Table 1.
| CFIR domains and definition | Constructs and definition | Themes |
|---|---|---|
| Intervention characteristics (key attributes of an intervention that may impact implementation success) | (i) Complexity of CEASE (perceived difficulty of the intervention, reflected by duration, scope, radicalness, disruptiveness, centrality, and intricacy and number of steps required to implement) (ii) Adaptability of CEASE (the degree to which an intervention can be adapted, tailored, refined, or reinvented to meet local needs) |
(i) Screening all families at every visit for tobacco use with an iPad (ii) Ability to adapt or make changes to CEASE |
| Outer setting (includes the features of the external context or environment that might influence implementation) | (i) Patient and family needs and resources (the extent to which patient needs, as well as barriers and facilitators to meet those needs, are accurately known and prioritized by the organization) | Patients and their families: (i) Need for tobacco control (ii) Patient population characteristics (iii) Parents barriers to CEASE (iv) Parents response to CEASE External cessation support: (i) Access and coverage for NRT (i) Free help and resources from the quitline |
| Inner setting(includes features of the implementing organization that might influence implementation) | (i) Implementation climate (ii) Organizational incentives (extrinsic incentives such as goal-sharing awards, performance reviews, promotions, and raises in salary, and less tangible incentives such as increased stature or respect) (iii) Relative priorities (individuals' shared perception of the importance of the implementation within the organization) (iv) Culture (norms, values, and basic assumptions of a given organization) |
CEASE implementation in the office (i) Extent to which the practice was able to bill for these services (ii) CEASE vs. other priorities (iii) MOC credits as an incentive Organizational culture (i) Culture of the practice |
| Characteristics of individuals (characteristics of individuals involved in implementation that might influence implementation) | (i) Knowledge and beliefs about the intervention (individuals' attitudes toward and value placed on the intervention as well as familiarity with facts, truths, and principles related to the intervention) | CEASE and staff (i) Second- and thirdhand smoke beliefs and knowledge (ii) Beliefs and motivation of the staff to address tobacco use in families (iii) Feeling proud for helping smoking family members quit |
| Process (includes strategies or tactics that might influence implementation) | (i) Engaging (attracting and involving appropriate individuals in the implementation and use of the intervention through a combined strategy of social marketing, education, role modeling, training, and other similar activities) (ii) CEASE champions (individuals who dedicate themselves to supporting, marketing, and “driving through” an [implementation] [101] (p. 182), overcoming indifference or resistance that the intervention may provoke in an organization) |
(i) Engaging staff with CEASE (ii) CEASE champions as drivers or motivators for other staff members |