The original CFIR (Laura J. Damschroder et al. 2009) elaborated on this domain, stating that innovations usually come to a setting as a poor fit, requiring an active process to adapt the innovation and engage individuals to accomplish implementation. The innovation is often complex and multi-faceted, with many interacting components (Butler et al. 2017). Innovations can be conceptualized as having ‘core components’ (the essential and indispensable elements of the innovation) and an ‘adaptable periphery’ (adaptable elements, structures, and systems related to the innovation and setting into which it is being implemented) (Fixsen 2007; T. Greenhalgh, Robert, et al. 2004). For example, a clinical reminder to screen for obesity has an alert that pops up on the computer screen at the appropriate time for the appropriate patient. This feature is part of the core of the innovation. However, depending on the work processes at individual clinics, the clinical reminder may pop up during the patient assessment by a nurse manager or during the visit with the primary care provider. This feature is part of the adaptable periphery of the innovation; these components can be modified to a particular setting and vice versa in a co-evolving and co-adaptive way (Kirsh, Lawrence, and Aron 2008; Plsek and Greenhalgh 2001).