Using correlation to identify determinants of implementation

A Telephone Lifestyle Coaching (TLC) program was piloted in 25 sites in Veterans Health Administration (VHA) medical centers. Our team conducted an in-depth evaluation of implementation in 11 of those pilot sites. This article shows how the CFIR was used to qualitatively code themes. Analysts also independently rated each construct to indicate whether it was a barrier or facilitator to implementation and how strongly it manifested (e.g., strong facilitator, weak barrier). The rate of referrals made by each pilot site was used to indicate penetration, which is an implementation outcome. Pearson correlation was computed to assess the association of each construct with the implementation outcome measure; the p-value was used to identify key determinants of implementation. 7 CFIR constructs within the Inner Setting and Process domains were identified as determinants of implementation. Appendices provide detail about the context of this evaluation including the strategies used to implement and qualitative descriptions of non-significantly correlated constructs. This method assumes each construct is independently correlated with the outcome. Other methods, such as Qualitative Comparative Analysis (QCA) can be used to identify multiple pathways and combinations of constructs that may lead to desired outcomes.

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