Table 1.

CFIR Codebook (CFIRGuide.org) with definitions, and interview questions.

Characteristics of individuals: The individuals involved with the implementation process

Knowledge and beliefs about the innovation: Individuals’ knowledge and beliefs about the intervention as well as familiarity with facts, truths, and principles related to the intervention. Example question: What do you know about the “best practices” for treating co-occurring chronic pain and opioid use disorder?

Individual identification with organization: How individuals perceive the organization and their degree of commitment with that organization.

Individual stage of change: The phase an individual is in, as they progress toward sustained use of the intervention.

Self-efficacy: Individual confidence in their ability to achieve implementation goals. Example question: How confident are you that you would be able to successfully implement these practices? Why?

Innovation characteristics: Key attributes of interventions that influence the success of implementation

Complexity: Perceived difficulty of adopting the intervention.

Cost: Costs associated with the intervention and its implementation. Example question: What kind of costs must be considered when implementing these practices?

Evidence strength and quality: Perceptions of the quality and validity of evidence supporting the intervention. Example question: What kind of information or evidence are you aware of that shows whether or not the different practices for treating chronic pain and opioid use disorder are effective?

Innovation source: Perception of key stakeholders about whether the intervention is externally or internally developed. Example question: Please tell me your perceptions about what is considered “best practice” for treating patients with chronic pain and opioid use disorder? Can you tell me about the organization/group that developed these guidelines?

Relative advantage: Stakeholders’ perception of the advantage of implementing the intervention versus an alternative solution. Example question: How do these practices compare? Is one better than the others?

Adaptability: The degree to which an intervention can be tailored to meet the needs of the people involved.

Trialability: The ability to test the intervention in the organization, and to be able to reverse course (undo implementation) if warranted.

Design quality and packaging: Perceived quality in how the intervention is presented.

Inner setting: The structural, political, and cultural contexts through which the implementation process will proceed

Structural characteristics: The social architecture, age, maturity, and size of an organization. Example question: What kinds of infrastructure changes were/will be needed to accommodate these practices?

Implementation climate: The capacity for change, shared receptivity of involved individuals to an intervention, and the extent to which use of that intervention will be supported within their organization.

Culture: Norms, values, and basic assumptions of a given organization. Example question: How do you think your organization’s culture (general beliefs, values, assumptions that people embrace) would affect the implementation of this practice?

Goals & feedback: The degree to which goals are clearly communicated, acted upon, and fed back to staff, and alignment of that feedback with goals. Example question: Do you get any feedback reports about your work?

Learning climate: A climate in which: (a) leaders express their own fallibility and need for team members’ assistance and input; (b) team members feel that they are essential, valued, and knowledgeable partners in the change process; (c) individuals feel psychologically safe to try new methods; and (d) there is sufficient time and space for reflective thinking and evaluation. Example question: To what extent are new ideas embraced and used to make improvements in your organization?

Relative priority: Individuals’ shared perception of the importance of the implementation within the organization. Example question: What kinds of high-priority initiatives or activities are already happening in your setting?

Tension for change: The degree to which stakeholders perceive the current situation as intolerable or needing change.

Compatibility: The degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values, and perceived risks and needs, and how the intervention fits with existing workflows and systems.

Organizational incentives and rewards: Extrinsic incentives such as goal-sharing awards, performance reviews, promotions, and raises in salary, and less tangible incentives such as increased stature or respect.

Networks and Communications: The nature and quality of webs of social networks and the nature and quality of formal and informal communications within an organization. Example question: Tell me a little bit about your team or colleagues, who would you consider to be in your team in your practice? Are meetings, such as staff meetings, held regularly?

Readiness for Implementation: Indicators of organizational commitment to its decision to implement an intervention.

Available resources: The level of resources dedicated for implementation and on-going operations, including money, training, education, physical space, and time. Example question: Do you have sufficient resources to implement these practices? What resources would you need?

Leadership engagement: Commitment, involvement, and accountability of leaders and managers with the implementation.

Access to knowledge and information: Ease of access to digestible information and knowledge about the intervention and how to incorporate it into work tasks.

Outer setting: The economic, political, and social context within which an organization resides.

External policies & incentives: A broad construct that includes external strategies to spread interventions, including policy and regulations, external mandates, recommendations and guidelines, pay-for-performance, collaboratives, and public or benchmark reporting. Example question: What kind of local, state, or national performance measures, policies, regulations, or guidelines influenced your/your organization’s decision to implement new practices to treat co-occurring chronic pain and opioid use disorder?

Needs & resources of those served by the organization: The extent to which patient needs are prioritized by the organization. Example question: What barriers do/will the individuals served by your organization face in participating in trying to adopt these practices?

Peer pressure: Pressure to implement an intervention.

Cosmopolitanism: The degree to which an organization is networked with other external organizations.

Process: The processes involved in implementing a new practice.

Planning: The degree to which a scheme or method of behavior and tasks for implementing an intervention are developed in advance, and the quality of those schemes or methods. Example question: What have you done (or what do you plan to do) to get a plan in place to implement these practices?

Engaging: Involving appropriate individuals in the implementation and use of the intervention. Example question: Who are the key influential individuals to get on board to implement these interventions?

Executing: Carrying out or accomplishing the implementation according to plan.

Reflecting and evaluating: Feedback about the progress and quality of implementation. Example question: How do you assess progress when implementing new practices?

Note. CFIR = Consolidated Framework for Implementation Research.