Table 1 A guide to applying NPT and CFIR to understand interactions between processes and context in the evaluation of implementation work

1. Ensuring methodological fit

• Ensure implementation project and evaluation/research aim fit with scope and focus of NPT and CFIR

• Consider using a theory and framework criteria matching tool (such as T-Cast [21])

• Engage with stakeholders for contextual understanding and to develop shared understandings of methodological fit between project objectives and the integrated use of NPT and CFIR

2. Developing the interview guide

• Open-ended questions to explore bi-directional connections between contextual conditions and the work people do to implement an innovation

• Prompt interviewee to recall specific situations

• Cross-referencing each question with prompts as memory aids to further explore NPT and CFIR constructs

• In-depth familiarity with NPT and CFIR constructs is key to rapidly respond with prompts to explore constructs as they emerge in interviews and to inquire about constructs that are absent

• Regular discussions with stakeholders and pilot testing ensure comprehensiveness and applicability

3. Developing the coding manual

• Initial inductive coding allows for exploration of aspects of an implementation experience not anticipated from NPT and CFIR constructs

• Integration of NPT and CFIR constructs and inductive codes based on regular meetings among research team members to reach a consensus on the coding structure

• Multiple coding highlights where CFIR and NPT integrate and complement each other

4. Analyzing the qualitative data

• Openness to explore the complexities through applying multiple codes to interview passages

• Using multiple coding to think through a web of connections across CFIR domains and NPT mechanisms to move beyond description to explain how and why change may occur to integrate an innovation into routine practices

5. Reporting the findings

• Clearly describe the methodology of integrating NPT and CFIR in the methods

• When describing results focus on the interaction and entanglement, rather than separating results by processes and contextual factors

• Reflect on and report pros and cons of applying NPT and CFIR together in your study