Modify the innovation and/or the Inner Setting for optimal fit and integration into work processes.

There is extensive literature that emphasizes the key role of adaptations to ensure optimal fit between the innovation and setting(s) within which it is being implemented and delivered (Chambers et al., 2013; Chambers & Norton, 2016; Greenhalgh, Robert, et al., 2004; Hill et al., 2018; Kerins et al., 2020; Lennox et al., 2018; Moore et al., 2021; Stirman et al., 2019; von Thiele Schwarz et al., 2019; Wells et al., 2020). Most of the literature focuses on adapting the innovation but adaptations of the setting (e.g., workflows) are often needed as well, to optimize fit (Chambers et al., 2013; Hill et al., 2018; Kerins et al., 2020; Wells et al., 2020) and achieve optimal sustained outcomes (von Thiele Schwarz et al., 2019). Adapting includes determining and documenting the types of adaptations made, ideally following an adaptation framework (Stirman et al., 2019). We refer users to above cited articles for further guidance on best practices for adapting.

Qualitative coding guidelines that are aligned with the Updated CFIR will be added in the future.

As we become aware of measures, we will post them here. Please contact us with updates.

Chambers, D. A., Glasgow, R. E., & Stange, K. C. (2013). The dynamic sustainability framework: Addressing the paradox of sustainment amid ongoing change. Implementation Science, 8(1), 117.

Chambers, D. A., & Norton, W. E. (2016). The Adaptome: Advancing the Science of Intervention Adaptation. Am J Prev Med, 51(4 Suppl 2), S124-31.

Greenhalgh, T., Robert, G., Macfarlane, F., Bate, P., & Kyriakidou, O. (2004). Diffusion of innovations in service organizations: Systematic review and recommendations. Milbank Q, 82(4), 581–629.

Hill, J. N., Locatelli, S. M., Bokhour, B. G., Fix, G. M., Solomon, J., Mueller, N., & LaVela, S. L. (2018). Evaluating broad-scale system change using the Consolidated Framework for Implementation Research: Challenges and strategies to overcome them. BMC Research Notes, 11(1), 560.

Kerins, C., McHugh, S., McSharry, J., Reardon, C. M., Hayes, C., Perry, I. J., Geaney, F., Seery, S., & Kelly, C. (2020). Barriers and facilitators to implementation of menu labelling interventions from a food service industry perspective: A mixed methods systematic review. International Journal of Behavioral Nutrition and Physical Activity, 17(1), 48.

Lennox, L., Maher, L., & Reed, J. (2018). Navigating the sustainability landscape: A systematic review of sustainability approaches in healthcare. Implementation Science, 13(1), 27.

Moore, G., Campbell, M., Copeland, L., Craig, P., Movsisyan, A., Hoddinott, P., Littlecott, H., O’Cathain, A., Pfadenhauer, L., Rehfuess, E., Segrott, J., Hawe, P., Kee, F., Couturiaux, D., Hallingberg, B., & Evans, R. (2021). Adapting interventions to new contexts—The ADAPT guidance. BMJ, n1679.

Stirman, S. W., Baumann, A. A., & Miller, C. J. (2019). The FRAME: an expanded framework for reporting adaptations and modifications to evidence-based interventions. Implementation Science, 14(1), 1–10.

von Thiele Schwarz, U., Aarons, G. A., & Hasson, H. (2019). The Value Equation: Three complementary propositions for reconciling fidelity and adaptation in evidence-based practice implementation. BMC Health Services Research, 19(1), 868.

Wells, R., Breckenridge, E. D., & Linder, S. H. (2020). Wellness project implementation within Houston’s Faith and Diabetes initiative: A mixed methods study. BMC Public Health, 20(1), 1050.