Table 2.

Major Findings. Results have been organized according to the stakeholder interviewed (patient or staff) and the Consolidated Framework for Implementation Research (CFIR) [18]

CFIR Construct	Construct Description	Applicable Principles	Staff Perspective	Patient Perspective	Best Practices & Suggestions for Successful Implementation
Characteristics of the Intervention	Multi-faceted components of the intervention (may include core or more adaptable, peripheral components)	• Complexity • Adaptability • Trialability • Relative advantage	• Concern that recruitment materials for the PC arm were not created with enough focus on the target audience • Online format has advantages for streamlining the consent process	Patients report being interested in the online format for learning more about available research study opportunities, but also appreciate the advantages that face-to-face/interpersonal communication offers in the traditional CoE setting	• For PC designs, choose study designs with clearly defined self-report measures and procedures that are easily adaptable to the online environment • Use appropriate health literacy levels in study recruitment, consent, and enrollment/procedure materials
Inner Setting	Structural and cultural contexts through which the implementation process must occur (e.g., communications, culture, readiness for change)	• Available resources • Culture and climate • Readiness for implementation	• Insufficient resource regarding marketing expertise for design of study materials • Greater communication needed at multiple touchpoints to implement editing of study materials/study process	Not applicable	• Hire an advertising/marketing professional • Identify one “point person” on staff to communicate all recommended study changes (with firm deadlines) to study team members • Implement a shared mechanism for editing study materials in real time to be sure patient questions/concern are being adequately addressed
Characteristics of Individuals	How individual choices, mindsets, and personalities impact the implementation process	• Knowledge and beliefs about the intervention self-efficacy • Personal attributes	• Concerns that patients will be “left behind” if they are not comfortable using online technologies	• Patients report feeling confident in their ability to learn about new studies in the online environment	• Reiterate to staff members that the implementation of new technology in the research process is a balance – it is not an “all or nothing” approach (a mixture of CoE and PC principles will require greater flexibility on their part) • Develop hard copies of educational materials for distribution in various settings to ensure that those not online will not be “forgotten”
Process	Series of subprocesses (linear or non-linear) that occur at multiple levels to form the overall implementation	• Reflecting and evaluating • Key stakeholders • Engaging • Opinion leaders	• Face-to-face communication is still important • The online consent process is a major step in the right direction • A hybrid approach (CoE and PC elements) would work best	• Role of the local physician is paramount – patients see this individual as an opinion leader and influential in their decision to enroll in a study	• Engage existing online networks (e.g. Facebook groups) to leverage their followers to increase study awareness and establish greater trust • Design online/web-based elements using theory-based, PC approaches • Incorporate physicians into the design phases of online materials given their role as opinion leaders for patients