Economic, environmental, political, and/or technological conditions enable the Outer Setting to support implementation and/or delivery of the innovation.
Conditions of the local community can enable the Outer Setting to support implementation and/or delivery of the innovation (Dy et al., 2015; Means et al., 2020). Conditions can include economic (e.g., recession) (Kerins et al., 2020), environmental (e.g., built environment), political (e.g., instability or corruption) (Flottorp et al., 2013), and/or technological (e.g., IT infrastructure) factors (Ashok et al., 2018; Dy et al., 2015; Means et al., 2020; Yuan et al., 2019). While not all innovations require support from the Outer Setting, these themes are important when the innovation is community-based or relies on the community for support or resources, especially in low- to middle- income countries, where resource constraints are common (Means et al., 2020); with these innovations, local conditions may influence implementation outcomes and equity in implementation.
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.
Ashok, M., Hung, D., Rojas-Smith, L., Halpern, M. T., & Harrison, M. (2018). Framework for Research on Implementation of Process Redesigns: Quality Management in Health Care, 27(1), 17–23. https://doi.org/10.1097/QMH.0000000000000158
Dy, S. M., Ashok, M., Wines, R. C., & Rojas Smith, L. (2015). A Framework to Guide Implementation Research for Care Transitions Interventions: Journal for Healthcare Quality, 37(1), 41–54. https://doi.org/10.1097/01.JHQ.0000460121.06309.f9
Flottorp, S. A., Oxman, A. D., Krause, J., Musila, N. R., Wensing, M., Godycki-Cwirko, M., Baker, R., & Eccles, M. P. (2013). A checklist for identifying determinants of practice: A systematic review and synthesis of frameworks and taxonomies of factors that prevent or enable improvements in healthcare professional practice. Implementation Science, 8(1), 35. https://doi.org/10.1186/1748-5908-8-35
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. https://doi.org/10.1186/s12966-020-00948-1
Means, A. R., Kemp, C. G., Gwayi-Chore, M.-C., Gimbel, S., Soi, C., Sherr, K., Wagenaar, B. H., Wasserheit, J. N., & Weiner, B. J. (2020). Evaluating and optimizing the consolidated framework for implementation research (CFIR) for use in low- and middle-income countries: A systematic review. Implementation Science, 15(1), 1–19. https://doi.org/10.1001/jamasurg.2017.5565
Yuan, S., Wang, F., Li, X., Jia, M., & Tian, M. (2019). Facilitators and barriers to implement the family doctor contracting services in China: Findings from a qualitative study. BMJ Open, 9(10), e032444. https://doi.org/10.1136/bmjopen-2019-032444