Kononowech Jennifer, Hagedorn Hildi, Hall Carmen, Helfrich Christian D, Lambert-Kerzner Anne C, Miller Susan C, Sales Anne E, Damschroder Laura
Center for Clinical Management Research, VA Ann Arbor Healthcare System, 2800 Plymouth Rd, Ann Arbor, MI, USA.
Center for Care Delivery and Outcomes Research, Minneapolis VA Health Care System, 1 Veterans Drive, Minneapolis, MN, USA.
Implement Sci Commun. 2021 Feb 13;2(1):19. doi: 10.1186/s43058-021-00121-0.
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.
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.
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.
Mapping results reveal that the ORCA focuses measurement prominently on Inner Setting, Process, and Intervention Characteristics. This mapping guide can help improve consistency in measurement and reporting, enabling more efficient comparison and synthesis of findings that use either the ORCA instrument or the CFIR framework. The guide helps advance implementation science utilizing mixed methods by providing CFIR users with quantitative measures for selected constructs and enables ORCA users to map their findings to CFIR constructs.
实施研究人员认识到组织因素的重要作用，因此试图使用定量测量工具来评估这些因素。然而，研究人员受到一些工具的阻碍，这些工具测量的是相似的结构，但依赖于不同的术语和/或定义。实施研究综合框架（CFIR）提供了一个结构分类法，该分类法源自先前的框架以及与实施相关结构的实证研究。CFIR包括基于原始的《促进卫生服务研究实施行动》（PARiHS）框架的结构，该框架突出了特定循证干预措施（EBI）的证据强度、组织变革背景的有利程度以及促进EBI实施的能力的关键作用。尽管CFIR是最常用的实施框架之一，但它不包括定量测量方法。组织资源与背景评估（ORCA）是一种基于PARiHS开发的定量测量工具，用于评估其三个领域。这三个领域中的因素在概念上与CFIR中的结构相似，但并不直接匹配。这项工作的目的是将ORCA调查项目映射到CFIR结构，以便能够直接比较和综合使用CFIR和/或ORCA的各项研究结果。
两个不同的独立研究团队，各自使用严格的持续比较技术，经过深思熟虑并达成共识，将ORCA中的各个项目映射到CFIR的五个领域和39个结构。
ORCA项目主要映射到CFIR五个领域中的三个：内部环境、过程和干预特征。两个研究团队在较高的领域层面上对88%的映射达成了一致；在较低的结构层面上，他们对62.2%的ORCA项目的映射是一致的。
映射结果表明，ORCA的测量主要集中在内部环境、过程和干预特征上。本映射指南有助于提高测量和报告的一致性，从而能够更有效地比较和综合使用ORCA工具或CFIR框架的研究结果。该指南通过为CFIR用户提供选定结构的定量测量方法，帮助推进采用混合方法的实施科学研究，并使ORCA用户能够将其研究结果映射到CFIR结构。
