3
these domains through adapted planning questions [39]
and lists the updated constructs [40]. The CFIR frame-
work has been shown to be especially useful in identifying
adoption and implementation barriers across each domain
that can be directly mapped to implementation strate-
gies [41]. Furthermore, Eaton et al. [38] suggested that
an early structured pre-implementation evaluation can be
beneficial in identifying actionable barriers and facilita-
tors for future widespread adoption and implementation
efforts. Some strategies identified from previous research
include involving stakeholders at the outset, engaging sub-
ject matter experts to create meaningful content, piloting
the intervention with subject matter experts, evaluating
fidelity, usability, and acceptability with end users, and
studying the effectiveness of the intervention. However,
there are limited documented uses of IS frameworks in
OSH. One of the few is Tinc et al.’s application of CFIR
to identify barriers to and facilitators for the uptake of
an evidence-based intervention in agriculture safety [42].
These researchers found that CFIR factors such as “access
to knowledge and information,” “leadership engagement”
(Inner Setting), and “engaging” and “reflecting and evaluat-
ing” (Implementation Process) were significantly associated
with positive intervention outcomes, suggesting the CFIR
framework might be useful in other areas of occupational
and public health.
VR Mine Rescue Training (VR-MRT)
Bringing together their expertise in mine rescue, training,
and immersive development, NIOSH researchers have
developed a VR training framework—VR Mine Rescue
Training (VR-MRT). VR-MRT is a single or multiplayer
VR application designed to supplement current mine res-
cue training. The platform focuses on scenario-based train-
ing with the goal of improving mine rescue team members’
procedural, collaborative, and problem-solving skills with
a focus on decision making. The trainees can visualize
and interact with a mine environment using a VR head-
set (e.g., Meta Quest 2 and 3) and work through scenarios
together with their teammates. As described in Bellanca et
al. [1], VR-MRT consists of five modules: Scenario Editor,
Simulation Module, Director Module, Spectator Module,
and Debrief Module. The Scenario Editor allows train-
ers to create their own content through a drag-and-drop
interface. Trainers can either use the built-in room-and-
pillar style tile sets (i.e., coal, stone) that snap together or
import their own geometry (e.g., LiDAR, photogramme-
try). In the mine geometry, trainers can place both built-
in and custom objects and hazards. They are also able to
set up static ventilation zones as well as a dynamic ventila-
tion node network that runs on NIOSH’s MFIRE [43].
The Simulation Module allows one or more trainees to
experience the scenarios. Trainees are either co-located or
Table 1. CFIR 2.0 Domainsa, Planning Questionsb, and Constructsa
Innovation Is this intervention superior to status quo?
Constructs Source, Evidence-Based, Relative Advantage, Adaptability, Trialability,
Complexity, Design, Cost
Outer Setting Why is it important to implement this intervention now? Are there
regulatory or environmental pressures?
Constructs Critical Incidents, Local Attitudes, Local Conditions, Partnerships &
Connections, Policies &Laws, Financing, External Pressure
Inner Setting Will this intervention fit the system? Is it feasible?
Constructs Physical Infrastructure, IT Infrastructure, Work Infrastructure,
Relational Connections, Communications, Culture, Tension for Change,
Compatibility, Relative Priority, Incentive Systems, Mission Alignment,
Resources, Access to Knowledge and Information
Individuals Does the staff have the skill and the will to deliver the intervention?
Constructs High-level Leaders, Mid-level Leaders, Opinion Leaders, Implementation
Facilitators, Implementation Leads, Implementation Team Members, Other
Implementation Support, Innovation Deliverers, Innovation Recipients
Imp. Process How is work affected by the intervention? What is needed to implement
the intervention
Constructs Teaming, Assessing Needs, Assessing Context, Planning, Tailoring Strategies,
Engaging, Doing, Reflecting &Evaluating
a As described in [40] b Adapted from [39]
these domains through adapted planning questions [39]
and lists the updated constructs [40]. The CFIR frame-
work has been shown to be especially useful in identifying
adoption and implementation barriers across each domain
that can be directly mapped to implementation strate-
gies [41]. Furthermore, Eaton et al. [38] suggested that
an early structured pre-implementation evaluation can be
beneficial in identifying actionable barriers and facilita-
tors for future widespread adoption and implementation
efforts. Some strategies identified from previous research
include involving stakeholders at the outset, engaging sub-
ject matter experts to create meaningful content, piloting
the intervention with subject matter experts, evaluating
fidelity, usability, and acceptability with end users, and
studying the effectiveness of the intervention. However,
there are limited documented uses of IS frameworks in
OSH. One of the few is Tinc et al.’s application of CFIR
to identify barriers to and facilitators for the uptake of
an evidence-based intervention in agriculture safety [42].
These researchers found that CFIR factors such as “access
to knowledge and information,” “leadership engagement”
(Inner Setting), and “engaging” and “reflecting and evaluat-
ing” (Implementation Process) were significantly associated
with positive intervention outcomes, suggesting the CFIR
framework might be useful in other areas of occupational
and public health.
VR Mine Rescue Training (VR-MRT)
Bringing together their expertise in mine rescue, training,
and immersive development, NIOSH researchers have
developed a VR training framework—VR Mine Rescue
Training (VR-MRT). VR-MRT is a single or multiplayer
VR application designed to supplement current mine res-
cue training. The platform focuses on scenario-based train-
ing with the goal of improving mine rescue team members’
procedural, collaborative, and problem-solving skills with
a focus on decision making. The trainees can visualize
and interact with a mine environment using a VR head-
set (e.g., Meta Quest 2 and 3) and work through scenarios
together with their teammates. As described in Bellanca et
al. [1], VR-MRT consists of five modules: Scenario Editor,
Simulation Module, Director Module, Spectator Module,
and Debrief Module. The Scenario Editor allows train-
ers to create their own content through a drag-and-drop
interface. Trainers can either use the built-in room-and-
pillar style tile sets (i.e., coal, stone) that snap together or
import their own geometry (e.g., LiDAR, photogramme-
try). In the mine geometry, trainers can place both built-
in and custom objects and hazards. They are also able to
set up static ventilation zones as well as a dynamic ventila-
tion node network that runs on NIOSH’s MFIRE [43].
The Simulation Module allows one or more trainees to
experience the scenarios. Trainees are either co-located or
Table 1. CFIR 2.0 Domainsa, Planning Questionsb, and Constructsa
Innovation Is this intervention superior to status quo?
Constructs Source, Evidence-Based, Relative Advantage, Adaptability, Trialability,
Complexity, Design, Cost
Outer Setting Why is it important to implement this intervention now? Are there
regulatory or environmental pressures?
Constructs Critical Incidents, Local Attitudes, Local Conditions, Partnerships &
Connections, Policies &Laws, Financing, External Pressure
Inner Setting Will this intervention fit the system? Is it feasible?
Constructs Physical Infrastructure, IT Infrastructure, Work Infrastructure,
Relational Connections, Communications, Culture, Tension for Change,
Compatibility, Relative Priority, Incentive Systems, Mission Alignment,
Resources, Access to Knowledge and Information
Individuals Does the staff have the skill and the will to deliver the intervention?
Constructs High-level Leaders, Mid-level Leaders, Opinion Leaders, Implementation
Facilitators, Implementation Leads, Implementation Team Members, Other
Implementation Support, Innovation Deliverers, Innovation Recipients
Imp. Process How is work affected by the intervention? What is needed to implement
the intervention
Constructs Teaming, Assessing Needs, Assessing Context, Planning, Tailoring Strategies,
Engaging, Doing, Reflecting &Evaluating
a As described in [40] b Adapted from [39]