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Table 1 CFIR [7]

From: Examining the variations in the implementation of interventions to address stillbirth from the national to subnational levels: experiences from Uganda

 

Domain

Definition

Related constructs

1

Intervention characteristics

Features of the intervention that might influence its implementation

Eight constructs comprise this domain: (1) intervention source, which refers to perceptions of whether intervention is internally or externally developed; (2) evidence strength—perception of quality and validity of evidence; (3) relative advantage—perception of advantage of implementing intervention vs available alternatives; (4) adaptability—degree to which intervention can be tailored or refined to meet local needs; (5) trialability—ability to test intervention; (6) complexity—perceived difficulty of implementation; (7) design quality—perceived excellence in how intervention is packaged; and (8) cost—expenses associated with implementation

2

Outer setting

Features of external context and environment that might influence implementation

Four constructs form this domain: (1) patient needs—extent to which patient requirements and barriers are known and addressed; (2) cosmopolitanism—extent to which organization is networked with other organizations; (3) peer pressure—competitive pressure to implement from peers; (4) external policies and incentives—external strategies to spread intervention

3

Inner settings

Features of the implementing organizations that might influence implementation

12 constructs relate to this domain: (1) structural characteristics—social architecture and size of organization; (2) networks and communication—webs of interlinkages within an organization; (3) culture—norms, values within an organization; (4) implementation climate—absorptive capacity for change; (5) tension to change—extent to which stakeholders perceive current situation as intolerable; (6) compatibility—tangible fit between meaning and value of intervention; (7) relative priority—shared perception of importance of implementing intervention; (8) organizational incentive—extrinsic value of implementing intervention; (9) goals and feedback—communication of goals to staff with feedback aligned to the goals; (10) learning climate—individuals feel safe to try new methods with sufficient time for reflective thinking and evaluation; (11) readiness to implement—tangible and immediate indicators for organizational commitment to implement intervention; and (12) leadership engagement—commitment, involvement and accountability of leaders to implementation

4

Characteristics of individuals involved

Characteristics of individuals involved in implementation that might influence implementation

Five constructs form this domain: (1) knowledge and beliefs about intervention—attitudes and values placed on the intervention; (2) self efficacy—individual beliefs in their own capacity to execute the intervention; (3) individual stage of change—phase of progress towards skilled, enthusiastic use of intervention; (4) individual identification with organization—individual’s degree of commitment and relationship to the organization; and (5) other personal attributes—broad to include other personal traits such as intellectual ability, tolerance of ambiguity, etc.

5

Process implementation

Strategies and tactics employed that might influence implementation

Eight constructs form this domain: (1) planning and execution—developing tasks for implementing intervention; (2) engaging—involving appropriate individuals; (3) opinion leaders—individuals within organization with formal and informal influence over attitudes of others; (4) formally appointed internal implementation leaders—individuals with formal responsibility for implementing intervention; (5) champions—individuals who dedicate themselves to support and market intervention; (6) external change agents—individuals affiliated with external entity who formally influence intervention; (7) execution—accomplishing the implementation according to plan; (8) reflection and evaluation—quantitative and qualitative feedback about the implementation process