TABLE 1.
Emergent1 CFIR Construct Descriptions and Study-specific Modifications
| CFIR Domain/Construct | Description | Study-specific Modification |
|---|---|---|
| Program Characteristics | ||
| Relative Advantage | Community partners’ perception of the advantage of implementing the intervention vs. an alternative solution | To capture references to status quo as there were no other comparable alternatives at the time of the launch of Safe Station |
| Design Quality and Packaging | Perceived excellence in how the intervention is bundled, presented, and assembled | Modified to focus on the issue of accessibility. Per the CFIR guide website, “Packaging is related to how the intervention is bundled, presented, or assembled and even how accessible it is for users. When components are more easily accessible to users, it promotes use of the new procedures.”1 |
| Evidence Strength and Quality | Community partners’ perception of the quality and validity of evidence resulting in the desired outcomes | To capture community partners’ references to their own evidence about how to measure the success (quality) of Safe Station; e.g., reduced overdoses, numbers of people accessing Safe Station, etc. |
| Cost | Costs of the intervention and costs associated with implementing that intervention | No modifications |
| Complexity | Perceived difficulty of implementation | To capture perceptions about role strain and/or incompatibility with job description |
| Inner Setting | ||
| Available Resources | The level of resources dedicated for implementation, including money, training, physical space, and time | Also, to capture references to volume; e.g., ‘there were 15 Safe Station [events] in one 24-hour period over the weekend,’ implying too many for staff to handle given available resources/staffing |
| Tension for Change | The degree to which community partners perceive the current situation as intolerable or needing change | Current situation defined as opioid overdose epidemic in NH communities |
| Compatibility | The degree of tangible fit of the intervention within individual norms and existing workflows | No modifications |
| Networks and Communications | The nature of social networks, formal and informal communication within an organization | Given the lack of formal communication, to capture references to informal messaging and communication among staff and leadership |
| Access to Knowledge and Information | Ease of access to digestible information and knowledge about the intervention and its incorporation | Primarily a proxy for references to training or lack thereof |
| Culture | Norms, values, and basic assumptions of a given organization | No modifications |
| Outer Setting | ||
| Client Needs and Resources | The extent to which patient needs are accurately known and prioritized by the organization | Re-named this construct ‘Client’ Needs and Resources instead of CFIR ‘Patient’ Needs and Resources |
| Cosmopolitanism | The degree to which an organization is networked with other external organizations | To capture references to multi-organizational partnerships, as well as to characterize the nature and communication of those partnerships |
| Characteristics of Individuals | ||
| Knowledge and Beliefs about Safe Station/Safe Station Clients | Individuals’ attitudes toward and value placed on the intervention as well as familiarity with facts, truths, and principles related to intervention | Also, attitudes towards people served by the intervention (Safe Station). To capture myths/facts about addiction; e.g., misunderstandings about the chronic nature of addiction and the likelihood that someone may make repeated attempts to get help |
| Self-Efficacy | Individual belief in their own capabilities to execute implementation | No modifications |
| Process | ||
| Planning | The degree to which a method of behavior and tasks for implementation are developed in advance | No modifications |
CFIR = The Consolidated Framework for Implementation Research
1
Emergent refers to CFIR constructs that were referenced/aligned with what was said in the interviews. Twenty-three of the CFIR constructs did not emerge during interviews and thus are not included here.