Table 2 Identified facilitators and barriers based on CFIR domains and constructs
CFIR domain | Barriers/facilitators | CFIR construct | Description |
|---|---|---|---|
Intervention Characteristics | Facilitators | Relative advantage of TASSH | • Reduce the workloads of overburdened workers • Improve overall efficiency • The ability for patients to access care in the same clinic or location • Reduce clinic wait times • Reduce the stigma faced by PLWHIV |
Barriers | Complexity of TASSH | Potential for disagreements and conflicts over roles and role boundaries | |
Inner setting | Facilitators | Compatibility with existing workflows and processes | • Integration of the existing CHEWs into the national structures to improve referral systems |
Access to knowledge and information | • Availability of educational support for evidence-based practice for hypertension management within the HIV clinics | ||
Barriers | Available resources and support | • Inadequate availability of diagnostic equipment and drugs for HTN across HIV clinics | |
Networks and communication | • Weak referral networks and patient tracking mechanism for HTN management within HIV clinics | ||
Outer setting | Facilitators | Needs of those served by the intervention | • Supports patients’ needs |
Incentives | • Provision of non-monetary incentives in the form of professional development | ||
Barriers | External policies | • Existing national polices on NCD management and task-sharing are not implemented in the clinics • No specific action in task-shifting policy to minimize workload | |
Characteristics of individuals | Facilitators | Knowledge and beliefs | • Knowledge of benefit for implementing TASSH and values placed on the importance of EBP |
Implementation process | Facilitators | Planning | • Accommodate shift preferences and minimize scheduling conflicts for the nurses; Implement simplified data collection tools; align program goals with national guidelines for NCDs |