CFIR domain | Construct | Effect |
---|---|---|
Intervention characteristics | Relative advantage—at age 11–12 (increased immunogenicity, completion of series before risk, access to at-risk population) | Facilitator |
Adaptability—use older age of initiation | Barrier | |
Outer setting | Patient needs and resources—optional as not mandated by school | Barrier |
Peer pressure | Barrier | |
External policy and incentives—financial incentives for series completion, e.g., meaningful use | Facilitator | |
Inner setting | Networks and communication—communication to coordinate implementation of 3 doses across staff and providers | Facilitator |
Readiness for implementation—leadership engagement in system level improvements and use of available resources, e.g., EMR alerts, outreach calls | Facilitator | |
Characteristics of individuals | Knowledge and beliefs—perceive value to completing by age 13 | Facilitator |
Knowledge and beliefs—perceive value to bundling | Facilitator | |
Self-efficacy—confident to strongly recommend vaccine and to convince hesitant parents | Facilitator | |
Self-efficacy—enthusiastic about HPV vaccine | Facilitator | |
Readiness to change—has made personal efforts for improvement | Facilitator | |
Process | Planning—discuss/implement changes for increased vaccine use | Facilitator |
Engaging—involve staff in meaningful problem-solving | Facilitator | |
Executing—strong recommendation, routinely provide at age 11/12, bundle 3 vaccines | Facilitator | |
Reflecting and evaluating—with a view to making changes | Facilitator |