Table 2:

Summary of CFIR dimensions, barriers and facilitators from quantitative and qualitative measures

CFIR dimensions	Barriers	Facilitators
IPT intervention characteristics	Finding the right format (small-group, individual, large group) in a system where staffing is tight but trust can be low Some potential participants (esp. men) did not want to be labelled as having MDD, did not believe that it helps to discuss problems Counselors used to highly structured treatments needed practice to learn to balance reflection and structure	Feasible, acceptable to prisoner participants Prisoner participants were enthusiastic about IPT (a safe place to discuss real issues and emotions) High enthusiasm among study counselors who used IPT (a safe place to talk about emotions, time-limited, practical, solution-focused, effective) When counselors learned to balance reflection and structure, they liked it and viewed it as beneficial to clients
Inner setting	Not enough treatment staff, treatment staff overworked Efforts to obtain more resources often unsuccessful Stressful working environment and difficult interactions with other prison employees led to provider turnover Organizational readiness (including supervision frequency and practices, collegial support) varied widely across facilities and programs Space, scheduling can be challenging	Unmet mental health needs Study counselors liked IPT and saw it as a bright spot in their challenging days Prisoner mental health is very important to prisoners, and important to facilities and state prison systems Individuals who are incarcerated can be drawn to something new or different
Outer setting	Prisoner mental health is only “somewhat important” to local legislators and the public Parole and probation requirements led some prisoners to deny mental health problems, could provide challenges to building social support
Characteristics of individuals affecting implementation	Men’s prisons are less conducive to vulnerability than women’s prisons; it took men’s groups longer to open up (but there was no differential effectiveness by gender; Johnson et al., 2019). Counselors without formal mental health training learned IPT well, but it took longer	Prison administrators and providers: are interested in EBPs for MDD are open to feedback and to learning new EBPs are deeply committed to trying to help their clients view rehabilitation (vs. punishment) as the prisons’ primary goal are competent in helping clients set goals, cope with triggers, and respecting client preferences very much want new and better strategies for treating their clients Women’s groups and groups of individuals with longer sentences may form trust more quickly

Bolded = factors that emerged in both quantitative and qualitative results