Constructs

The table below lists CFIR constructs by domain along with a short description. Clicking on the domain or construct name will take you to more information including:

  • Detailed description with a rationale for inclusion in CFIR
  • Qualitative codebook guidelines
  • Quantitative measures when available (check back periodically for updates)

Download the constructs table: PDF, Excel, or Word

 Construct Short Description
I. INTERVENTION CHARACTERISTICS
AIntervention SourcePerception of key stakeholders about whether the intervention is externally or internally developed.
BEvidence Strength and QualityStakeholders’ perceptions of the quality and validity of evidence supporting the belief that the intervention will have desired outcomes.
CRelative AdvantageStakeholders’ perception of the advantage of implementing the intervention versus an alternative solution.
DAdaptabilityThe degree to which an intervention can be adapted, tailored, refined, or reinvented to meet local needs.
ETrialabilityThe ability to test the intervention on a small scale in the organization, and to be able to reverse course (undo implementation) if warranted.
FComplexityPerceived difficulty of the intervention, reflected by duration, scope, radicalness, disruptiveness, centrality, and intricacy and number of steps required to implement.
GDesign Quality and PackagingPerceived excellence in how the intervention is bundled, presented, and assembled.
HCostCosts of the intervention and costs associated with implementing the intervention including investment, supply, and opportunity costs.
II. OUTER SETTING
APatient Needs and ResourcesThe extent to which patient needs, as well as barriers and facilitators to meet those needs, are accurately known and prioritized by the organization.
BCosmopolitanismThe degree to which an organization is networked with other external organizations.
CPeer PressureMimetic or competitive pressure to implement an intervention; typically because most or other key peer or competing organizations have already implemented or are in a bid for a competitive edge.
DExternal Policies and IncentivesA broad construct that includes external strategies to spread interventions, including policy and regulations (governmental or other central entity), external mandates, recommendations and guidelines, pay-for-performance, collaboratives, and public or benchmark reporting.
III. INNER SETTING
AStructural CharacteristicsThe social architecture, age, maturity, and size of an organization.
BNetworks and CommunicationsThe nature and quality of webs of social networks and the nature and quality of formal and informal communications within an organization.
CCultureNorms, values, and basic assumptions of a given organization.
DImplementation 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 organization.
1Tension for ChangeThe degree to which stakeholders perceive the current situation as intolerable or needing change.
2CompatibilityThe 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.
3Relative PriorityIndividuals’ shared perception of the importance of the implementation within the organization.
4Organizational Incentives and RewardsExtrinsic incentives such as goal-sharing awards, performance reviews, promotions, and raises in salary, and less tangible incentives such as increased stature or respect.
5Goals and FeedbackThe degree to which goals are clearly communicated, acted upon, and fed back to staff, and alignment of that feedback with goals.
6Learning Climate A climate in which: a) leaders express their own fallibility and need for team members’ assistance and input; b) team members feel that they are essential, valued, and knowledgeable partners in the change process; c) individuals feel psychologically safe to try new methods; and d) there is sufficient time and space for reflective thinking and evaluation.
EReadiness for ImplementationTangible and immediate indicators of organizational commitment to its decision to implement an intervention.
1 Leadership EngagementCommitment, involvement, and accountability of leaders and managers with the implementation.
2Available ResourcesThe level of resources dedicated for implementation and on-going operations, including money, training, education, physical space, and time.
3Access to Knowledge and InformationEase of access to digestible information and knowledge about the intervention and how to incorporate it into work tasks.
IV. CHARACTERISTICS OF INDIVIDUALS
AKnowledge and Beliefs about the InterventionIndividuals’ attitudes toward and value placed on the intervention as well as familiarity with facts, truths, and principles related to the intervention.
BSelf-efficacyIndividual belief in their own capabilities to execute courses of action to achieve implementation goals.
CIndividual Stage of ChangeCharacterization of the phase an individual is in, as he or she progresses toward skilled, enthusiastic, and sustained use of the intervention.
DIndividual Identification with OrganizationA broad construct related to how individuals perceive the organization, and their relationship and degree of commitment with that organization.
EOther Personal AttributesA broad construct to include other personal traits such as tolerance of ambiguity, intellectual ability, motivation, values, competence, capacity, and learning style.
V.PROCESS
APlanningThe degree to which a scheme or method of behavior and tasks for implementing an intervention are developed in advance, and the quality of those schemes or methods.
BEngagingAttracting 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.
1Opinion LeadersIndividuals in an organization who have formal or informal influence on the attitudes and beliefs of their colleagues with respect to implementing the intervention.
2Formally Appointed Internal Implementation LeadersIndividuals from within the organization who have been formally appointed with responsibility for implementing an intervention as coordinator, project manager, team leader, or other similar role.
3Champions“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.
4External Change AgentsIndividuals who are affiliated with an outside entity who formally influence or facilitate intervention decisions in a desirable direction.
CExecutingCarrying out or accomplishing the implementation according to plan.
DReflecting and EvaluatingQuantitative and qualitative feedback about the progress and quality of implementation accompanied with regular personal and team debriefing about progress and experience.

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