Table 4

Practice Culture Assessment Scores Over Time by Group

Subscale	RAP	CQI	SD	Differential Change Over Time	P Value
Change Culture
Baseline	66.2	69.5	67.1	Overall: F_4,66 = 1.91	.12
9 months	68.5	68.5	66.6	RAP × SD: F_2,52 = 3.33	.04
18 months	64.0	67.3	66.9	CQI × SD: F_2,42 = 0.51	.60
	…^a	…	…	CQI × RAP: F_2,38 = 1.75	.19
Chaos
Baseline	47.7	43.4	49.0	Overall: F_4,66 = 3.47	.01
9 months	50.2	46.8	50.0	RAP × SD: F_2,52 = 3.87	.03
18 months	50.8	48.2	47.3	CQI × SD: F_2,42 = 5.63	.007
	…^b	…^b	…	CQI × RAP: F_2,38 = 0.49	.62
Work Culture
Baseline	69.8	68.7	66.5	Overall: F_4,66 = 2.34	.06
9 months	68.8	69.2	68.1	RAP × SD: F_2,52 = 4.59	.01
18 months	66.4	68.6	68.5	CQI × SD: F_2,42 = 0.49	.62
	…^b	…	…	CQI × RAP: F_2,38 = 1. 59	.22

CQI = continuous quality improvement; RAP = reflective adaptive process; SD = self-directed.
Note: Scores are means.
↵a P <.01 within-group change.
↵b P <.05 within-group change.