Application of the CFIR model
First, survey questions assessing each CF Program’s experience were
grouped into 1 of the 5 primary domains of the CFIR model: 1)Intervention Characteristics —annual mental health screening,
provision of psychological interventions by CF care team members,
referrals for treatment; 2) Outer Setting —educational materials
developed by the MHAC, courses and presentations focused on mental
health at the North American CF Conference (NACFC), leadership at the CF
Foundation; 3) Inner
Setting —program
characteristics, the practice of utilizing a multidisciplinary team,
training in quality improvement, family education days, leadership
provided by the CF Center Director; 4) Characteristics of
Individuals —professional background and training of the MHC and years
of experience working on a CF team; and 5) Processes of
Implementation —development of the role of the MHC on the
multidisciplinary team, integration of mental health data into team
discussions, plans for execution of annual screening, follow-up of
elevated scores and/or suicidal ideation and provision of mental health
interventions.
The next step of this pragmatic application of the CFIR
model18 quantified each CF program’s success with
implementation based on response scores that ranged from basic to
advanced. As seen in Figure 1, levels of implementation were categorized
as follows: 1) Pre-implementation/Basic, 2) Implementation of
standardized screening, 3) Addressing barriers to implementation, 4)
Full Implementation, and 5) Sustainability.