CFIR

CFIR stands for the Consolidated Framework for Implementation Research. It is a comprehensive, meta-theoretical framework used to study and guide the implementation of innovations in health care and related fields. The framework helps researchers identify factors that may facilitate or impede the adoption, implementation, and sustainability of new practices, programs, or policies.

Origin and scope: The CFIR was developed in 2009 by Damschroder and colleagues as an integrative framework that consolidates constructs from multiple implementation theories into a single structure. It delineates 39 constructs across five major domains to support systematic assessment of implementation contexts.

Domains and sample constructs:

- Intervention Characteristics: relative advantage, adaptability, complexity, trialability, design quality and packaging, cost, evidence strength and quality, source.

- Outer Setting: patient needs and resources; cosmopolitanism; peer pressure; external policies and incentives.

- Inner Setting: structural characteristics; networks and communication; culture; implementation climate; readiness for implementation.

- Characteristics of Individuals: knowledge and beliefs about the intervention; self-efficacy; individual stage of change; other personal attributes.

- Process: planning; engaging; executing; reflecting and evaluating.

Applications and use: CFIR is used to guide data collection, synthesis of qualitative and quantitative data, and identification of determinants that influence implementation success. It supports tailoring strategies to local contexts and evaluating implementation efforts. The framework is widely applied in health services research, clinical settings, public health, and social services to improve the uptake and sustainability of innovations.

Limitations: While comprehensive, CFIR can be complex and time-consuming to apply. It requires careful tailoring to the local setting and is best used as a guide for systematic assessment rather than a prescriptive method.