ABSTRACT

The contexts within which implementation of evidence-based innovations occur can have enormous impact on implementation success. This essay describes a widely used implementation framework that provides an organized list of potential barriers and facilitators to implementation (referred to as constructs). The Consolidated Framework for Implementation Research (CFIR) describes 39 potential constructs arranged across five domains: 1) Innovation Characteristics (e.g., Evidence Strength and Quality); 2) Outer Setting (e.g., Patient Needs and Resources); 3) Inner Setting (e.g., Leadership Engagement); 4) Characteristics of Individuals (e.g., Attitudes and Beliefs); and 5) Process (e.g., Planning). The CFIR provides guidance for systematic assessment of context. As evidenced by many published reviews, the CFIR has promoted comparison of results across studies, contributing to a rapidly growing knowledge base, and it has stimulated new theoretical developments through adaptations, measurement, and strategies to improve implementation outcomes. Continued refinement of the CFIR will help to advance the science of implementation.