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Int J Health Policy Manag. 2018 Mar 6;7(9):791-797. doi: 10.15171/ijhpm.2018.17.

Development and Content Validation of a Transcultural Instrument to Assess Organizational Readiness for Knowledge Translation in Healthcare Organizations: The OR4KT.

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Population Health and Optimal Health Practices Research Unit, CHU de Québec-Université Laval Research Centre, Québec, QC, Canada.
Department of Nursing Sciences, Université Laval, Québec, QC, Canada.
Faculty of Nursing, Université Laval, Québec, QC, Canada.
CRED Research Centre - École Supérieure des Affaires, Beirut, Lebanon.
CHEO Research Institute, Centre for Practice Changing Research Building, Ottawa, ON, Canada.
Better Outcomes Registry & Nerwork (BORN) Ontario, Ottawa, ON, Canada.
Primary Care Research Unit of Bizkaia - Osakidetza, Basque Health Service, Bilbao, Spain.
BioCruces Health Research Institute, Baracaldo, Spain.
Faculty of Nursing and School of Public Health, University of Alberta, Edmonton, AB, Canada.
Department of Family Medicine, Université Laval, Québec, QC, Canada.



Implementing effective interventions in healthcare requires organizations to be ready to support change. This study aimed to develop, adapt transculturally, and assess the content and face validity of the Organizational Readiness for Knowledge Translation (OR4KT) tool. The OR4KT was designed to measure the readiness of healthcare organizations to implement evidence-informed change across a variety of services.


Based on systematic reviews of the literature, a Delphi exercise, and expert consultation, we first generated an initial pool of items. Second, we developed and assessed content validity of the pilot OR4KT questionnaire in English. Third, we created French and Spanish versions using a sequential forward and backward translation approach, and transcultural adaptation by a consensus process. Finally, we conducted pilot studies in three contexts - the Basque country region (Spain), and the provinces of Québec and Ontario (Canada) - where 30 experts assessed the face validity of the three versions of OR4KT.


We selected 59 items, grouped in 6 dimensions (organizational climate, context, change content, leadership, organizational support, and motivation) for the final English version of OR4KT. Translation and transcultural adaptation did not identify any content or language problems. Our findings indicate that the English, French and Spanish versions of OR4KT are linguistically equivalents and have high face validity. Only minor revisions to the wording of some items were recommended.


The OR4KT holds promise as a measure of readiness for knowledge translation (KT) in healthcare organizations. The validity and reliability of the three versions of the OR4KT will be assessed in real-life contexts of implementation of evidence-based changes in healthcare.


Healthcare Organizations; Instrument Development; Knowledge Translation; Readiness for Change; Transcultural Validation

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