Michie et al. include psychological and physical ability (Michie et al. 2011) within Capability. Interpersonal competence, knowledge, and skills to fulfill roles are important for successful implementation (Ashok et al. 2018; Dy et al. 2015). Past experiences with implementation and/or the innovation helps build capability (King et al. 2019). Capabilities including personal traits of competence and learning style are important for tailoring training strategies (Greenhalgh, Robert, et al. 2004; Barwick et al. 2020).
The original CFIR (Damschroder, Aron, et al. 2009) elaborated saying that the competence of individuals to judge the effectiveness of an innovation is facilitated by their understanding of underlying principles that justify using the innovation (E. Rogers 2003). Skilled use and delivery of the innovation is a key outcome metric for effective implementation (Klein and Sorra 1996), but assessments of skill can also be a key implementation determinant; see the CFIR outcomes addendum (Damschroder, Reardon, Opra Widerquist, et al. 2022) for more detail about the nuanced but important distinctions between determinants and outcomes. Capability is important to assess at individual and sub-group levels to assess quality of implementation and prospects for sustainability. If knowledge, for example through training (see Inner Setting: Access to Knowledge and Information), is not obtained prior to an individual having to use the innovation, rejection and discontinuance are likely (Klein et al. 2001). When knowledge can be codified and transferred across contexts, implementation is more likely to be successful (Greenhalgh, Robert, et al. 2004).
Self-efficacy, confidence in one’s ability to make the change, has been widely studied and is among the most common individual measures in theories of individual change (R. P. Grol et al. 2007; Bandura 1977; US DHHS-National Cancer Institute 2005). Individuals with high confidence in their capability are more likely to embrace the innovation and exhibit committed use even in the face of obstacles. If individuals are not confident in their ability to use the innovation or experience a level of failure early-on, they may not be motivated to persist in the face of challenges that may arise (US DHHS-National Cancer Institute 2005).