Table 3.

Facilitators and barriers identified by stakeholders for implementing Picterus JP, based on the Consolidated Framework for Implementation Research (CFIR)

CFIR domain	Facilitators	Barriers
a) Innovation: Picterus JP	Easy to use Useful: improves detection, decreases blood pricking, saves resources	Doubts or uncertainties about performance in real-life scenarios and in all types of skin colours Requires internet connection Potential high cost
b) Outer setting: National health system, IMSS, and Oaxaca community	Aligns with mission Adequate digital literacy among healthcare workers Community acceptance through awareness-raising and dissemination would facilitate acceptance	Long process to get regulatory approval Added value needs to be identified by authorities Unstable mobile data network in Oaxaca
c) Inner setting: IMSS health facilities in the study	Adequate physical infrastructure Requires minimal equipment Compatible with work routine	Insufficient internal internet network
d) Individuals: HCWs, health administrators	Expressed need and desire to improve NNJ detection Willingness and motivation to use new technology	Resistance to change