nccmt spotlight webinar - the consolidated framework for implementation research (cfir): application...
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Funded by the Public Health Agency of Canada | Affiliated with McMaster UniversityProduction of this presentation has been made possible through a financial contribution from the Public Health Agency of Canada. The views expressed here do not necessarily reflect the views of the Public Health Agency of Canada. .
The Consolidated Framework for Implementation Research (CFIR): Application and Tools
Presenter:Laura J. Damschroder, MS, MPH
November 12, 20151:00 – 2:30 PM ET
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The Consolidated Framework for Implementation Research (CFIR):
Application and Toolshttp://www.nccmt.ca/registry/view/eng/210.html
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Laura J. Damschroder, MS, MPH
Research ScientistAnn Arbor Veteran’s Affairs, Center for Clinical Management Research and HSR&D Center of Excellence
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The Consolidated Framework for Implementation Research (CFIR): Application and Tools
Laura J. Damschroder, MS, MPH
November 12, 2015National Centre for Methods and Tools (NCCMT) Webinar SeriesMcMaster University
The views expressed in this presentation are my own and do not reflect the position or policy of the Department of Veterans Affairs or the United States government
Poll Question #3
Have you heard of the CFIR?
A. What is the CFIR?B. I am familiar with the CFIRC. I have thought about using the CFIR in my workD. None of the above
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Goals for Implementation Research
Case study: Application of the CFIR
Building the knowledge-base
Implementation Strategies
Outline
Roadmap for implementation science
• Science– Collaborative, systematic knowledge
building• Praxis
– Tools and processes for practitioners– Identify effective strategies
• Tailored to context– Contribute to culture of learning
healthcare system
Dual Goals for Implementation ResearchIS Goals
Power of Theory
• Organizing framework for research studies
• Build scientific knowledge base• Context, mechanisms of action• Generalize through theory• Syntheses
• Provides common terms & definitions
• Efficient way to systematically build collective knowledge
Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., … Grimshaw, J. (2014). Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implementation Science, 9, 51.Foy R, Ovretveit J, Shekelle PG, et al. The role of theory in research to develop and evaluate the implementation of patient safety practices. Quality & safety in health care. Feb 11 2011.
IS Goals
Poll Question #4
Which of the following best describes your work?
A. Developing and testing innovationsB. Developing and testing implementation approachesC. Implement innovationsD. All of the aboveE. Other
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Innovations to Improve Patient Care
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• “Active Ingredients”• Adaptability
Innovation Science Goal: Improved health & well being of patients
Colquhoun, H., Leeman, J., Michie, S., Lokker, C., Bragge, P., Hempel, S., … Grimshaw, J. (2014). Towards a common terminology: a simplified framework of interventions to promote and integrate evidence into health practices, systems, and policies. Implementation Science, 9, 51.
Establishing “internal validity” is priority
Control or ignore CONTEXT
Weight Loss Program Innovation• ASPIRE Comparative Effectiveness Trial
– High fidelity coaching more weight loss• VA DPP Comparative Effectiveness Trial
– DPP higher fidelity to ASPIRE-ID’d domains of coaching
• Affirmed by patient ratings of delivery– National MOVE! program guidance updated
• http://www.move.va.gov/GrpSessions.asp
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Innovations to Improve Patient Care
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• “Active Ingredients”• Adaptability
Innovation: Improved health & well being of patients
RCTs along do not provide sufficient information
Preparing for and Explaining Implementation
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• Barriers & Facilitators• Why did/will it work?
Implementation Science Goal: Drawing on knowledge about how an innovation will achieve expected benefits and the causes,
effects, and factors that determine its success (or failure) in clinical practiceGrol, et al. (2007). Planning and studying improvement in patient care: The use of theoretical perspectives. Milbank Quarterly, 85(1), 93–138.
Establishing “external validity” is priority
Embrace and understand CONTEXT
…in all its wicked complexity
Use of theory in implementationAssess targeted Innovation and
Context
1
Sales A, Smith J, Curran G, Kochevar L. Models, strategies, and tools. Theory in implementing evidence-based findings into health care practice. J. Gen. Intern. Med. Feb 2006;21 Suppl 2:S43-49.Bartholomew, L. K., Parcel, G. S., & Kok, G. (1998). Intervention mapping: a process for developing theory- and evidence-based health education programs. Health Educ Behav, 25(5), 545-563.
Use theory to guide assessment
Case Study
VA MOVE! Weight Management Program
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CFIR
Highly Variable ImplementationMOVE!®
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Number of Visits Reported by Study Site 1 & 2 Years Since Dissemination
FY 2007 FY 20080
10
20
30
40
50
60
70
# Vi
sits
/ 1
000
Vete
rans
CFIR
Outcomes
24Proctor, E., H. Silmere, R. Raghavan, P. Hovmand, G. Aarons, A. Bunger, R. Griffey, and M. Hensley, Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Administration and Policy in Mental Health, 2011. 38(2): p. 65-76.
Assess targeted EBP change and
context
1
French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. Apr 24 2012;7(1):38.
Who needs to do what differently?
Which barriers & facilitators need to be
addressed?
Applying Theory
Consolidated Framework for Implementation Research (CFIR)
• A comprehensive framework to promote consistent use of constructs, terminology, and definitions– Five Domains– 39 Constructs
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Damschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. 2009, 4:50.
CFIR
OUTER CONTEXT
INNER CONTEXT
PRACTITIONER
INNOVATIONPROCESS
SLIDE CREDIT: ©Dr. Melanie Barwick, SickKids / U Toronto, Canada 2015
Consolidated Framework for Implementation Research
LOCAL REALITY
CFIR
CFIRConsolidated Framework for
Implementation ResearchDamschroder L, Aron D, Keith R, Kirsh S, Alexander J, Lowery J: Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. 2009, 4:50.
Poll Question #4
What types of data do you typically rely on in your work?
A. Qualitative data e.g., interview transcripts, field notesB. Quantitative data e.g., surveysC. A lot of bothD. Neither
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Understanding Context• Qualitative Data
– Interviews– Artifact data (e.g., P&Ps, journals, meeting notes)– Quantitative ratings
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31
www.CFIRGuide.org
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33
34
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Understanding Context• Qualitative Data
– Interviews– Artifact data (e.g., P&Ps, journals, meeting notes)– Quantitative ratings
• Quantitative Measures– Not well developed
• Martinez, R., C. Lewis, and B. Weiner, Instrumentation issues in implementation science. Implementation Science, 2014. 9(1): p. 118
– Synthesis of measures– Chaudoir, S.R., A.G. Dugan, and C.H. Barr, Measuring factors affecting implementation of health innovations: A systematic review of
structural, organizational, provider, patient, and innovation level measures. Implement Sci, 2013. 8(1): p. 22.
– Assessment of measures – work in progress– REGISTRATION IS FREE BUT NECESSARY: http
://www.societyforimplementationresearchcollaboration.org/sirc-projects/sirc-instrument-project/measures-collection/
– Lewis, C., C. Stanick, R. Martinez, B. Weiner, M. Kim, M. Barwick, and K. Comtois, The Society for Implementation Research Collaboration Instrument Review Project: A methodology to promote rigorous evaluation. Implementation Science, 2015. 10(1): p. 2.
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Quantitative Measureshttp://cfirguide.org/quant.html
CFIR
7th Annual D&I Conference December 2014
Inner Setting: Networks & Communications
• HIGH IMPLEMENTATION SITES:– Both sites had a high degree of “teamness”– Meet regularly
• LOW IMPLEMENTATION SITES– Did not have regular team meetings– Lack of effective communication
• Patients confused about the program
Damschroder, L.J. and J.C. Lowery, Evaluation of a large-scale weight management program using the consolidated framework for implementation research (CFIR). Implement Sci, 2013. 8: p. 51.
CFIR
Data Collection, Coding, Rating
• Coded qualitative data using CFIR as “codebook”
• Rated strength and valence of each construct– Scale: -2 to +2– By transcript– Rolled up ratings by sites
• Blinded to site outcomes
CFIR
Qualitative Data: Construct Ratings
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Implementation Effectiveness: Low HighI. INTERVENTION CHARACTERISTICS Relative advantage -2 1 2 2II. OUTER SETTING Patient needs & resources -2 0 2 2 External Policy & Incentives -1 -2 0 1III. INNER SETTING Networks and communications -2 -2 2 2 Implementation Climate Tension for change 0 0 1 1 Relative priority -1 -2 1 2 Goals and feedback -2 -1 1 2
Learning climate N/A -1 1 2 Readiness for Implementation Leadership Engagement -2 -1 2 2 Available resources -2 -2 1 -1V. PROCESS Planning -1 N/A 1 1Executing -2 1 2 2Reflecting & Evaluating -1 -2 1 2
CFIR
Goals and feedback
Number of Referrals per 1000 Veterans by Site
Variable referral rates
Follow-up Interviews
CFIR
Site ID V03-3 V02-6 V03-4 V05-1 V01-2 V03-1 V01-4 V01-3 V02-2 V01-6 V02-3Referral Rate 2.0094 2.3236 2.5855 5.9953 6.0434 6.8834 7.7227 10.2359 10.4929 12.7301 14.5311Structural Characteristics
-2 -2 -2 -1 0 -1 -1 -1 -1 -1 2Networks & Communications
-1 1 . . . -1 -1 0 0 2 2Compatibil ity 1 -1 1 1 -1 1 -1 1 2 2 2
Referral rate & Construct Ratings by SiteCFIR
Compatibility
• Correlation: 0.55 (p=0.08)
V03-3 V02-6 V03-4 V05-1 V01-2 V03-1 V01-4 V01-3 V02-2 V01-6 V02-30
5
10
15
Refe
rred
/100
0
-2
-1
0
1
2
CFIR
Compatibility
• Negative Rating – e.g., – Only providers could refer to TLC in some sites
• Our nurses are specifically forbidden to write orders …everything that gets written has to be written by a physician[…] this has formed a really labor intensive situation for practitioners, so they are super rebelling against anything else coming down. [MOVE! Coordinator, V02-6]
CFIR
Compatibility
• Positive rating – e.g., – Perceived compatibility with clinical initiatives
• …this …really helps the patient to have ownership for their processes and their living, and it definitely blends very nicely with the health coaching
CFIR
BUILDING ON FINDINGS ACROSS STUDIES
Knowledge
Comparing Findings Across Studies
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Study: MOVE! TeleMOVE TLC
Structural Characteristics
Networks & Communications
Tension for Change
Compatibility
Relative Priority
Goals & Feedback
Learning Climate
Leadership Engagement
Available Resources
Strongly Distinguishes
Weakly Distinguishes
Not assessed
Knowledge
0 0 1 1 0 0 0 0 1 1 0 0 0 0 0 1 1 1 0 0 0 1 1 1 1 1 1 0 0 1 1 1 1
A. Intervention Source E E E I 2 1 1 0 2 1 M M M M M M M M M M M M M M M M M M M M M M MB. Evidence Strength and Quality
-2 1 2 1 M M M M M M M M M M M M M M M M M M M M M M M
C. Relative Advantage -2 1 2 2 1 1 1 1 2 0 M M 2 0 1 1 0 1 M M M M M M M M M M M M M M MD. Adaptability -2 2 2 2 0 0 1 1 1 1 1 1 1 1 1 2 1 1 -1 X 1 1 X 1 2 1 1 1 1 1 1 2 2E. Trialability 0 0 1 0 M M M M M M M M M M M M M M M M M M M M M M MF. Complexity M -2 -2 2 M M M M M M M M -1 -2 -2 M -2 -1 -2 -1 -2 -2 -1 -2 X 2 1G. Design Quality and Packaging
-2 2 1 1 -1 -1 M M M X -1 X -1 -1 X 1 -1 -1 1 1 0 -1 1 2 -1 0 0
H. Cost 0 0 0 0 M M M M M M M M M M M M M M M M M M M M M M MA. Patient Needs and Resources
-2 X 2 2 1 1 2 0 1 1 M 0 1 M M 1 1 1 M M M M M M M M M 2 2 2 2 2 2
B. Cosmopolitanism 0 0 0 0 M M M M M M M M M M M M M M M M M M M M M M MC. Peer Pressure 0 0 0 0 M M M M M M M M M M M M M M M M M M M M M M MD. External Policy and Incentives
-1 -2 0 1 M M M M M M M M M M M M M M M M M M M M M M M
A. Structural Characteristics
M M M M M M M M M M M M M M M M M M M M M M M M M M M
B. Networks and Communications
-2 -2 2 2 2 1 1 2 2 -2 M M 1 -1 M 1 1 M 1 1 -1 1 X 1 X 1 X X 2 2 2 2 1
C. Culture M M M M M M M M M M M M M M M M M M M M M M M M M M M1. Tension for Change 0 0 1 1 M M M M M M M M M M M M M M M M M M M M M M M2. Compatibility -2 1 1 2 1 1 2 1 1 -1 1 1 1 1 1 1 1 1 X X 0 1 1 0 1 1 1 -1 1 1 0 2 13. Relative Priority -1 -2 1 2 M M M M M M M M M M M M M M M M M X 1 1 1 1 1
4. Organizational Incentives and Rewards 0 -1 0 1 M M M M M M M M M M M M M M M M M M M M M M M
5. Goals and Feedback -2 -1 1 2 -1 1 -1 -1 1 2 1 -1 -1 0 X 1 -1 -1 M M M M M M M M M M M M M M M6. Learning Climate M -1 1 2 M M M M M M M M M M M M M M M M M M M M M M M1. Leadership Engagement
-2 -1 2 2 -1 0 1 1 2 0 -1 M 1 -1 X 2 1 -1 X 1 1 2 0 0 -1 2 X X 0 1 2 1 1
2. Available Resources -2 -2 1 -1 X X -1 -1 1 1 X -1 X 1 0 1 1 -1 -1 1 1 -1 1 1 1 X X3. Access to Knowledge and Information
-1 M 1 -1 -1 -2 -1 0 -1 1 M M M M M M M M M M M X 1 1 1 1 1
A. Knowledge and Beliefs about the Intervention
M M M M 2 -1 2 1 1 2 1 1 1 1 1 2 1 1 1 2 2 1 1 2 1 2 2
B. Self-Efficacy M M M M M M M M M M M M M M M M M M M M M M M M M M MC. Individual Stage of Change
M M M M M M M M M M M M M M M M M M M M M M M M M M M
D. Individual Identification with Organization
M M M M M M M M M M M M M M M M M M M M M M M M M M M
E. Other Personal Attributes
M M M M M M M M M M M M M M M M M M M M M M M M M M M
A. Planning -1 M 1 1 M -1 M M M 1 M M X 1 1 1 1 M X 2 1 1 0 2 2 2 21. Opinion Leaders M M M M M M M M M M M M M M M M M M M M M M M M M M M2. FAIIL -1 2 2 2 M M M M M M M M M M M M M M M M M M M M M M M3. Champions -1 2 1 2 1 M M 1 1 2 1 1 1 1 1 2 1 1 1 1 2 1 1 2 2 2 14. External Change Agents
0 0 0 0 M M M M M M M M M M M M M M M M M M M M M M M
5. Key Stakeholders -2 -2 2 2 M M M M M M M M 1 0 0 0 1 0 0 1 2 M M M M M M6. Patients M M M M M M M M M M M M M M M M M M M M M M M M M M MC. Executing M M M M -1 M -1 M M 0 1 M M M M M M M M M M M M M M M MD. Reflecting and Evaluating
-1 -2 1 2 -1 -1 2 0 2 1 M -1 1 -1 M 2 -1 M 0 X -1 1 1 0 0 1 1 1 1 2 1 2 2
Causal complexity:Set Relations vs. Correlations:
• Equifinality: Various (combinations of) conditions can lead to the same outcome.
• Conjunctural causation: Conditions do not necessarily exert their impact on the outcome in isolation from one another, but sometimes have to be combined in order to reveal causal patterns.
• Asymmetrical causation: The occurrence and non-occurrence of social phenomena require separate analysis– the presence versus absence of conditions might play crucially
different roles in bringing about the outcome.
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Knowledge
Qualitative Comparative Analysis• Case-oriented analysis
– Rather than variable-oriented• Based on set theory and Boolean algebra• Appropriate when
– The phenomenon of interest is best understood in terms of set relations
– Evaluate configurations of conditions across cases• Describe causal complexity related to an outcome
• Number of cases does not matter
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Knowledge
Use QCA to Reveal Combinations of CFIR Constructs Success
Studies Cases7 53
• Behavioral Change Programs– Group-based weight management– Phone-based coaching for lifestyle change– Technology-enabled weight management program
• TeleRetinopathy Program• Specialty Care
– SCAN-ECHO– Specialty Care Neighborhood– E-Consults
What We Learned
• Causal complexity confirmed• Different pathways lead to success• Analytical limitations
– Solutions sets depended on the cases included– Must KNOW your data – link with qualitative data
• A priori theories• Triangulate through different analyses, theories
Knowledge
Preparing for and Explaining Implementation
53
• Barriers & Facilitators• Why did/will it work?
Implementation: Theories about how an innovation will achieve expected benefits and the causes, effects, and
factors that determine its success (or failure) Grol, et al. (2007). Planning and studying improvement in patient care: The use of theoretical perspectives. Milbank Quarterly, 85(1), 93–138.
Insufficient reporting of contextual factors
Assess targeted EBP change and
context
1
French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. Apr 24 2012;7(1):38.
Develop tailored implementation
strategy
2
Who needs to do what differently?
Which barriers & facilitators need to be
addressed?
What strategies could be used to address barriers &
facilitators?
Applying Theory
Implementation Strategy
Construct Issue/Barrier Change StrategiesGoals & Feedback
55Powell, Byron J., Thomas J. Waltz, Matthew J. Chinman, Laura J. Damschroder, Jeffrey L. Smith, Monica M. Matthieu, Enola K. Proctor, and JoAnn E. Kirchner. "A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project." Implementation Science 10, no. 1 (2015): 21.
• It is challenging to track patients’ weight and other measures over time. Often staff lack time and ability to analyze these data and develop cogent business cases needed to support the program.
• Clearly align program data with org goals & communicate CFIR
• Develop tools for quality monitoring1
• Audit and provide feedback1
• Anecdotal success stories help to bring data “alive” for leaders and other stakeholders.
Strategies
Expert Recommendations for Implementing Change (ERIC)
• A mixed methods approach to establish expert consensus on a common nomenclature for implementation strategy terms and definitions
Strategies
Engage consumers
Train and educate
stakeholders
Change infrastructure
Develop stakeholder interrelationships
Provide interactive assistance
Utilize financial strategies
Use evaluative and iterative strategies
Adapt & tailor to context
Support clinicians
73 strategies clustered into 9 groups
1
23
283442 49
66&709
10
111213
22
44
4
5
14
18
23
61
26
27
46
56
37
39
41
50
6269
6
7
1740
47
5264
48
5163
67
68
24
25
36 38
45
65
72
3557
8
33
53
54
58
21
30
32
59
15
1629
60
1920
3143
55
7173
SLIDE CREDIT: Dr. Byron Powell, University North Carolina, USA. 2015
Strategies
E.g., Provide Interactive Assistance
1
23
283442 49
66&709
10
111213
22
44
4
5
14
18
23
61
26
27
46
56
37
39
41
50
6269
6
7
1740
47
5264
48
5163
67
68
24
25
36 38
45
65
72
3557
8
33
53
54
58
21
30
32
59
15
1629
60
1920
3143
55
7173
8 Centralize technical assistance 53 Provide local clinical supervision
33 Facilitation 54 Provide local technical assistance
SLIDE CREDIT: Dr. Byron Powell, University North Carolina, USA. 2015
Strategies
Tailoring to Context
• Which strategies best address specific barriers as aligned with constructs from the
CFIR?ERIC Strategies
• Build a coalition• Identify and prepare champions• Involve patients and family members• Inform local opinion leaders• Conduct educational meetings• Use mass media• Visit other sites• Conduct educational meetings• Conduct local consensus discussions• Conduct educational outreach visits• Capture and share local knowledge• Tailor strategies• Conduct local needs assessment• Alter incentive/allowance structures• Conduct cyclical small tests of change• Develop a formal implementation blueprint• Identify early adopters• Promote adaptability
CFIR ConstructsI. INTERVENTION CHARACTERISTICSA Intervention SourceB Evidence Strength & QualityC Relative advantageD AdaptabilityE TrialabilityF ComplexityG Design Quality and PackagingH CostII. OUTER SETTINGA Patient Needs & ResourcesB CosmopolitanismC Peer PressureD External Policy & IncentivesIII. INNER SETTINGA Structural CharacteristicsB Networks & Communications
Strategies
Survey of Implementation Experts
Audit and provide feedback
Select and rank up to 7 strategies that best address barriers related to Goals and Feedback:
♦ Goals are not clearly communicated or acted upon, nor do stakeholders receive feedback that is
aligned with goals. ♦
Strategies
Tailor an Intervention Strategy
Select a domain
Tailor an Intervention Strategy
Techniques
Select a construct
Learn more about the construct in the wiki, or click
Techniques
Tailor an Intervention Strategy
Audit and provide feedback
Obtain and use patient/consumer and family feedback
Facilitate relay of clinical data to providers
Process: Reflecting & Evaluating Select techniques you
want to include for each construct…
Tailor an Intervention Strategy
Repeat steps until all relevant constructs have
been addressed, then click “Create Tailored
Implementation Strategy”
Create Tailored Implementation Strategy
0
Tailor an Intervention Strategy
Reflecting & Evaluating • Facilitate relay of clinical data to providers
Structural Characteristics• Create new clinical teams• Make billing easier• Change service sites
Leadership Engagement• Provide clinical supervision
Evidence Strength & Quality• Provide on-going consultation
Process
Inner Setting
The tool will generate a document that lists the techniques you chose
which can then be used as a basis for a documented tailored
Implementation Strategy
Innovation Characteristics
Assess targeted EBP change and
context
1
French SD, Green SE, O'Connor DA, et al. Developing theory-informed behaviour change interventions to implement evidence into practice: a systematic approach using the Theoretical Domains Framework. Implement Sci. Apr 24 2012;7(1):38.
Develop tailored implementation
strategy
2
Who needs to do what differently?
Which barriers & facilitators need to be addressed?
What techniques could be used to address barriers &
facilitators?
How can change (progress) be measured and understood?
Applying Theory
Applying Theory
68
Execute tailored implementation
strategy
3
Assess targeted EBP change and
context
1Develop tailored implementation
strategy
2
Concurrent monitoring and
refinement
Theory-informed
Applying Theory
69
Execute tailored implementation
strategy
3
Assess targeted EBP change and
context
1Develop tailored implementation
strategy
2
Evaluate effectivenessof implementation
strategy
4
Proctor E., et al. Outcomes for implementation research: conceptual distinctions, measurement challenges, and research agenda. Adm. Policy Ment Health 2011;38:65-76
Achieving Optimal Outcomes
70
ClinicalInnovation
Adapted from: Proctor, E. K., Landsverk, J., Aarons, G., Chambers, D., Glisson, C., & Mittman, B. (2009). Implementation research in mental health services: An emerging science with conceptual, methodological, and training challenges. Administration and Policy in Mental Health and Mental Health Services Research, 36(1), 24-34.
Roadmap
Applying Theory
7171
Assess fit of findings with initial theory
5
Execute tailored implementation
strategy
Evaluate effectivenessof implementation
strategy
34
Assess targeted EBP change and
context
1Develop tailored implementation
strategy
2
Applying Theory
72
Assess fit of findings with initial theory
5
Execute tailored implementation
strategy
Evaluate effectivenessof implementation
strategy
34
Assess targeted EBP change and
context
1Develop tailored implementation
strategy
2
Add to the knowledge-base
Example Critique of CFIR
Roadmap for Implementation Science• Foundation: Common Terminology & Constructs• Assess Context
– Quantitative & Qualitative• Targeted innovations
– Intervention mapping (http://www.interventionmapping.com)
– Adaptations (http://www.biomedcentral.com/content/pdf/1748-5908-8-65.pdf )
• Implementation Strategies– Strategy Taxonomy (e.g., http://www.implementationscience.com/content/10/1/21/abstract)
– Tailored to context (forthcoming)
• Generate Testable Theories
Roadmap
Packaging for the (real) world
• Guidance for planning successful implementations– Context assessment tools
• Implementation Strategies– “How to” execute strategies– Tailored to context
• “Learning” repositories– Collective learning
Roadmap
Poll Question #5
What are your next steps? I plan to …
A. access the CFIR Tool.B. read the NCCMT summary of the CFIR Tool. C. consider using the CFIR Tool. D. tell a colleague about the CFIR Tool.
Follow us @nccmt Suivez-nous @ccnmo
• Use Q&A to post comments and/or questions
• ‘Send’ questions to All (not privately to ‘Host’)
Q&A
Participant Side Panel in WebExYour Comments/Questions
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NCCMT’s Applicability & Transferability Tool
December 9, 2015 from 1:00 – 2:30pm EST
The Applicability and Transferability of Evidence Tool (A&T Tool) is designed to help public health managers and planners decide whether the evidence you find can be used in your local setting.
Register at: https://health-evidence.webex.com
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Funded by the Public Health Agency of Canada | Affiliated with McMaster UniversityThe views expressed here do not necessarily reflect the views of the Public Health Agency of Canada.
For more information about the National Collaborating Centre for Methods and Tools:
NCCMT website www.nccmt.caContact: [email protected]