Using the consolidated framework for implementation research to evaluate clinical trials: An example from multisite nursing research.

BACKGROUND: The Consolidated Framework for Implementation Research (CFIR) is a comprehensive guide for determining the factors that affect successful implementation of complex interventions embedded in real-time clinical practice. PURPOSE: The study aim was to understand implementation constructs in a multi-site translational research study on readiness for hospital discharge that distinguished study sites with low versus high implementation fidelity. METHODS: In this descriptive study, site Principal Investigator interviews (from 8 highest and 8 lowest fidelity sites) were framed with questions from 20 relevant CFIR constructs. Analysis used CFIR rules and rating scale (+2 to -2 per site) and memos created in NVivo 11. FINDINGS: From a bimodal distribution of differences (1.5 and 5), 7 constructs distinguished high and low fidelity sites with ≥5-point difference. DISCUSSION: CFIR provided a determinant framework for identifying elements of a study site's context that impact implementation fidelity and clinical research outcomes.