Table 1 CFIR operationalization

Intervention Characteristics

Features of the intervention being implemented into a particular setting that might influence implementation

Individualized, evidence-based, patient-centered, computerized lupus decision-aid (DA)

Outer Setting

Economic, political, and social context, typically outside an organization, in which an intervention is implemented

External policies, reimbursement systems, incentives applicable to the rheumatology clinics within the diverse settings (urban vs suburban, number of patients seen, type of clinic, practice type, etc.).

Inner Setting

Structural and cultural context through which the implementation process proceeds

Six of the study clinics are rheumatology-only clinics, while the other nine are multispecialty. Twelve of the study clinics are owned by a university, while only three are not owned by a university. Two of the study clinics have less than 10 members, while nearly half have 31 or more clinic members. On average, the study clinics have 2.27 (SD = 0.25) physical locations where they care for patients. The average number of years of experience in the clinic is 2.28 (SD = 0.25).

Characteristics of Individuals

Impact of individuals on implementation success

Self-efficacy, knowledge, and beliefs about the DA among physicians, pharmacists, administrative director/clinic managers, nurses, medical assistants, patient technicians, front office staff and study coordinators.

Process

Methods by which implementation is accomplished

How clinics would go about using the DA: key people who should get on board with this implementation; current communication mode with patients, how clinics should communicate with lupus patients about the availability of the DA; accessing the DA; how clinic should inform patients about availability of the DA and how to use it.