Barriers and Facilitators by Study Period
| Domain | Definition | T1 (n = 14) | T2 (n = 12) | T3 (n = 10) | T4 (n = 13) | ||||
|---|---|---|---|---|---|---|---|---|---|
| Bar | Fac | Bar | Fac | Bar | Fac | Bar | Fac | ||
| Systemic | |||||||||
| Environmental context | Physical and structural resources of the context, its processes, and resources | 6 | 7 | 1 | 1 | 0 | 0 | 0 | 0 |
| Culture | System culture, beliefs and behaviors in relation to change and staffing roles | 1 | 9 | 0 | 7 | 0 | 5 | 0 | 1 |
| Communication processes | Processes of conveying information within the system, online, and in-person | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 3 |
| External requirements | Any external pressures or expectations that affect system deliverables | 4 | 5 | 8 | 9 | 2 | 6 | 4 | 6 |
| Staff | |||||||||
| Staff commitment and attitudes | Micro-level beliefs, attitudes, and behaviors toward change in general and toward the intervention | 5 | 10 | 2 | 3 | 2 | 4 | 4 | 6 |
| Understanding, awareness | Understanding of the aims and methodology of the intervention | 1 | 6 | 0 | 4 | 0 | 5 | 1 | 9 |
| Role identity | Beliefs and attitudes towards one's work role and responsibilities | 3 | 6 | 3 | 2 | 3 | 1 | 1 | 3 |
| Skills, ability, confidence | Staff's sense of their capacity to carry out the intervention while managing patients and the environment | 12 | 11 | 11 | 11 | 10 | 7 | 13 | 11 |
| Intervention | |||||||||
| Ease of integration | How well the intervention “fits” with the system, resources, and needs, and its ability to adapt as needed | 7 | 14 | 1 | 9 | 0 | 5 | 0 | 13 |
| Face validity, evidence base | Whether the intervention is grounded in evidence and how effective it looks to meet its aims | 2 | 3 | 2 | 0 | 3 | 3 | 2 | 0 |
| Safety, legal, and ethics concerns | How well an intervention addresses important concerns of safety and legality to protect staff and patients | 0 | 0 | 0 | 0 | 0 | 0 | 4 | 0 |
| Supportive components | Components of the intervention that work to support and facilitate necessary changes | 0 | 5 | 0 | 9 | 0 | 3 | 0 | 3 |
Barriers and facilitators were not examined at T0.
Bar, barrier; Fac, facilitator.