Table 5.
Summary of factors impacting clinician implementation of eOrygen using the Consolidated Framework for Implementation Research (CFIR).
| CFIR domain | CFIR construct | Description | Illustrative quote | Implementation impact |
| Characteristics of individuals | Self-efficacy | Clinicians expressed varying levels of confidence when it came to implementing the intervention. This variance in confidence had a notable influence on their motivation and capacity to use the platform as part of their clinical practice. | “[H]ard when I didn’t know exactly what I was prompting them to do sometimes.” (Focus group 1) | Barrier |
| Inner setting | Implementation climate: relative priority | Clinicians frequently cited competing priorities, including concerns related to young people’s risk, handling acute presentations, and the challenge of being understaffed, as significant barriers that impeded their ability to engage with, and become familiar with, the eOrygen platform. | “Might’ve been a little bit me as well of not feeling like I had the time or just forgetting sometimes to just the other priorities I have.” (Focus group 3) | Barrier |
| Outer setting | Young people’s needs and resources | Clinicians demonstrated a strong understanding of young people’s needs, including the complexities associated with addressing these needs effectively. This encompassed underaddressed comorbid conditions, clinical complexity, and barriers related to motivation and the specific age group within the cohort. | “All the comorbidities...we don’t always get to do the, you know, anxiety management stuff or like skills-based stuff as much as, um, I feel like as much as I did in other clinics.” (Focus group 3) | Facilitator |
| Intervention characteristics | Complexity | Clinicians considered the process for connecting and onboarding young people to the eOrygen platform to be lengthier and more in-depth than what young people typically expect when engaging with technology. | “’Cause young people want, unfortunately, they want everything now and right there and then. So, if they click and it doesn’t work, they’ll be like, ‘now there’s nothing, it’s not working.’” (Focus group 3) | Barrier |
| Characteristics of individuals | Knowledge and beliefs about intervention | Clinicians had positive regard for the eOrygen platform overall. However, their implementation was hindered by a lack of comprehensive knowledge about how the platform practically worked. | “We’re all probably a bit limited in thinking about how we’re using it.” (Focus group 2) | Facilitator and barrier |
| Intervention characteristics | Evidence strength and quality | Clinicians had the perception that the intervention had a strong evidence base and provided quality information to support young people. However, they also had a limited understanding of which components of the intervention led to effective outcomes. | “I didn’t have to go and do my own homework or ensure that I was using like, up-to-date and relevant information.” (Focus group 3) | Facilitator and barrier |