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Table 4 Barriers to conducting the study described using the CFIR

From: Motivational interviewing for low mood and adjustment early after stroke: a feasibility randomised trial

CFIR domain Element Barrier Quote
Intervention characteristics Design quality and packaging Possibility of being allocated to attention control “Patients did not cite AC as a reason for not participating in the study but personally feel it was an issue”
  Patients viewed intervention as burdensome “One of the main reasons for people declining was essentially people were saying they have got enough on their plate”
  Baseline assessments were considered lengthy “I do not sometimes feel like I can do a session after the baseline, sometimes they are tired”
Characteristics of individuals Self-efficacy Patients declining to participate reduced confidence to recruit “This trial got the most negative responses…it sort of knocked my confidence a bit”
  MI therapists lacked confidence in their ability to deliver MI “Do not feel a hundred per cent confident in my skills in MI, it’s difficult to know whether I am doing it right”
  MI skills weakened due to irregular recruitment “There were periods with no patients so not doing MI, so felt I was losing skills a little bit”
Other personal attributes High turnover among therapy assistants “Therapy assistants are looking for other jobs and there is high turnover among them”
Inner setting Networks and communication Lack of co-ordination for the trial on-site “Would be better to have someone identified as the co-ordinator within the hospital, it was difficult knowing who was doing what”
Structural characteristics Backfill for therapy assistants was not always appropriate “Backfill does not really cover my time… because of the way our team is made up… therapy assistants are not generic, we are specialised, so backfill was not appropriate”
Available resources Therapy assistants left their role “Going from three therapists in each arm to one has been difficult”
Leadership engagement Supervisors lacked knowledge of the study “Supervisors in [new department] did not know anything about the study so it has been a bit tricky to do the study role”
Relative priority Therapy assistant role prioritised over study role “It’s difficult to say, ‘Oh no I cannot do that because I have got the motivational interviewing’….In some ways you feel like that should take priority over the MI”
Process Executing Not enough training and feedback “Training was quite intensive to start with but then fizzled out when recruitment started… we did not get a lot of feedback… Would be useful to be able to refresh skills”