The CORE (Consensus on Relevant Elements) Approach to Determining Initial Core Components of an Innovation

Abstract

Identifying an intervention's core components is indispensable to gauging whether an intervention is implemented with fidelity and/or is modified; it is often a multi-stage process, starting with the first stage of identifying an initial set of core components that are gradually refined. This first stage of identifying initial core components has not been thoroughly examined. Without a clear set of steps to follow, interventions may vary in the rigor and thought applied to identifying their initial core components. We devised the CORE (Consensus on Relevant Elements) approach to synthesize opinions of intervention developers/implementers to identify an intervention's initial core components, particularly applicable to innovative interventions. We applied CORE to a peer-based intervention that aids military veterans with post-incarceration community reintegration. Our CORE application involved four intervention developers/implementers and two moderators to facilitate the seven CORE steps. Our CORE application had two iterations, moving through Steps 1 (individual core component suggestions) through 7 (group discussion for consensus), then repeating Steps 4 (consolidation of component definitions) through 7. This resulted in 18 consensus-reached initial core components of the peer-based intervention, down from the 60 that the developers/implementers individually suggested at Step 1. Removed components were deemed to not threaten the intervention's effectiveness even if absent. CORE contributes to filling a critical gap regarding identifying an intervention's initial core components (so that the identified components can be subsequently refined), by providing concrete steps for synthesizing the knowledge of an intervention's developers/implementers. Future research should examine CORE's utility across various interventions and implementation settings.

Beyond Effectiveness: Implementation Science 101 for Clinicians and Clinical Researchers

“…Figure 1 provides a graphic representation of how the intervention (top 2 shaded boxes) and its implementation (bottom 2 shaded boxes) relate to one another and the contextual factors that influence both. This figure represents a simplification of the well-established Implementation Research Logic Model 2 and incorporates key concepts and references in the field 1–26 …”

“…That blood pressure monitoring may happen in a clinic, pharmacy, or patient’s home, and may use manual or electronic equipment, all providing different forms to achieve that core function. The Consensus on Relevant Elements provides an approach to determine the initial specifications of an intervention 8 . Clinical interventions known to be effective in some context can be adapted to another context and adaptations can be guided and tracked by the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME) 9 …”

“…The Consensus on Relevant Elements provides an approach to determine the initial specifications of an intervention. 8 Clinical interventions known to be effective in some context can be adapted to another context and adaptations can be guided and tracked by the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME). 9 Clinical intervention outcomes are the effects of a clinical intervention on health services and/or on patients.…”