Introduction: Conscientiousness is among the strongest predictors of individual differences in major life outcomes. Yet decades of work understanding the optimal lower-order structure of Conscientiousness has not rectified the differences that remain among existing models and measures. To precisely measure its relations to major life outcomes, it is necessary to work toward a comprehensive, replicable conceptualization of the construct’s structure. Methods: The present pre-registered study used three samples (Ns = 446, 406, & 424) to explore the domain’s latent structure with item-level “bass-ackward” factor analyses and evaluate the resulting structure’s interpretability, parsimony, and replicability. Participants completed self-report measures of Conscientiousness and criteria in its nomological network (e.g., FFM traits, externalizing behavior, disinhibitory traits; informant reports were collected as well). Results: The factor analyses identified five interpretable and replicable factors (i.e., Deliberation, Order, Industriousness, Self-Discipline, and Dependability) using predominant measures of general personality. An additional factor (i.e., Traditionalism) was introduced in the six-factor solution when the item pool was expanded to include less widely used measures of general personality. Conclusion: The authors discuss the item composition of each factor, their relation to existing models and measures of the domain’s structure, their association with relevant criteria, and the general implications of conceptualizing Conscientiousness using flexible, item-level factor analysis.

BACKGROUND Tobacco smoking is associated with significant morbidity and premature mortality in individuals with serious mental illness. A 2-year pragmatic clinical trial (PCORI PCS-1504-30472) that enrolled 1100 individuals with serious mental illness in the greater Boston area was conducted to test 2 interventions for tobacco cessation for individuals with serious mental illness: (1) academic detailing, which delivers education to primary care providers and highlights first-line pharmacotherapy for smoking cessation, and (2) provision of community health worker support to smoker participants. Implementing and scaling this intervention in other settings will require the systematic identification of barriers and facilitators, as well as the identification of relevant subgroups, effective and unique components, and setting-specific factors. OBJECTIVE This protocol outlines the proposed mixed methods evaluation of the pragmatic clinical trial to (1) identify barriers and facilitators to effective implementation of the interventions, (2) examine group differences among primary care physicians, and (3) identify barriers that stakeholders such as clinical, payor, and policy leaders would anticipate to impact the implementation of effective components of the intervention. METHODS Qualitative interviews will be conducted with all study community health workers and selected smoker participants, primary care providers, and other stakeholders. Measures of performance and engagement will guide purposive sampling. The Consolidated Framework for Implementation Research will guide qualitative data collection and analysis in accordance with the following framework approach: (1) familiarization, (2) identifying a thematic framework, (3) indexing, (4) charting, and (5) mapping and interpretation. Joint display analyses will be constructed to analyze and draw conclusions across the quantitative and qualitative data. RESULTS The 3-year cluster-randomized trial has concluded, and the analysis of primary outcomes is underway. Results from the pragmatic trial and this mixed methods implementation evaluation will be used to help disseminate, scale, and expand a systems intervention. CONCLUSIONS The results of this mixed methods implementation evaluation will inform strategies for dissemination and solutions to potential barriers to the implementation of interventions from a smoking cessation trial for individuals with serious mental illness. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/25390

ObjectiveThe present study examined the hierarchical structure of Conscientiousness across three large samples using item‐level analyses.BackgroundConscientiousness is among the strongest predictors of individual differences in major life outcomes. Yet decades of work understanding the optimal lower‐order structure of Conscientiousness has not rectified the differences that remain among existing models and measures. To precisely measure its relations to major life outcomes, it is necessary to work toward a comprehensive, replicable conceptualization of the construct's structure.MethodsThe present pre‐registered study used three samples (Ns = 446, 406, & 424) to explore the domain's latent structure with item‐level “bass‐ackward” factor analyses and evaluate the resulting structure's interpretability, parsimony, and replicability. Participants completed self‐report measures of Conscientiousness and criteria in its nomological network (e.g., FFM traits, externalizing behavior, disinhibitory traits; informant reports were collected as well).ResultsThe factor analyses identified five interpretable and replicable factors (i.e., deliberation, order, industriousness, self‐discipline, and dependability) using predominant measures of general personality. An additional factor (i.e., traditionalism) was introduced in the six‐factor solution when the item pool was expanded to include less widely used measures of general personality.ConclusionThe authors discuss the item composition of each factor, their relation to existing models and measures of the domain's structure, their association with relevant criteria, and the general implications of conceptualizing Conscientiousness using flexible, item‐level factor analysis.

Background Tobacco smoking is associated with significant morbidity and premature mortality in individuals with serious mental illness. A 2-year pragmatic clinical trial (PCORI PCS-1504-30472) that enrolled 1100 individuals with serious mental illness in the greater Boston area was conducted to test 2 interventions for tobacco cessation for individuals with serious mental illness: (1) academic detailing, which delivers education to primary care providers and highlights first-line pharmacotherapy for smoking cessation, and (2) provision of community health worker support to smoker participants. Implementing and scaling this intervention in other settings will require the systematic identification of barriers and facilitators, as well as the identification of relevant subgroups, effective and unique components, and setting-specific factors. Objective This protocol outlines the proposed mixed methods evaluation of the pragmatic clinical trial to (1) identify barriers and facilitators to effective implementation of the interventions, (2) examine group differences among primary care physicians, and (3) identify barriers that stakeholders such as clinical, payor, and policy leaders would anticipate to impact the implementation of effective components of the intervention. Methods Qualitative interviews will be conducted with all study community health workers and selected smoker participants, primary care providers, and other stakeholders. Measures of performance and engagement will guide purposive sampling. The Consolidated Framework for Implementation Research will guide qualitative data collection and analysis in accordance with the following framework approach: (1) familiarization, (2) identifying a thematic framework, (3) indexing, (4) charting, and (5) mapping and interpretation. Joint display analyses will be constructed to analyze and draw conclusions across the quantitative and qualitative data. Results The 3-year cluster-randomized trial has concluded, and the analysis of primary outcomes is underway. Results from the pragmatic trial and this mixed methods implementation evaluation will be used to help disseminate, scale, and expand a systems intervention. Conclusions The results of this mixed methods implementation evaluation will inform strategies for dissemination and solutions to potential barriers to the implementation of interventions from a smoking cessation trial for individuals with serious mental illness. International Registered Report Identifier (IRRID) DERR1-10.2196/25390