Table 2 CFIR domains and construct descriptions (original and intersectionality supplemented CFIR comparison)”

CFIR Domain: Outer setting

The ‘economic, political, and social context within which an organization resides.’

The economic, political, geographical, environmental, physical, environmental, and social context within which an organization resides.

Patient needs and resources

The extent to which patient needs, as well as barriers and facilitators to meet those needs, are accurately known and prioritized by the organization.

The extent to which diverse patient perspectives, values, needs, as well as barriers (e.g., historical distrust of medical systems) and facilitators (e.g., high socioeconomic status) to meet those needs are accurately known, aligned with, and prioritized by the organization

External policies and incentives

A broad construct that includes external strategies to spread interventions, including policy and regulations (governmental or other central entity), external mandates, recommendations and guidelines, pay-for-performance, collaboratives, and public or benchmark reporting.

A broad construct that includes external strategies to spread interventions, including policy and regulations (governmental or other central entity), external mandates, recommendations and guidelines, pay-for-performance, collaboratives, and public or benchmark reporting and that the creation and sustainment of these strategies addresses systems of power, inclusivity, and equity.

Outer structures and systems

N/A (not in CFIR)

The overlapping structures and systems of a given society, including systems of privilege and oppression (e.g., sexism, racism, ableism).

Outer culture

N/A (not in CFIR)

The norms, values, and basic assumptions (e.g., heteronormativity) of a given society.

CFIR Domain: Inner setting

The ‘structural, political, and cultural context through which the intervention proceeds’ and the relationship between these elements.

The ‘structural, political, power, and cultural context through which the intervention proceeds’ and the relationship between these elements.

Networks and communications

The nature and quality of webs of social networks and the nature and quality of formal and informal communications within an organization

The nature, quality, and inclusivity of webs of social networks and the nature, quality, and access to formal and informal communications within an organization.

Inner culture

Norms, values, and basic assumptions of a given organization.

Norms, values, power structures, and basic assumptions (e.g., heteronormativity) of a given organization.

Compatibility

(sub-construct to CFIR construct “Implementation climate”)

The degree of tangible fit between meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values, and perceived risks and needs, and how the intervention fits with existing workflows and systems.

The degree of tangible fit between individuals’ intersecting social categories and the meaning and values attached to the intervention by involved individuals, how those align with individuals’ own norms, values, ways of knowing, and perceived risks and needs, and how the intervention fits with existing workflows and systems.

Organizational incentives and rewards

(sub-construct to CFIR construct “Implementation climate”)

Extrinsic incentives such as goal-sharing awards, performance reviews, promotions, and raises in salary, and less tangible incentives such as increased stature or respect.

Existence of and access to extrinsic incentives such as goal-sharing awards, performance reviews, promotions, and raises in salary, and less tangible incentives such as increased stature or respect.

Learning climate

(sub-construct to CFIR construct “Implementation climate”)

A climate in which: (a) leaders express their own fallibility and need for team members’ assistance and input; (b) team members feel that they are essential, valued, and knowledgeable partners in the change process; (c) individuals feel psychologically safe to try new methods; and (d) there is sufficient time and space for reflective thinking and evaluation.

A climate in which: (a) leaders, representative of diverse intersecting social factors, express their own fallibility and need and respect for team members’ assistance and input; (b) team members, representative of diverse intersecting social factors, feel they are partners and that their perspective is encouraged, essential, heard, valued, and considered knowledgeable in the change process; (c) individuals feel psychologically safe to try new methods; and (d) there is sufficient time and space for reflective thinking and evaluation in multiple venues/means (e.g., written reflection, discussion).

Access to knowledge and information

(sub-construct to CFIR construct “Readiness for implementation”)

Ease of access to digestible information and knowledge about the intervention and how to incorporate it into work tasks.

Ease of access to digestible information and knowledge about the intervention and how to incorporate it into work tasks.

CFIR Domain: Characteristics of Individuals

The individuals responsible for carrying out the intervention or otherwise related to the intervention, their agency, and their relationships to each other and the intervention.

The individuals responsible for carrying out the intervention or otherwise related to the intervention, their agency, intersecting social categories, and their relationships (e.g., power dynamics) to each other, the intervention, and those impacted by the intervention (e.g., patients).

Knowledge and beliefs about the intervention and those receiving the intervention

Individuals’ attitudes toward and value placed on the intervention as well as familiarity with facts, truths, and principles related to the intervention.

Individuals’ attitudes toward and value placed on the intervention as well as familiarity with and access to facts, truths, and principles related to the intervention and those receiving the intervention (e.g., patients, other health providers).

Self-efficacy

Individual belief in their own capabilities to execute courses of action to achieve implementation goals.

An individual’s belief in their own capabilities (related to their intersecting social factors) to execute courses of action to achieve implementation goals.

Other personal attributes

A broad construct to include other personal traits such as tolerance of ambiguity, intellectual ability, motivation, values, competence, capacity, and learning style.

A broad construct to include the intersection of other personal traits and social factors such as tolerance of ambiguity, motivation, values, competence, learning style. These individual traits and social factors interact with each other and other domains including the outer and inner setting (e.g., one’s values regarding educational achievement will be influenced by social systems, such as sexism and racism).