Mapping the organizational readiness to change assessment to the Consolidated Framework for Implementation Research

• Published in: Implementation Science Communications
• Main Authors: Jennifer Kononowech, Hildi Hagedorn, Carmen Hall, Christian D. Helfrich, Anne C. Lambert-Kerzner, Susan C. Miller, Anne E. Sales, Laura Damschroder
• Format: Article in Journal/Newspaper
• Language: English
• Published: BMC 2021
• Subjects: Implementation research frameworks; Surveys; Measurement; PARiHS; CFIR; ORCA; Medicine (General); R5-920; Orca
• Online Access: https://doi.org/10.1186/s43058-021-00121-0; https://doaj.org/article/a9c4202db8424a4fab1cc8cbd9401a7c

Abstract Background Implementation researchers recognize the influential role of organizational factors and, thus, seek to assess these factors using quantitative measurement instruments. However, researchers are hindered by instruments that measure similar constructs but rely on different nomenclature and/or definitions. The Consolidated Framework for Implementation Research (CFIR) provides a taxonomy of constructs derived from prior frameworks and empirical studies of implementation-related constructs. The CFIR includes constructs based on the original Promoting Action on Research Implementation in Health Services (PARiHS) framework which highlights the key roles of strength of evidence for a specific evidence-based intervention (EBI), favorability of organizational context for change, and capacities to facilitate implementation of the EBI. Although the CFIR is among the most frequently used implementation frameworks, it does not include quantitative measures. The Organizational Resource and Context Assessment (ORCA) is a quantitative measurement instrument that was developed based on PARiHS, assessing its three domains. Factors within these three domains are conceptually similar to constructs in the CFIR but do not match directly. The aim of this work was to map ORCA survey items to CFIR constructs to enable direct comparisons and syntheses of findings across studies using the CFIR and/or ORCA. Methods Two distinct, independent research teams, each used rigorous constant comparative techniques with deliberation and consensus to map individual items from the ORCA to the five domains and 39 constructs of CFIR. Results ORCA items were mapped primarily to three of five CFIR domains: Inner Setting, Process, and Intervention Characteristics. The two research teams agreed on 88% of mappings at the higher domain level; at the lower construct level, their mappings aligned for 62.2% of the ORCA items. Conclusions Mapping results reveal that the ORCA focuses measurement prominently on Inner Setting, Process, and ...