Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research

Abstract

Background Implementation researchers recognize the influential role of organizational factors and, thus, seek to assess these factors using quantitative measurement instruments. However, researchers are hindered by instruments that measure similar constructs but rely on different nomenclature and/or definitions. The Consolidated Framework for Implementation Research (CFIR) provides a taxonomy of constructs derived from prior frameworks and empirical studies of implementation-related constructs. The CFIR includes constructs based on the original Promoting Action on Research Implementation in Health Services (PARiHS) framework which highlights the key roles of strength of evidence for a specific evidence-based intervention (EBI), favorability of organizational context for change, and capacities to facilitate implementation of the EBI. Although the CFIR is among the most frequently used implementation frameworks, it does not include quantitative measures. The Organizational Resource and Context Assessment (ORCA) is a quantitative measurement instrument that was developed based on PARiHS, assessing its three domains. Factors within these three domains are conceptually similar to constructs in the CFIR but do not match directly. The aim of this work was to map ORCA survey items to CFIR constructs to enable direct comparisons and syntheses of findings across studies using the CFIR and/or ORCA. Methods Two distinct, independent research teams, each used rigorous constant comparative techniques with deliberation and consensus to map individual items from the ORCA to the five domains and 39 constructs of CFIR. Results ORCA items were mapped primarily to three of five CFIR domains: Inner Setting, Process, and Intervention Characteristics. The two research teams agreed on 88% of mappings at the higher domain level; at the lower construct level, their mappings aligned for 62.2% of the ORCA items. Conclusions Mapping results reveal that the ORCA focuses measurement prominently on Inner Setting, Process, and Intervention Characteristics. This mapping guide can help improve consistency in measurement and reporting, enabling more efficient comparison and synthesis of findings that use either the ORCA instrument or the CFIR framework. The guide helps advance implementation science utilizing mixed methods by providing CFIR users with quantitative measures for selected constructs and enables ORCA users to map their findings to CFIR constructs.

Organizational readiness to implement task-strengthening strategy for hypertension management among people living with HIV in Nigeria

“…The tool consists of three scales (evidence, context, and facilitation) with multiple subscales developed to assess elements of the PARIHS framework. ORCA was selected given that it is theory-grounded and has been used and validated as part of several evidence-based efforts in health facilities [ 21 , 25 ]. For the study, we focused on the context scale to assess the organizational readiness of health facilities in Akwa-Ibom, Nigeria, to integrate an evidence-based task-strengthening strategy within their HIV care centers.…”

Stakeholders’ perspectives on the feasibility of adopting a Healthy Nail Salon Recognition Program in Philadelphia: A qualitative study

“…The website dedicated to the dissemination of CFIR offers numerous resources for implementation science practitioners to use in their evaluation study ( The Consolidated Framework for Implementation Research – Technical Assistance for Users of the CFIR Framework , n.d.). In the context of this study, we selected constructs related to organizational readiness to qualitative gauge stakeholders’ perspectives on the city’s level of readiness for such a program (Kononowech et al, 2021). This type of formative research, conducted prior to the development a program, could provide useful information to program planners and community organizers.…”

“…CFIR Framework, n.d.). In the context of this study, we selected constructs related to organizational readiness to qualitative gauge stakeholders' perspectives on the city's level of readiness for such a program (Kononowech et al, 2021). This type of formative research, conducted prior to the development a program, could provide useful information to program planners and community organizers.…”

Development of health and safety training for Vietnamese American nail salon owners and workers

“…The CFIR has 39 constructs covering five domains: inner setting, outer setting, characteristics of individuals, intervention process, intervention characteristics, and the implementation process. Our questionnaire focused on implementation readiness constructs 20 to ensure the collected data were relevant to our research objectives. Our community partner assisted in the data collection by helping participants complete the questionnaire over the phone.…”