Table 2 Findings by CFIR domain and primary constructs
CFIR domain | CFIR construct | Findings |
|---|---|---|
Outer setting | ||
[Contextual factors that influence successful implementation] | Patient needs and resources | Stigma, trauma and criminalization; unpredictable illicit market; diverse population and needs |
External policy and incentives | Criminalization of drugs and people who use drugs | |
Intervention characteristics | ||
[Key attributes of drug checking a harm reduction intervention that influence successful implementation] | Relative advantage | Low barrier and greater benefits than risks of criminalization |
Evidence strength and quality | Accuracy of drug checks providing information on composition using a small sample | |
Design quality and packaging | Free and fast service | |
Adaptability | Harm reduction messaging | |
Inner setting | ||
[Key attributes of drug checking services and sites that influence successful implementation] | Culture and compatibility | Safety; respect; confidential and anonymous service; and harm reduction mandate |
Available resources | Multiple settings to meet diverse needs; paired with compatible services; pharmacies; mobile services | |
Characteristics of individuals | ||
[Key attributes of drug checking staff that influence successful implementation] | Knowledge and beliefs | Skilled technicians and trust, respect and freedom from judgement |
Process of implementation | ||
[Key attributes related to the process of implementing drug checking services that influence successful implementation] | Engaging and external change agents | Engaging people with lived and living experience in implementation and the intervention |