Table 3 Qualitative themes for digital health coaching, organized by implementation facilitators/barriers across the CFIR domains
From: A CFIR-guided qualitative study of digital health engagement among Black adults with type 2 diabetes
CFIR Domain | CFIR Construct | Implementation Determinant | Theme | Supporting Quotes |
|---|---|---|---|---|
Characteristics of Individuals | Self-Efficacy | Facilitator | Growing Confidence, from Initial Skepticism and Fear to Empowerment | I wasn’t too sure how the health coaching would go… but talking to the health coach gave me more confidence to ask questions that I really wanted (P557). |
Intervention Characteristics | Adaptability | Facilitator | Personalized, Flexible, and Compassionate Coaching | I had a lower hip replacement, there’s pain in my lower level of body. We [w/health coach] came up with easy chair exercises. I could not do the movement, but I could do it in my upper body which was still helping, and was beneficial to me (P112). |
Design Quality & Packaging | Facilitator | Accessibility and Reach of Phone-based Coaching | It was by phone. And I think I preferred the phone rather than Zoom (P769). | |
Facilitator | Behavioral Nudges and Motivational Reinforcement | Every week, I would get an email from my health coach with tidbits—health information she thought would be helpful based on what we discussed (P112). | ||
Outer Setting | Patient Needs & Resources | Facilitator | Social and Familial Support | All my family’s been great, my whole circle… my sister, my nephew. Because when I get tired of being at the house, they’ll take me and walk around the track or go swing. I love that (P39). |
Patient Needs & Resources | Barrier | Structural and Environmental Constraints to Lifestyle Change | In my neighborhood my street does not have sidewalks and curb stones. I used to walk in the streets and had to carry a stick for the dogs or cats and run in the yard when cars came by. Hard to walk safely (P769). | |
Patient Needs & Resources | Barrier | Competing Responsibilities | I'm constantly doing; I'm working 13, 14, 15 hours a day. And I forget or I get distracted and like I said, they either call or they’ll text and get me back in my head space (P268). |
