Table 4

Barriers and Facilitators by Study Period

DomainDefinitionT1 (n = 14)T2 (n = 12)T3 (n = 10)T4 (n = 13)
    Environmental contextPhysical and structural resources of the context, its processes, and resources67110000
    CultureSystem culture, beliefs and behaviors in relation to change and staffing roles19070501
    Communication processesProcesses of conveying information within the system, online, and in-person00000003
    External requirementsAny external pressures or expectations that affect system deliverables45892646
    Staff commitment and attitudesMicro-level beliefs, attitudes, and behaviors toward change in general and toward the intervention510232446
    Understanding, awarenessUnderstanding of the aims and methodology of the intervention16040519
    Role identityBeliefs and attitudes towards one's work role and responsibilities36323113
    Skills, ability, confidenceStaff's sense of their capacity to carry out the intervention while managing patients and the environment121111111071311
    Ease of integrationHow well the intervention “fits” with the system, resources, and needs, and its ability to adapt as needed7141905013
    Face validity, evidence baseWhether the intervention is grounded in evidence and how effective it looks to meet its aims23203320
    Safety, legal, and ethics concernsHow well an intervention addresses important concerns of safety and legality to protect staff and patients00000040
    Supportive componentsComponents of the intervention that work to support and facilitate necessary changes05090303
  • Barriers and facilitators were not examined at T0.

  • Bar, barrier; Fac, facilitator.