Domain | Included measures (N = 86) | % | Large-scale tools (n = 23) | % | Unique tools (n = 63) | % | Definition | Source | |
---|---|---|---|---|---|---|---|---|---|
Implementation outcomes | Acceptability | 18 | 20.9 | 0 | 0.0 | 18 | 28.6 | Perceptions by staff in organizations mandated to implement the policy, or perceptions of other stakeholders, that the policy mandate is agreeable, palatable, or satisfactory | Proctor et al. [19] |
Adoption | 32 | 37.2 | 10 | 43.5 | 22 | 34.9 | Intention and initial actions of mandated organizations to revise their organizational policies to address policy mandates (not policy development or passage of bills into law) | Proctor et al. [19] | |
Appropriateness | 9 | 10.5 | 0 | 0.0 | 9 | 14.3 | Perceived fit, relevance, or compatibility of the [policy] for a given practice setting, provider, or consumer; and/or perceived fit of the [policy] to address a particular issue or problem; context fit | Proctor et al. [19] | |
Feasibility | 8 | 9.3 | 1 | 4.3 | 7 | 11.1 | Extent to which a new [policy] can be successfully used or carried out within a given agency or setting; level of administration required to implement a policy, often called policy automaticity | Proctor et al. [19] | |
Fidelity/compliance | 70 | 81.4 | 21 | 91.3 | 49 | 77.8 | Degree to which a [policy] was implemented as it was prescribed | Proctor et al. [19] | |
Penetration | 15 | 17.4 | 8 | 34.8 | 7 | 11.1 | Integration of a [policy] within a service setting and its subsystems | Proctor et al. [19] | |
Sustainability | 3 | 3.5 | 1 | 4.3 | 2 | 3.2 | Extent [new policy] is maintained or institutionalized within a service setting’s ongoing, stable operations | Proctor et al. [19] | |
Cost of implementation | 5 | 5.8 | 0 | 0.0 | 5 | 7.9 | Cost impact of an implementation effort | Proctor et al. [19] | |
Policy/innovation characteristics | Adaptability | 3 | 3.5 | 0 | 0.0 | 3 | 4.8 | Degree to which [a policy] can be adapted, tailored, refined, or reinvented to meet local needs | Damschroder et al. [24] |
Complexity | 3 | 3.5 | 0 | 0.0 | 3 | 4.8 | Perceived difficulty of implementation, reflected by duration, scope, radicalness, disruptiveness, centrality, and intricacy and number of steps required to implement | Damschroder et al. [24] | |
Organizational characteristics/inner setting | Champions | 6 | 7.0 | 0 | 0.0 | 6 | 9.5 | Field or practice leaders, people who can facilitate and support practice change among professionals | Damschroder et al. [24] |
Organizational culture and climate | 9 | 10.5 | 1 | 4.3 | 8 | 12.7 | Culture: “Norms, values, and basic assumptions of a given organization”; or climate: “Absorptive capacity for change”, extent policy compliance will be rewarded, supported, and expected within their organization | ||
Policy implementation climate (IC) | 4 | 4.7 | 0 | 0.0 | 4 | 6.3 | Organizational climate specific to the policy mandate | Damschroder et al. [24] | |
IC: goals and feedback | 6 | 7.0 | 3 | 13.0 | 3 | 4.8 | Degree [the policy mandate] goals are clearly communicated, acted upon, and fed back to staff and alignment of that feedback with goals | Damschroder et al. [24] | |
IC: relative priority | 21 | 24.4 | 2 | 8.7 | 19 | 30.2 | Individuals’ shared perception of importance of the [policy] implementation within the organization, competing priorities | Damschroder et al. [24] | |
Opinion leaders | 7 | 8.1 | 0 | 0.0 | 7 | 11.1 | Individuals in an organization who have formal or informal influence on attitudes and beliefs of their colleagues with respect to implementing the policy | Damschroder et al. [24] | |
Readiness to implement (RI) | 5 | 5.8 | 0 | 0.0 | 5 | 7.9 | Damschroder et al. [24] | ||
RI: communication of policy | 41 | 47.7 | 18 | 78.3 | 23 | 36.5 | Communication plans and channels created for how the regulatory agency or implementing organization/s will disseminate policy mandate content information to implementers. Actions taken to disseminate policy requirements and guidelines to implementers. | Damschroder et al. [24] | |
RI: policy awareness/knowledge | 27 | 31.4 | 2 | 8.7 | 25 | 39.7 | Implementing staff/provider awareness the policy mandate exists, or knowledge of policy content | Damschroder et al. [24] | |
RI: leadership for implementation | 42 | 48.8 | 22 | 95.7 | 20 | 31.7 | Commitment, involvement, and accountability of leaders and managers with the implementation | Damschroder et al. [24] | |
RI: non-training resources | 43 | 50.0 | 15 | 65.2 | 28 | 44.4 | Level of resources dedicated for implementation and ongoing operations including money…physical space, and time, other than training resources | Damschroder et al. [24] | |
RI: training | 35 | 40.7 | 16 | 69.6 | 19 | 30.2 | Training of staff/providers in implementing organizations on how to implement the policy-mandated practices | Damschroder et al. [24] | |
Structure of organization | 2 | 2.3 | 0 | 0.0 | 2 | 3.2 | The social architecture, age, maturity, and size of an organization | Damschroder et al. [24] | |
Implementation process | Enforcement | 10 | 11.6 | 1 | 4.3 | 9 | 14.3 | Strategies used to hold individuals accountable for implementation fidelity/compliance | From screening/coding |
Evaluation | 35 | 40.7 | 18 | 78.3 | 17 | 27.0 | Quantitative and qualitative feedback about the progress and quality of implementation accompanied with regular personal and team debriefing about progress and experience. | Damschroder et al. [24] | |
General barriers and facilitators | 20 | 23.3 | 2 | 8.7 | 18 | 28.6 | Factors which facilitate/enable or hinder implementation | From screening/coding | |
Collaboration | 11 | 12.8 | 7 | 30.4 | 4 | 6.3 | Active involvement of other stakeholders in the organization to implement the policy | From screening/coding | |
Innovation participants | 19 | 22.1 | 10 | 43.5 | 9 | 14.3 | Engaging individuals who will directly benefit/receive the policy action | Damschroder et al. [24] | |
Actor relationships/networks | Actor relationships/networks | 45 | 52.3 | 22 | 95.7 | 23 | 36.5 | Presence and characteristics of relationships between parallel organizations that must collaborate for policy implementation to be effective | Bullock [47] |
Visibility of policy role and policy actors | 23 | 26.7 | 8 | 34.8 | 15 | 23.8 | Perceived presence and importance of different actors pertinent to implementation of the policy | Bullock [47] | |
Actor context | Political will for policy implementation | 12 | 14.0 | 3 | 13.0 | 9 | 14.3 | Societal desire and commitment to generate resources to carry out policies | Bullock [47] |
Target population characteristics | 1 | 1.2 | 0 | 0.0 | 1 | 1.6 | Demographics, norms, and neighborhood environments of the population groups that are affecting policy implementation | Bullock [47] | |
Other domain (not in manual) | CFIR process-planning | 2 | 2.3 | 0 | 0.0 | 2 | 3.2 | The degree to which a scheme or method of behavior and tasks for implementing [a policy] are developed in advance, and the quality of those schemes or methods | Damschroder et al. [24] |
CFIR innovation characteristics-relative advantage | 1 | 1.2 | 0 | 0.0 | 1 | 1.6 | Stakeholders’ perception of the advantage of implementing the intervention versus an alternative solution | Damschroder et al. [24] | |
CFIR inner setting-tension for change | 1 | 1.2 | 0 | 0.0 | 1 | 1.6 | The degree to which stakeholders perceive the current situation as intolerable or needing change | Damschroder et al. [24] |