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Table 2 Implementation determinants and outcomes in eight determinant frameworks

From: Making sense of implementation theories, models and frameworks

  Characteristics of the implementation object Characteristics of the users/adopters (e.g. health care practitioners) Characteristics of the end users (e.g. patients) Characteristics of the context Characteristics of the strategy or other means of facilitating implementation Outcomes
PARIHS (Kitson et al. [5]; Rycroft-Malone [64]) Characteristics of the evidence Characteristics of the clinical experience (addressed as an aspect of the evidence element) Characteristics of the patient experience (addressed as an aspect of the evidence element) Characteristics of the context (comprising culture, leadership and evaluation) Characteristics of the facilitation, i.e. the process of enabling or making easier the implementation Successful implementation of research
Conceptual Model (Greenhalgh et al. [17]) Innovation attributes Aspects of adopters (e.g. psychological antecedents and nature of the adoption decision) and assimilation by organizations Not addressed Features of the inner context (organizational antecedents and organizational readiness for innovation) and outer context (e.g. informal interorganizational networks and political directives) Influences (e.g. opinion leaders, champions and network structure) lying on a continuum from diffusion to dissemination Successful diffusion, dissemination and implementation of innovations
Grol et al. [22] Features of the innovation Features of the professionals who should use the innovation Features of the patients Features of the social setting (e.g. attitudes of colleagues, culture and leadership) and of the economic, administrative and organizational context Features of the methods and strategies for dissemination and implementation used Implementation of new evidence, guidelines and best practices or procedures
Nutley et al. [21] Nature of the research to be applied Personal characteristics of researchers and potential research users and links between research and its users Not addressed Context for the use of research Strategies to improve the use of research Use of research
Cochrane et al. [59] Guidelines and evidence barriers Cognitive and behavioural barriers, attitudinal and rational-emotional barriers, health care professional and physician barriers Patient barriers Support and resource barriers, system and process barriers Not addressed Adherence to guidelines or implementation of evidence into clinical practice
Ecological Framework (Durlak and DuPre [57]) Characteristics of the innovation Provider characteristics Not addressed Community-level factors (comprising general organizational features, specific organizational practices and processes, and specific staffing considerations) Features of the prevention support system (comprising training and technical assistance) Successful implementation of innovations
CFIR (Damschroder et al. [60]) Intervention characteristics Characteristics of individuals Patient needs and resources (addressed as an aspect of the outer setting) Characteristics of the inner setting (e.g. structural characteristics, networks and communications, culture) and outer setting (e.g. cosmopolitanism, external policies and incentives) Effectiveness of process by which implementation is accomplished (comprising planning, engaging, executing, reflection and evaluating) Successful implementation of interventions
Gurses et al. [58] Guideline characteristics Clinician characteristics Not addressed Systems characteristics (e.g. physical environment, organizational characteristics) and implementation characteristics (e.g. tension for change and getting ideas from outside the organization) Implementation characteristics (e.g. change agents’ characteristics, relative strengths of supporters and opponents) Adherence to guidelines
  1. Conceptual Model Conceptual Model for Considering the Determinants of Diffusion, Dissemination, and Implementation of Innovations in Health Service Delivery and Organization (full title, [17]), CFIR Consolidated Framework for Implementation Research, PARIHS Promoting Action on Research Implementation in Health Services.