Table 2.
Ratings assigned to CFIR constructs by unit based on the rating criteria.a
| Domains and constructs of CFIR | High implementation units | Low implementation unit | Distinguishing constructsb | ||||
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Unit 1 | Unit 2 | Unit 3 | Unit 4 | Unit 5 |
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| 1. Intervention characteristics |
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Intervention source | External | External | Missing | Missing | External |
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Evidence strength & quality | Missing | Missing | Missing | Missing | Missing |
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Relative advantage | +2 | +2 | 0 (mix) | +1 | 0 | Weak |
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Adaptability | +1 | +2 | +1 | +1 | +1 |
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Trialability | +2 | +2 | +2 | +2 | –1 | Strong |
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Complexity (reverse rated)c | +1 | +1 | +1 | +1 | +1 |
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Design quality and packaging | +1 | +1 | +1 | –1 | 0 |
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Cost | 0 (mix) | 0 | –1 | –2 | Missing |
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| 2. Outer setting |
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Patient needs & resources | 0 | +1 | 0 | 0 | –1 | Weak |
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Cosmopolitanism | Missing | Missing | Missing | Missing | Missing |
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Peer pressure | Missing | Missing | Missing | Missing | Missing |
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External policies & incentives | Missing | Missing | Missing | Missing | Missing |
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| 3. Inner setting |
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Structural characteristics | 0 | 0 | 0 | 0 | –1 | Weak |
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Networks & communications | +1 | 0 (mix) | +1 | +2 | +1 |
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Culture | –1 | –1 | +1 | –1 | –2 | Weak |
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Implementation climate |
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Tension for change | +1 | +1 | 0 (mix) | +1 | –2 | Strong |
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Compatibility | Missing | +1 | 0 (mix) | +2 | –2 | Strong |
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Relative priority | 0 | Missing | 0 | +1 | –2 | Strong |
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Organizational incentives & rewards | 0 | +1 | 0 | Missing | Missing |
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Goals & feedback | Missing | Missing | Missing | 0 (mix) | 0 |
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Learning climate | +1 | +1 | Missing | Missing | +1 |
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Readiness for implementation |
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Leadership engagement | +1 | 0 | +1 | 0 | +1 |
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Available recourses | +2 | +2 | +2 | +2 | –1 | Strong |
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Access to information and knowledge | +2 | +1 | +2 | +2 | Missing |
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| 4. Characteristics of individuals |
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Knowledge and belief about the intervention | +2 | +2 | 0 (mix) | +2 | –1 | Weak |
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Self-efficacy | +1 | +1 | +2 | +2 | +1 |
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Individual stage of change | –1 | +2 | –1 | –1 | –1 |
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Individual identification with organization | Missing | Missing | Missing | Missing | Missing |
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Other personal attributes | Missing | Missing | Missing | Missing | Missing |
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| 5. Process |
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Planning | Missing | +1 | Missing | +1 | –2 | Strong |
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Engaging |
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Opinion leaders | Missing | Missing | Missing | Missing | –2 |
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Formally appointed internal implementation leaders | 0 | 0 | +1 | 0 | –1 | Weak |
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Champions | Missing | Missing | Missing | Missing | Missing |
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External change agents | –1 | +2 | +1 | +2 | –1 |
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Executing | Missing | Missing | Missing | Missing | Missing |
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Reflecting & evaluating | 0 | Missing | Missing | 0 | Missing |
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a–2: Construct found to have a strong negative influence; –1: construct found to have a weak negative influence; 0: construct found to have neutral influence; 0 (mix): construct had mixed positive and negative influences, which balanced each other; +1: construct found to have a weak positive influence; +2: construct found to have a strong positive influence; Missing: not asked or miscoded.
bWeak: construct weakly distinguished between high and low implementation units; Strong: construct strongly distinguished between high and low implementation units.
cReverse rated: a positive rating means a less complex implementation.