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Implementation Science
Published in: Implementation Science 1/2022

Open Access 01-12-2022 | Research

The updated Consolidated Framework for Implementation Research based on user feedback

Authors: Laura J. Damschroder, Caitlin M. Reardon, Marilla A. Opra Widerquist, Julie Lowery

Published in: Implementation Science | Issue 1/2022

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Abstract

Background

Many implementation efforts fail, even with highly developed plans for execution, because contextual factors can be powerful forces working against implementation in the real world. The Consolidated Framework for Implementation Research (CFIR) is one of the most commonly used determinant frameworks to assess these contextual factors; however, it has been over 10 years since publication and there is a need for updates. The purpose of this project was to elicit feedback from experienced CFIR users to inform updates to the framework.

Methods

User feedback was obtained from two sources: (1) a literature review with a systematic search; and (2) a survey of authors who used the CFIR in a published study. Data were combined across both sources and reviewed to identify themes; a consensus approach was used to finalize all CFIR updates. The VA Ann Arbor Healthcare System IRB declared this study exempt from the requirements of 38 CFR 16 based on category 2.

Results

The systematic search yielded 376 articles that contained the CFIR in the title and/or abstract and 334 unique authors with contact information; 59 articles included feedback on the CFIR. Forty percent (n = 134/334) of authors completed the survey. The CFIR received positive ratings on most framework sensibility items (e.g., applicability, usability), but respondents also provided recommendations for changes. Overall, updates to the CFIR include revisions to existing domains and constructs as well as the addition, removal, or relocation of constructs. These changes address important critiques of the CFIR, including better centering innovation recipients and adding determinants to equity in implementation.

Conclusion

The updates in the CFIR reflect feedback from a growing community of CFIR users. Although there are many updates, constructs can be mapped back to the original CFIR to ensure longitudinal consistency. We encourage users to continue critiquing the CFIR, facilitating the evolution of the framework as implementation science advances.
Appendix
Available only for authorised users
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Metadata
Title
The updated Consolidated Framework for Implementation Research based on user feedback
Authors
Laura J. Damschroder
Caitlin M. Reardon
Marilla A. Opra Widerquist
Julie Lowery
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Implementation Science / Issue 1/2022
Electronic ISSN: 1748-5908
DOI
https://doi.org/10.1186/s13012-022-01245-0

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