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Table 1 Key CFIR domains and constructs assessed

From: Readiness to implement on-site molecular testing for tuberculosis in community health centers in Uganda

CFIR domain/constructs

Focus area assessed for Xpert implementation

I. Intervention characteristics

a. Where the intervention originated (e.g., internal or external)

Perception of whether the intervention originated externally or as part of the National TB Program

b. Evidence strength and quality

Assessment of effectiveness of Xpert testing relative to the current TB diagnostic and treatment approach

c. Design quality and package

Perceptions on simplicity and quality compared to the standard test for TB (sputum smear microscopy)

d. Relative advantage

Perceived advantages of Xpert testing relative to smear microscopy for TB testing and diagnosis.

II. Inner setting

a. Structural characteristics

Size of the health facility, number of health workers, and patient population

b. Individual stage of change

How site staff perceived their roles and how easily they could change their practices to accommodate onsite Xpert testing.

c. Compatibility

Assessment of how patient workload is handled and anticipated impact on workflow processes to facilitate same day testing and treatment with Xpert.

d. Networks and communication

Opinions on how information shared between individuals, across departments and in the whole health facility, including formal and informal communication and social networks (not specific to intervention). How Xpert will impact communication about TB diagnosis and treatment. Staff teamwork and ability to work together

e. Implementation/learning climate

 

1) Tension for change

Degree to which staff perceive their current practices for TB assessment as needing change.

2) Relative priority

Shared opinions among health center staff about the importance of implementation of Xpert in the community health facilities.

3) Organizational incentives and rewards

Understanding the role of extrinsic incentives in the adoption of new practices and how they could best be deployed to promote implementation of Xpert.

4) Goals and Feedback

Assessment of the degree to which facility goals were communicated to staff, acted upon, and the extent to which performance evaluation from leaders aligned with goals.

III. Characteristics of individuals

a. Knowledge and beliefs about the intervention

Staff receptivity to Xpert and attitudes and knowledge about key aspects of the intervention.