Table 4 Consolidated Framework for Implementation Research (CFIR) determinants that influence HEALTH implementation (aims 2 and 3)
Factor | Definition | Sample item/citation |
|---|---|---|
Mother level | ||
 Socio-economic status | Social standing or class of an individual or group | Which of the following describes your current living situation? [11] |
 Racial/ethnic background | Participant’s geographic region of origin, ancestry and cultural tradition, common history, religion | Which of the following represent your Hispanic origin or ancestry? [11] |
 Cultural norms | Unspoken rules or patterns of behavior that are perceived as normal or socially acceptable | Most people who are important to me think I should make healthy food choices [91] |
Parent educator level | ||
 Parent educator characteristics | ||
  Knowledge and beliefs about HEALTH | Parent educators’ attitudes toward and value placed on HEALTH and familiarity with facts, truths, and principles related to HEALTH | I can distinguish between different curricula which address healthy weight [80]. |
  Self-efficacy | Parent educator belief in their own capabilities to achieve implementation goals | I am confident I can implement HEALTH as prescribed at this PAT site [74, 75]. |
 Intervention characteristics—HEALTH | ||
  Evidence strength and quality | Parent educators’ perceptions of the quality and validity of evidence supporting the belief that HEALTH will have desired outcomes | HEALTH should be effective, based on current scientific knowledge [92]. |
  Relative advantage | Parent educators’ perception of the advantage of implementing HEALTH versus usual care | In general, HEALTH would be more effective in helping women prevent gaining weight than our current curriculum [80]. |
  Complexity | Perceived difficulty of implementation, reflected by duration, scope, radicalness, disruptiveness, centrality, intricacy, and number of steps required | HEALTH would be difficult to teach [80]. |
PAT site level | ||
 Outer setting | ||
  Participant needs and resources | Extent to which client needs (and barriers and facilitators to meeting those needs) are accurately known and prioritized by the organization | HEALTH will improve the overall quality of life for clients who receive it. |
  External policy and incentives | External strategies to spread interventions, including policy and regulations (governmental, other central entity), external mandates, recommendations and guidelines | Do you anticipate any funding changes in the next few years? |
 Inner setting—PAT site | ||
  Structural characteristics | Social architecture, age, maturity, and size of a PAT site | Determined from administrative data. |
  Culture | Norms, values, and basic assumptions of a PAT site | Management at your PAT site reward innovation and creativity to improve practice client care [93]. |
  Implementation climate | Absorptive capacity for change, shared receptivity of involved individuals to an intervention, and the extent to which use of the intervention will be rewarded, supported, and expected in the PAT site | Staff members involved in implementing HEALTH are appreciated for their efforts [93]. |
  Readiness for implementation | Tangible, immediate indicators of organizational commitment to its decision to implement HEALTH | People who work here are determined to implement this change [94]. |