A systematic review of the use of the Consolidated Framework for Implementation Research

M Alexis Kirk, Caitlin Kelley, Nicholas Yankey, Sarah A Birken, Brenton Abadie, Laura Damschroder, M Alexis Kirk, Caitlin Kelley, Nicholas Yankey, Sarah A Birken, Brenton Abadie, Laura Damschroder

Abstract

Background: In 2009, Damschroder et al. developed the Consolidated Framework for Implementation Research (CFIR), which provides a comprehensive listing of constructs thought to influence implementation. This systematic review assesses the extent to which the CFIR's use in implementation research fulfills goals set forth by Damschroder et al. in terms of breadth of use, depth of application, and contribution to implementation research.

Methods: We searched Scopus and Web of Science for publications that cited the original CFIR publication by Damschroder et al. (Implement Sci 4:50, 2009) and downloaded each unique result for review. After applying exclusion criteria, the final articles were empirical studies published in peer-review journals that used the CFIR in a meaningful way (i.e., used the CFIR to guide data collection, measurement, coding, analysis, and/or reporting). A framework analysis approach was used to guide abstraction and synthesis of the included articles.

Results: Twenty-six of 429 unique articles (6 %) met inclusion criteria. We found great breadth in CFIR application; the CFIR was applied across a wide variety of study objectives, settings, and units of analysis. There was also variation in the method of included studies (mixed methods (n = 13); qualitative (n = 10); quantitative (n = 3)). Depth of CFIR application revealed some areas for improvement. Few studies (n = 3) reported justification for selection of CFIR constructs used; the majority of studies (n = 14) used the CFIR to guide data analysis only; and few studies investigated any outcomes (n = 11). Finally, reflections on the contribution of the CFIR to implementation research were scarce.

Conclusions: Our results indicate that the CFIR has been used across a wide range of studies, though more in-depth use of the CFIR may help advance implementation science. To harness its potential, researchers should consider how to most meaningfully use the CFIR. Specific recommendations for applying the CFIR include explicitly justifying selection of CFIR constructs; integrating the CFIR throughout the research process (in study design, data collection, and analysis); and appropriately using the CFIR given the phase of implementation of the research (e.g., if the research is post-implementation, using the CFIR to link determinants of implementation to outcomes).

Keywords: Consolidated Framework for Implementation Research; Frameworks; Implementation research; Synthesis; Theory.

Figures

Fig. 1
Fig. 1
PRISMA diagram of study selection
Fig. 2
Fig. 2
Count of CFIR constructs used in studies. Note: This figure includes only studies which specified CFIR constructs used (n=15). Nine studies specified only domains that were used and no constructs. Two studies made no explicit reference to any CFIR domains or constructs

References

    1. McEvoy R, Ballini L, Maltoni S, O’Donnell CA, Mair FS, MacFarlane A. A qualitative systematic review of studies using the normalization process theory to research implementation processes. Implement Sci. 2014;9:2. doi: 10.1186/1748-5908-9-2.
    1. Larsen KR, Voronovich ZA, Cook PF, Pedro LW. Addicted to constructs: science in reverse? Addiction. 2013;108(9):1532–3. doi: 10.1111/add.12227.
    1. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50. doi: 10.1186/1748-5908-4-50.
    1. Damschroder LJ, Hagedorn HJ. A guiding framework and approach for implementation research in substance use disorders treatment. Psychol Addict Behav. 2011;25(2):194. doi: 10.1037/a0022284.
    1. Meho LI, Yang K. Impact of data sources on citation counts and rankings of LIS faculty: Web of Science versus Scopus and Google Scholar. J Am Soc Inf Sci Technol. 2007;58(13):2105–25. doi: 10.1002/asi.20677.
    1. Falagas ME, Pitsouni EI, Malietzis GA, Pappas G. Comparison of PubMed, Scopus, Web of Science, and Google scholar: strengths and weaknesses. FASEB J. 2008;22(2):338–42. doi: 10.1096/fj.07-9492LSF.
    1. Ritchie J, Lewis J, Nicholls CM, Ormston R. Qualitative research practice: a guide for social science students and researchers. Thousand Oaks, CA: SAGE Publications Inc; 2013.
    1. Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):117. doi: 10.1186/1471-2288-13-117.
    1. Kalkan A, Roback K, Hallert E, Carlsson P. Factors influencing rheumatologists’ prescription of biological treatment in rheumatoid arthritis: an interview study. Implement Sci. 2014;9:153. doi: 10.1186/s13012-014-0153-5.
    1. Robins LS, Jackson JE, Green BB, Korngiebel D, Force RW, Baldwin L-M. Barriers and facilitators to evidence-based blood pressure control in community practice. J Am Board Fam Med. 2013;26(5):539–57. doi: 10.3122/jabfm.2013.05.130060.
    1. Cilenti D, Brownson RC, Umble K, Erwin PC, Summers R. Information-seeking behaviors and other factors contributing to successful implementation of evidence-based practices in local health departments. J Public Health Manag Pract. 2012;18(6):571–6. doi: 10.1097/PHH.0b013e31825ce8e2.
    1. Ilott I, Gerrish K, Booth A, Field B. Testing the Consolidated Framework for Implementation Research on health care innovations from South Yorkshire. J Eval Clin Pract. 2013;19(5):915–24.
    1. Ruffolo MC, Capobianco J. Moving an evidence-based intervention into routine mental health care: a multifaceted case example. Soc Work Health Care. 2012;51(1):77–87. doi: 10.1080/00981389.2011.622674.
    1. Shimada SL, Hogan TP, Rao SR, Allison JJ, Quill AL, Feng H, et al. Patient-provider secure messaging in VA: variations in adoption and association with urgent care utilization. Med Care. 2013;51:S21–8. doi: 10.1097/MLR.0b013e3182780917.
    1. Zulman DM, Ezeji-Okoye SC, Shaw JG, Hummel DL, Holloway KS, Smither SF, et al. Partnered research in healthcare delivery redesign for high-need, high-cost patients: development and feasibility of an Intensive Management Patient-Aligned Care Team (ImPACT) J Gen Intern Med. 2014;29(4):861–9. doi: 10.1007/s11606-014-3022-7.
    1. Luck J, Bowman C, York L, Midboe A, Taylor T, Gale R, et al. Multimethod evaluation of the VA’s peer-to-peer toolkit for patient-centered medical home implementation. J Gen Intern Med. 2014;29(2):572–8. doi: 10.1007/s11606-013-2738-0.
    1. Forman J, Harrod M, Robinson C, Annis-Emeott A, Ott J, Saffar D, et al. First things first: foundational requirements for a medical home in an academic medical center. J Gen Intern Med. 2014;29(2):640–8. doi: 10.1007/s11606-013-2674-z.
    1. Connell LA, McMahon NE, Watkins CL, Eng JJ. Therapists’ Use of the Graded Repetitive Arm Supplementary Program (GRASP) Intervention: a practice implementation survey study. Phys Ther. 2014;94(5):632–43. doi: 10.2522/ptj.20130240.
    1. Cragun D, DeBate RD, Vadaparampil ST, Baldwin J, Hampel H, Pal T. Comparing universal Lynch syndrome tumor-screening programs to evaluate associations between implementation strategies and patient follow-through. Genet Med. 2014;16:773–82. doi: 10.1038/gim.2014.31.
    1. Damschroder LJ, Lowery JC. Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR) Implement Sci. 2013;8(1):51. doi: 10.1186/1748-5908-8-51.
    1. Kilbourne AM, Abraham KM, Goodrich DE, Bowersox NW, Almirall D, Lai Z, et al. Cluster randomized adaptive implementation trial comparing a standard versus enhanced implementation intervention to improve uptake of an effective re-engagement program for patients with serious mental illness. Implement Sci. 2013;8(1):1–14. doi: 10.1186/1748-5908-8-136.
    1. English M. Designing a theory-informed, contextually appropriate intervention strategy to improve delivery of paediatric services in Kenyan hospitals. Implement Sci. 2013;8:39. doi: 10.1186/1748-5908-8-39.
    1. Green CA, McCarty D, Mertens J, Lynch FL, Hilde A, Firemark A, et al. A qualitative study of the adoption of buprenorphine for opioid addiction treatment. J Subst Abuse Treat. 2014;46(3):390–401. doi: 10.1016/j.jsat.2013.09.002.
    1. Martinez RG, Lewis CC, Weiner BJ. Instrumentation issues in implementation science. Implement Sci. 2014;9:118. doi: 10.1186/s13012-014-0118-8.
    1. Proctor E, Silmere H, Raghavan R, Hovmand P, Aarons G, Bunger A, et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm Policy Ment Health. 2011;38(2):65–76. doi: 10.1007/s10488-010-0319-7.
    1. Klein KJ, Sorra JS. The challenge of innovation implementation. Acad Manage Rev. 1996;21(4):1055–80.
    1. Kitson AL, Rycroft-Malone J, Harvey G, McCormack B, Seers K, Titchen A. Evaluating the successful implementation of evidence into practice using the PARiHS framework: theoretical and practical challenges. Implement Sci. 2008;3(1):1. doi: 10.1186/1748-5908-3-1.
    1. Helfrich CD, Damschroder LJ, Hagedorn HJ, Daggett GS, Sahay A, Ritchie M, et al. A critical synthesis of literature on the promoting action on research implementation in health services (PARIHS) framework. Implement Sci. 2010;5(1):82. doi: 10.1186/1748-5908-5-82.
    1. Colquhoun HL, Brehaut JC, Sales A, Ivers N, Grimshaw J, Michie S, et al. A systematic review of the use of theory in randomized controlled trials of audit and feedback. Implement Sci. 2013;8(1):66. doi: 10.1186/1748-5908-8-66.
    1. Prestwich A, Sniehotta FF, Whittington C, Dombrowski SU, Rogers L, Michie S. Does theory influence the effectiveness of health behavior interventions? Meta-analysis. Health Psychol. 2014;33(5):465. doi: 10.1037/a0032853.
    1. Davidoff F, Dixon-Woods M, Leviton L, Michie S. Demystifying theory and its use in improvement. BMJ Qual Saf. 2015;24:228–38. doi: 10.1136/bmjqs-2014-003627.
    1. French SD, Green SE, O’Connor DA, McKenzie JE, Francis JJ, Michie S, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. 2012;7(1):38. doi: 10.1186/1748-5908-7-38.
    1. Acosta J, Chinman M, Ebener P, Malone PS, Paddock S, Phillips A, et al. An intervention to improve program implementation: findings from a two-year cluster randomized trial of Assets-Getting To Outcomes. Implement Sci. 2013;8:87. doi: 10.1186/1748-5908-8-87.
    1. Baker W, Harris M, Battersby M. Health workers’ views of a program to facilitate physical health care in mental health settings: implications for implementation and training. Australas Psychiatry. 2014;22:560–3. doi: 10.1177/1039856214546675.
    1. Balas MC, Burke WJ, Gannon D, Cohen MZ, Colburn L, Bevil C, et al. Implementing the awakening and breathing coordination, delirium monitoring/management, and early exercise/mobility bundle into everyday care: opportunities, challenges, and lessons learned for implementing the ICU Pain, Agitation, and Delirium Guidelines. Crit Care Med. 2013;41(9 Suppl 1):S116–27. doi: 10.1097/CCM.0b013e3182a17064.
    1. Connell L, McMahon N, Harris J, Watkins C, Eng J. A formative evaluation of the implementation of an upper limb stroke rehabilitation intervention in clinical practice: a qualitative interview study. Implement Sci. 2014;9:90. doi: 10.1186/s13012-014-0090-3.
    1. Jv D, Corneau S, Henderson T, Quastel A, Griller R, Stergiopoulos V. Reducing service and substance use among frequent service users: a brief report from the Toronto community addictions team. Subst Use Misuse. 2013;48(7):532–8. doi: 10.3109/10826084.2013.787096.
    1. English M, Nzinga J, Mbindyo P, Ayieko P, Irimu G, Mbaabu L. Explaining the effects of a multifaceted intervention to improve inpatient care in rural Kenyan hospitals—interpretation based on retrospective examination of data from participant observation, quantitative and qualitative studies. Implement Sci. 2011;6(1):124. doi: 10.1186/1748-5908-6-124.
    1. Gilmer TP, Katz ML, Stefancic A, Palinkas LA. Variation in the implementation of California’s full service partnerships for persons with serious mental illness. Health Serv Res. 2013;48(6pt2):2245–67. doi: 10.1111/1475-6773.12119.
    1. Jones CM, Stewart C, Roszell SS. Beyond best practice: implementing a unit-based CLABSI project. J Nurs Care Qual. 2015;30(1):24–30. doi: 10.1097/NCQ.0000000000000076.
    1. Sanchez SH, Sethi SS, Santos SL, Boockvar K. Implementing medication reconciliation from the planner’s perspective: a qualitative study. BMC Health Serv Res. 2014;14(1):290. doi: 10.1186/1472-6963-14-290.
    1. Shaw J, Sidhu K, Kearney C, Keeber M, McKay S. Engaging home health care providers in a fall prevention best practice initiative. Home Health Care Serv Q. 2013;32(1):1–16. doi: 10.1080/01621424.2013.757177.
    1. Zulman DM, Damschroder LJ, Smith RG, Resnick PJ, Sen A, Krupka EL, et al. Implementation and evaluation of an incentivized Internet-mediated walking program for obese adults. Transl Behav Med. 2013;3(4):357–69. doi: 10.1007/s13142-013-0211-6.

Source: PubMed

スポンサーと協力者

医学的状態

薬物療法

3
購読する