCRIPT Adoption Scale (SAS) was developed. We evaluated the validity of the five constructs of the Rogers' Diffusion of Innovation Model in an Organization to predict routine SCRIPT program use: Relative Advantage, Compatibility, Complexity, Observability, and Trialability. After reviewing the literature and developing draft SAS Forms, expert panel reviews established the face and content validity of a 43-item SAS. It was administered to 90% of the RFTS DCC population (N = 85/90). Psychometric analyses confirmed the validity and reliability of a 28-item scale. All 28 items had factor loadings of > 0.40 (0.43-0.81). All SAS sub-scales were strongly correlated, r = 0.51 to 0.97, with each other supporting the convergent validity of a five factor SAS. The internal consistency of the SAS was r = 0.93 and stability was r = 0.76. While several specific SAS sub-scales need to be improved, the SAS can be adapted by prenatal care programs to measure the attributes of adoption of new, evidence-based health education methods.