Abstract
BackgroundImplementation frameworks may support local implementation strategies with a sound theoretical foundation. The Consolidated Framework for Implementation Research (CFIR) facilitates identification of contextual barriers and facilitators, and the Expert Recommendations for Implementing Change (ERIC) allows identifying adequate implementation strategies. Both instruments are already used in German-speaking countries; however, no standardised and validated translation is available thus far. The aim of this study was to translate the CFIR and ERIC framework into German, in order to increase the use of these frameworks and the adherence to evidence-based implementation efforts in German-speaking countries.MethodsThe translation of the original versions of the CFIR and ERIC framework was guided by the World Health Organisation’s recommendations for the process of translating and adapting both conceptual frameworks. Accordingly, a four-step process was employed: first, forward translation from English into German was conducted by a research team of German native speakers with fluent knowledge of the English language. Second, a bilingual expert panel comprising one researcher with German as his mother tongue and expert command of the English language and one English language expert and university teacher reviewed the translation and discussed inconsistencies with the initial translators. Third, back-translation into English was conducted by an English native speaking researcher. The final version was pre-tested with 12 German researchers and clinicians who were involved in implementation projects using cognitive interviews.ResultsThe translation and review process revealed some inconsistencies between the original version and the German translations. All issues could be solved by discussion. Central aspects of the items were confirmed in 60 to 70% of the items, and modifications were proposed in 30% of the items. Finally, we revised one CFIR-item heading after pre-testing. The final version was given consent by all involved parties.ConclusionsNow, two validated and tested implementation frameworks to guide implementation efforts are available in the German language and can be used to increase the application of agreed-on implementation strategies into practice.
Highlights
Implementation frameworks may support local implementation strategies with a sound theoretical foundation
Conclusions: two validated and tested implementation frameworks to guide implementation efforts are available in the German language and can be used to increase the application of agreed-on implementation strategies into practice
Many interventions in health care are considered to be effective, but efficacy in terms of achieving desired changes in patient-relevant health outcomes is critically dependent on successful implementation [1, 2]
Summary
Implementation frameworks may support local implementation strategies with a sound theoretical foundation. The Consolidated Framework for Implementation Research (CFIR) facilitates identification of contextual barriers and facilitators, and the Expert Recommendations for Implementing Change (ERIC) allows identifying adequate implementation strategies. Both instruments are already used in German-speaking countries; no standardised and validated translation is available far. It can help to identify potential barriers and help facilitators to change, and can be used as theory-based constructs for developing effective implementation strategies [1].The Expert Recommendations for Implementing Change (ERIC) systematically catalogued implementation strategies via input from a wide range of stakeholders and structured them into different categories and definitions [5, 6]. A tool was built that linked the context assessment using CFIR and implementation strategies to be considered using ERIC, the CFIR–ERIC–matching tool (available under www.cfirguide.org) [8]
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