Table 1.

Colorectal Cancer Screening Barriers and Tailored Exemplars of Implementation Strategies Mapped to CFIR Barriers

CFIR Domain	Constructs (Examples)	Examples of Barriers to CRC Screening	Examples of Mitigating Implementation Strategies
Intervention characteristics	Intervention source, adaptability, complexity, cost	Colonoscopy is perceived to be complex and time consuming12	Provide mailed CRC screening tests with step-by-step instructions13
Inner setting: features of the implementing organization	Networks and communications, culture, implementation climate	Low PCP-to-GI referral rates14	Develop clinical reminders for providers15 Audit provider performance and provide feedback13
Outer setting: external context or environment	Knowledge of patient needs and resources, peer pressure, external policies and incentives	Inadequate public transportation12	Provide bus passes or travel vouchers.
Characteristics of individuals: clinicians and other staff within the implementing organization	Providers’ knowledge and beliefs about the intervention, self-efficacy, individual stage of change	Clinicians are not confident that they can appropriately choose between/council about CRC screening modalities16	Provide technical assistance16
Implementation process	Planning, engaging, executing, reflecting and evaluating an intervention	Implementation barriers to CRC screening are not routinely assessed17	Use external coaching to help providers assess and address implementation barriers 17

NOTE. where existing studies have used implementation strategies that may address stated barriers, these are provided and cited. Where such examples are not available, a hypothetical example is provided.

CFIR, consolidated framework for implementation research; CRC, colorectal cancer; GI, gastroenterologist; PCP, primary care provider.