Table 3

Mapping of key lessons to existing CFIR constructs known to influence successful implementation

CFIR construct13Construct definition13Lesson (Abbreviated)
Prioritise NCDsMap existing resourcesEngage stakeholdersTailor interventionsGenerate evidenceMainstream with QI
Intervention characteristics
Intervention sourcePerception of key stakeholders about whether the intervention is externally or internally developed.XX
Evidence strength and qualityStakeholders’ perceptions of the quality and validity of evidence supporting the belief that the intervention will have desired outcomes.XXX
Relative advantageStakeholders’ perception of the advantage of implementing the intervention vs an alternative solution.XXX
AdaptabilityThe degree to which an intervention can be adapted, tailored, refined or reinvented to meet local needs.XX
TrialabilityThe ability to test the intervention on a small scale in the organisation and to be able to reverse course (undo implementation) if warranted.XX
ComplexityPerceived difficulty of implementation, reflected by duration, scope, radicalness, disruptiveness, centrality and intricacy and number of steps required to implement.XX
Design quality and packagingPerceived excellence in how the intervention is bundled, presented and assembled.X
CostCosts of the intervention and costs associated with implementing the intervention including investment, supply and opportunity costs.XX
Outer setting
Patient needs and resourcesThe extent to which patient needs, as well as barriers and facilitators to meet those needs, are accurately known and prioritised by the organisation.XX
Inner setting
CultureNorms, values and basic assumptions of a given organisation.X
Implementation climateThe absorptive capacity for change, shared receptivity of involved individuals to an intervention and the extent to which use of that intervention will be rewarded, supported and expected within their organisation.XXX
Tension for changeThe degree to which stakeholders perceive the current situation as intolerable or needing change.XX
CompatibilityThe degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values and perceived risks and needs and how the intervention fits with existing workflows and systems.XXXX
Relative priorityIndividuals’ shared perception of the importance of the implementation within the organisation.XX
Readiness for implementationTangible and immediate indicators of organisational commitment to its decision to implement an intervention.X
Leadership engagementCommitment, involvement and accountability of leaders and managers with the implementation.XX
Available resourcesThe level of resources dedicated for implementation and ongoing operations, including money, training, education, physical space and time.XXX
Access to knowledge & InformationEase of access to digestible information and knowledge about the intervention and how to incorporate it into work tasks.XX
Characteristics of individuals
Knowledge and beliefs about the InterventionIndividuals’ attitudes towards and value placed on the intervention as well as familiarity with facts, truths and principles related to the intervention.XX
EngagingAttracting and involving appropriate individuals in the implementation and use of the intervention through a combined strategy of social marketing, education, role modelling, training and other similar activities.XXX
Opinion leadersIndividuals in an organisation who have formal or informal influence on the attitudes and beliefs of their colleagues with respect to implementing the intervention.XX
Reflecting and evaluatingQuantitative and qualitative feedback about the progress and quality of implementation accompanied with regular personal and team debriefing about progress and experience.XX
  • NCD, non-communicable disease.