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Table 4 Consolidated Framework for Implementation Research (CFIR) determinants that influence HEALTH implementation (aims 2 and 3)

From: Disseminating and implementing a lifestyle-based healthy weight program for mothers in a national organization: a study protocol for a cluster randomized trial



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].


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].


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.


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].