Evidence-Based Practice Attitude Scale (EBPAS-36)
Evidence-Based Practice Attitude Scale (36-item) · Also known as: EBPAS, EBPAS-36, Evidence-Based Practice Attitude
The EBPAS-36 is a 36-item self-report questionnaire that assesses clinicians' and organizational leaders' attitudes toward adopting and implementing evidence-based practices (EBP). Developed by Aarons in 2005 and refined through multiple validation studies, it measures four core dimensions: perceived requirements to adopt EBP, the appeal and usefulness of EBP to individual practice, organizational openness to innovation, and perceived divergence between current practice and EBP requirements. The EBPAS is widely used in healthcare, mental health, child welfare, and substance abuse treatment settings to predict adoption readiness and guide implementation planning.
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When to use it
The EBPAS-36 is appropriate for assessing staff attitudes in any clinical or human service organization considering, planning, or implementing evidence-based practices. It is particularly valuable at baseline (pre-implementation) to predict adoption success and identify barriers, and periodically during implementation to monitor attitude change. Use in hospitals, clinics, mental health centers, child welfare agencies, schools, and substance abuse treatment programs. The scale is less appropriate for individual clinicians in solo practice or highly specialized research settings where organizational context is minimal.
Strengths & limitations
- Multidimensional assessment of attitudes—captures perceived mandate, usefulness, organizational openness, and fit simultaneously, providing actionable profiles for intervention design
- Strong psychometric validation—tested across multiple healthcare and social service settings with good internal consistency (Cronbach's α = 0.63–0.80 per subscale) and predictive validity for implementation success
- Practical brevity—36 items require only 5–10 minutes for completion, feasible in busy clinical workflows
- Predictive utility—subscale scores correlate with downstream adoption behaviors and implementation fidelity; useful for risk-stratifying sites at baseline
- Free and publicly available—no licensing fees; encourages widespread adoption monitoring
- Moderate internal consistency on some subscales (α <0.70 on Divergence in some samples) suggests subscales may not be perfectly unidimensional
- Primarily tested in mental health and substance abuse treatment; applicability to other healthcare sectors (pediatrics, oncology, primary care) less established
- Self-report bias—respondents may report attitudes favorable to adoption when they perceive organizational pressure, especially if survey completion is visible to leadership
- Subscale interdependence—attitudes toward EBP are not entirely independent; perceived Requirements may influence Appeal ratings, limiting ability to distinguish true separable factors
Frequently asked
How do I interpret a subscale mean of 2.0 on the 0–4 scale?
A mean of 2.0 (5-point scale midpoint) represents neutral or uncertain attitudes. For Requirements, this indicates moderate perceived mandate; for Appeal, it suggests moderate usefulness; for Openness, it indicates cautious receptivity. Scores >2.5 generally indicate positive attitudes; <1.5 indicate skepticism. Interpretation depends on context—in mandated settings, requirement scores >2.5 are expected; in voluntary adoption, appeal and openness are more critical.
Can EBPAS scores predict whether implementation will succeed?
EBPAS scores correlate with implementation success, but are not deterministic. Research shows organizations with baseline mean EBPAS >2.8 and high Appeal/Openness have higher adoption rates (65–80%) vs. those with lower scores (30–50%). However, strong leadership support, adequate resources, and aligned organizational systems can partially overcome low EBPAS attitudes. Use EBPAS as one input to readiness assessment, not the sole predictor.
Should I allow respondents to skip items or answer 'unsure'?
Best practice is to require a rating (0–4) for each item. Missing data on the EBPAS-36 compromises subscale scoring and introduces bias. If respondents are unsure, instruct them to select '2' (Moderately) as default neutral; this preserves data integrity. Missing item rates >10% warrant investigation of comprehension issues or engagement concerns.
Can the EBPAS-36 be administered anonymously?
Yes—the EBPAS-36 was designed for anonymous completion to minimize social desirability bias. Recommend anonymous online or paper survey administration. If aggregate feedback is needed, link responses to role (e.g., clinician vs. administrator) rather than individual ID. Anonymous administration increases response rate and honesty, particularly on Divergence items.
How does the EBPAS-36 differ from the EBPAS-50?
The EBPAS-50 (original) has 50 items yielding 4 subscales (Requirements, Appeal, Openness, Divergence) and one 2-item general attitude subscale. The EBPAS-36 retains the core 4 subscales with fewer items per subscale, sacrificing minor variance in measurement precision but improving feasibility. Both use the same 0–4 Likert scale and subscale structure. Use EBPAS-36 in time-constrained settings; EBPAS-50 in research requiring maximum precision.
Sources
- Aarons, G. A. (2011). Evidence-Based Practice Attitude Scale-50 (EBPAS-50) and EBPAS-36 short form: Psychometric properties. Implementation Science, 6(1), 89. link ↗
How to cite this page
ScholarGate. (2026, June 3). Evidence-Based Practice Attitude Scale (36-item). ScholarGate. https://scholargate.app/en/implementation-science/evidence-based-practice-attitude
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