Using the consolidated framework for implementation research to evaluate clinical trials: An example from multisite...

Area of Science:

• Implementation Science
• Translational Research
• Healthcare Management

Background:

• The Consolidated Framework for Implementation Research (CFIR) offers a structured approach to identify factors influencing the successful implementation of complex interventions in clinical settings.
• Understanding these factors is crucial for optimizing the integration of research findings into practice.

Purpose of the Study:

• To investigate implementation constructs within a multi-site translational research study focused on hospital discharge readiness.
• To differentiate study sites exhibiting low versus high implementation fidelity using the CFIR framework.

Main Methods:

• A descriptive study design was employed, involving interviews with Principal Investigators from eight high-fidelity and eight low-fidelity sites.
• Interviews were guided by questions derived from 20 relevant CFIR constructs.
• Data analysis utilized CFIR-specific rules, a rating scale from +2 to -2, and NVivo 11 for memo creation.

Main Results:

• A bimodal distribution of differences was observed, with seven CFIR constructs significantly distinguishing between high and low fidelity sites (≥5-point difference).
• These seven constructs represent critical determinants of implementation success.

Conclusions:

• The CFIR serves as a valuable determinant framework for pinpointing contextual elements that impact implementation fidelity.
• Applying the CFIR can enhance the understanding of factors influencing clinical research outcomes and intervention effectiveness.