Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2021 Jan 7;2(1):1.
doi: 10.1186/s43058-020-00099-1.

The CFIR Card Game: a new approach for working with implementation teams to identify challenges and strategies

Myra Piat  1 , Megan Wainwright  2 , Eleni Sofouli  3 , Hélène Albert  4 , Regina Casey  5 , Marie-Pier Rivest  4 , Catherine Briand  6 , Sarah Kasdorf  2 , Lise Labonté  2 , Sébastien LeBlanc  4 , Joseph J O'Rourke  7
Affiliations

The CFIR Card Game: a new approach for working with implementation teams to identify challenges and strategies

Myra Piat et al. Implement Sci Commun. .

Abstract

Background: The Consolidated Framework for Implementation Research (CFIR) and the ERIC compilation of implementation strategies are key resources for identifying implementation barriers and strategies. However, their respective density and complexity make their application to implementation planning outside of academia challenging. We developed the CFIR Card Game as a way of working with multi-stakeholder implementation teams that were implementing mental health recovery into their services, to identify barriers and strategies to overcome them. The aim of this descriptive evaluation is to describe how the game was prepared, played, used and received by teams and researchers and their perception of the clarity of the CFIR constructs.

Methods: We used the new CFIR-ERIC Matching Tool v.1 to design the game. We produced a deck of cards with each of the CFIR-ERIC Matching Tool barrier narratives representing all 39 CFIR constructs. Teams played the game at the pre-implementation stage at a time when they were actively engaged in a planning process for implementing their selected recovery-oriented innovation. The teams placed each card in either the YES or NO column of the board in response to whether they anticipated experiencing this barrier in their setting. Teams were also asked about the clarity of the barrier narratives and were provided with plain language versions if unclear. Researchers completed a reflection form following the game, and participants completed an open-added questionnaire that included questions specific to the CFIR Card Game. We applied a descriptive coding approach to analysis.

Results: Four descriptive themes emerged from this analysis: (1) the CFIR Card Game as a useful and engaging process, (2) difficulties understanding CFIR construct barrier narratives, (3) strengths of the game's design and structure and room for improvement and (4) mediating factors: facilitator preparation and multi-stakeholder dynamics. Quantitative findings regarding the clarity of the barrier narratives were integrated with qualitative data under theme 2. Only seven of the 39 original barrier narratives were judged to be clear by all teams.

Conclusions: The CFIR Card Game can be used to enhance implementation planning. Plain language versions of CFIR construct barrier narratives are needed. Our plain language versions require further testing and refining.

Keywords: CFIR-ERIC Matching Tool; Canada; Consolidated Framework for Implementation Research; Expert Recommendations for Implementing Change; Games; Guidelines; Housing; Implementation teams; Mental health recovery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4(1):50. - PMC - PubMed
    1. Kirk MA, Kelley C, Yankey N, Birken SA, Abadie B, Damschroder L. A systematic review of the use of the Consolidated Framework for Implementation Research. Implementation Sci. 2016;11(1):72. - PMC - PubMed
    1. Powell BJ, Waltz TJ, Chinman MJ, Damschroder LJ, Smith JL, Matthieu MM, et al. A refined compilation of implementation strategies: results from the Expert Recommendations for Implementing Change (ERIC) project. Implementation Sci. 2015;10(1):21. - PMC - PubMed
    1. Waltz TJ, Powell BJ, Fernández ME, Abadie B, Damschroder LJ. Choosing implementation strategies to address contextual barriers: diversity in recommendations and future directions. Implementation Sci. 2019;14(1):42. - PMC - PubMed
    1. Piat M, Albert H, Rivest MP, Casey R, Boyer R, Briand C, et al. Research Grant: Implementing mental health recovery guidelines into services: a pan Canadian Study (Project #148172). Canadian Institutes of Health Research (CIHR); 2017.

LinkOut - more resources