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. 2023 Nov 30;18(11):e0295204.
doi: 10.1371/journal.pone.0295204. eCollection 2023.

Improving the pragmatic usefulness of the scoring matrix for the Consolidated Framework for Implementation Research (CFIR). A proposal for a more frequency-based approach: The CFIR-f

George Economidis  1 , Anne-Marie Eades  2 , Anthony Shakeshaft  1   3 , Sara Farnbach  1
Affiliations

Improving the pragmatic usefulness of the scoring matrix for the Consolidated Framework for Implementation Research (CFIR). A proposal for a more frequency-based approach: The CFIR-f

George Economidis et al. PLoS One. .

Abstract

The Consolidated Framework for Implementation Research (CFIR) is a well-established framework for systematically identifying key factors influencing the implementation of programs. To enhance the classification of existing CFIR definitions, as well as its +2/-2 scoring system, this study incorporated the views of relevant experts to: i) improve how themes are scored; and ii) utilise more information regarding the frequency with which themes are identified. This structured, frequency-based approach to the CFIR's scoring process has been trialled as the CFIR-frequency (CFIR-f). Researchers thematically analysed semi-structured interview data from four groups of policy and program experts (N = 24) delivering two family-based therapies in New South Wales (NSW), Australia. Themes identified by less than 50% were excluded from further analysis. Themes identified by 50% or more of expert participants in the four groups were classified as enablers or barriers using clearly defined criteria. Each theme was allocated a score according to how many experts identified it as an enabler or barrier, and then mapped back onto the latest adaptation of the CFIR comprising 67 constructs. The CFIR-f successfully determined three enablers of, and six barriers to, implementation. Enablers included the family-based therapy programs, therapist training and participant monitoring systems. Barriers included referral, data collection and staffing difficulties, NSW adaptation issues and the suitability and safety of the programs for Aboriginal families. The same enablers and barriers were identified using both the CFIR-f and the original scoring approach, and the identified themes were successfully mapped to almost all CFIR constructs (65/67). This paper proposes a more frequency-based approach to CFIR's scoring process (the CFIR-f). By specifically utilising the frequency with which these barriers and enablers are identified, the CFIR-f engenders a list of ranked themes that service providers and policymakers can use to inform their decisions about program modification and implementation.

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Conflict of interest statement

All authors have approved the manuscript for submission. One co-author, Anthony Shakeshaft, was the lead investigator on a competitive tender (FACS.17.266) awarded by the NSW Government Department of Family and Community Services (now Department of Communities and Justice) to evaluate the Functional Family Therapy – Child Welfare [FFT-CW®] and Multisystemic Therapy for Child Abuse and Neglect [MST-CAN®] programs in New South Wales, Australia (2018-2020). The lead author, George Economidis, was employed part-time at the National Drug and Alcohol Research Centre as a Project Coordinator for the FFT-CW® and MST-CAN program evaluation from May 2018 to August 2020. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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