Table 2.

Qualitative implementation themes, by CFIR 2.0 domains

CFIR 2.0 Domains	CFIR 2.0 Construct	Definition	Study Result
Intervention characteristics
	Relative Advantage	Stakeholders see the advantage of implementing the innovation compared to an alternative solution or keeping things the same.	The perceived relative advantage of VR-JIT centered on Molly Porter’s (i.e., the virtual hiring manager) ability to be “blunt” and direct in comparison to the supportive, strengths-based clinical approach of IPS staff. Staff at multiple implementation levels (e.g., VR-JIT implementer, employment specialist, team leader) discussed this directive component to practicing job interviews as beyond their typical scope of practice.
	Relative Advantage	Stakeholders see the advantage of implementing the innovation compared to an alternative solution or keeping things the same.	Employment specialists discussed how VR-JIT recipients displayed an improved understanding about job search processes and stronger motivation to find employment after completing VR-JIT. Employment specialists shared that incorporating VR-JIT into IPS increased their efficiency. For example, IPS staff reported that VR-JIT enabled them to shift their attention to other important, yet time-consuming IPS tasks, like job development.
	Adaptability	Stakeholders believe that the innovation can be sufficiently adapted, tailored, or re-invented to meet local needs.	VR-JIT implementers reported that knowing how to troubleshoot technology before delivering VR-JIT reduced the chances of participants disengaging from VR-JIT, particularly for participants who had limited computer skills.
	Adaptability	Stakeholders believe that the innovation can be sufficiently adapted, tailored, or re-invented to meet local needs.	VR-JIT implementers reported it was important to clearly explain the rationale behind using the intervention as a few VR-JIT recipients thought they were attending real job interviews. Thus, contextualizing VR-JIT more clearly may better prepare participants for staying engaged with the intervention.
	Adaptability	Stakeholders believe that the innovation can be sufficiently adapted, tailored, or re-invented to meet local needs.	Although IPS staff consistently discussed the need for more time to contextualize VR-JIT for clients, IPS staff suggested some clients became less engaged with VR-JIT because some sessions were too lengthy (>75 min). Thus, adapting both the duration of VR-JIT sessions, and the frequency of scheduled sessions to meet individual client needs may enhance its delivery within IPS.
Outer Setting
	Community characteristics: built environment	Elements of the built environment create barriers/facilitators to implementation.	IPS staff described how transportation challenges impacted their client’s ability to attend weekly in-person VR-JIT sessions and suggested offering VR-JIT via remote services as a critical delivery adaptation
Individuals
	Innovation recipients	Receiving the innovation (directly or indirectly)	VR-JIT recipients with serious mental illnesses and long periods of disability faced some barriers staying engaged with VR-JIT sessions. IPS staff identified engagement barriers that they perceived as directly related to clients’ psychiatric symptoms or to ancillary issues, such as low-frustration tolerance.