Attract and encourage participation in implementation and/or the innovation. Note: Use this construct to capture themes related to Engaging that are not included in the Engaging subconstructs.

This construct includes attracting and involving appropriate individuals — specifically deliverers and recipients – in the implementation and use of the innovation through a combined strategy of social marketing, education, role modeling (Cruess et al., 2008), training, and other similar activities (see also Assessing Needs). Engaging deliverers and recipients of an innovation is an often overlooked part of implementation (Pronovost et al., 2008), but doing so helps ensure sustained change (Doyle et al., 2013; Lennox et al., 2018, 2020). As a result, it is important to identify and engage deliverers and recipients early and often (Breimaier et al., 2015). The original CFIR asserted that if supporters of the innovation outnumber and are better strategically positioned than the opponents, the implementation is more likely to be successful (Greenhalgh, Robert, et al., 2004).

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

Regarding quantitative measurement of this construct: In a systematic review of quantitative measures related to implementation, Dorsey et al. identified one measure (Dorsey et al., 2021). Using PAPERS criteria of measurement quality with an aggregate scale ranging from -9 to +36 (Lewis, Mettert, Stanick, et al., 2021), The single measure scored 2 for predictive validity; no other information on validity was available. Results indicate the need for continued development of high-quality measures.

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

Breimaier, H. E., Heckemann, B., Halfens, R. J. G., & Lohrmann, C. (2015). The Consolidated Framework for Implementation Research (CFIR): A useful theoretical framework for guiding and evaluating a guideline implementation process in a hospital-based nursing practice. BMC Nursing, 14(1), 43. https://doi.org/10.1186/s12912-015-0088-4.

Cruess, S. R., Cruess, R. L., & Steinert, Y. (2008). Role modelling—Making the most of a powerful teaching strategy. Bmj, 336(7646), 718–721.

Dorsey, C. N., Mettert, K. D., Puspitasari, A. J., Damschroder, L. J., & Lewis, C. C. (2021). A systematic review of measures of implementation players and processes: Summarizing the dearth of psychometric evidence. Implementation Research and Practice, 2, 263348952110024.

Doyle, C., Howe, C., Woodcock, T., Myron, R., Phekoo, K., McNicholas, C., Saffer, J., & Bell, D. (2013). Making change last: Applying the NHS institute for innovation and improvement sustainability model to healthcare improvement. Implementation Science, 8(1), 127. https://doi.org/10.1186/1748-5908-8-127.

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.

Lennox, L., Linwood-Amor, A., Maher, L., & Reed, J. (2020). Making change last? Exploring the value of sustainability approaches in healthcare: a scoping review. Health Research Policy and Systems, 18(1), 120. https://doi.org/10.1186/s12961-020-00601-0.

Lennox, L., Maher, L., & Reed, J. (2018). Navigating the sustainability landscape: A systematic review of sustainability approaches in healthcare. Implementation Science, 13(1), 27. https://doi.org/10.1186/s13012-017-0707-4.

Lewis, C. C., Mettert, K. D., Stanick, C. F., Halko, H. M., Nolen, E. A., Powell, B. J., & Weiner, B. J. (2021). The psychometric and pragmatic evidence rating scale (PAPERS) for measure development and evaluation. Implementation Research and Practice, 2, 263348952110373. https://doi.org/10.1177/26334895211037391.

Pronovost, P. J., Berenholtz, S. M., & Needham, D. M. (2008). Translating evidence into practice: A model for large scale knowledge translation. 337(oct06_1), a1714-. https://doi.org/10.1136/bmj.a1714.