Journal
IMPLEMENTATION SCIENCE
Volume 17, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s13012-021-01181-5
Keywords
Implementation science; Antecedent assessments; Implementation outcomes; Anticipated outcomes; Actual outcomes; Innovation outcomes; Implementation framework; Evaluation methods; Theory; Consolidated Framework for Implementation Research
Funding
- Veterans Affairs (VA) Quality Enhancement Research Initiative [QUE 15-286]
- VA Health Services Research and Development [LIP 20-116]
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This article introduces the updated version of the Consolidated Framework for Implementation Research (CFIR), CFIR 2.0, to address the gaps in its application. Based on a literature review and survey of authors, the researchers propose an Outcomes Addendum for the CFIR, which clarifies conceptual distinctions between anticipated implementation outcomes and actual implementation outcomes, implementation outcomes and innovation outcomes, and CFIR-based implementation determinants and innovation determinants.
Background The challenges of implementing evidence-based innovations (EBIs) are widely recognized among practitioners and researchers. Context, broadly defined as everything outside the EBI, includes the dynamic and diverse array of forces working for or against implementation efforts. The Consolidated Framework for Implementation Research (CFIR) is one of the most widely used frameworks to guide assessment of contextual determinants of implementation. The original 2009 article invited critique in recognition for the need for the framework to evolve. As implementation science has matured, gaps in the CFIR have been identified and updates are needed. Our team is developing the CFIR 2.0 based on a literature review and follow-up survey with authors. We propose an Outcomes Addendum to the CFIR to address recommendations from these sources to include outcomes in the framework. Main text We conducted a literature review and surveyed corresponding authors of included articles to identify recommendations for the CFIR. There were recommendations to add both implementation and innovation outcomes from these sources. Based on these recommendations, we make conceptual distinctions between (1) anticipated implementation outcomes and actual implementation outcomes, (2) implementation outcomes and innovation outcomes, and (3) CFIR-based implementation determinants and innovation determinants. Conclusion An Outcomes Addendum to the CFIR is proposed. Our goal is to offer clear conceptual distinctions between types of outcomes for use with the CFIR, and perhaps other determinant implementation frameworks as well. These distinctions can help bring clarity as researchers consider which outcomes are most appropriate to evaluate in their research. We hope that sharing this in advance will generate feedback and debate about the merits of our proposed addendum.
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