# Getting started with pcatR

## Read-before-use boundary

The pCAT has 14 items and two response components per item. `pcatR` preserves those components and derives item-level descriptive categories. It does not calculate an overall validated pCAT scale score. Open the complete technical guide with `pcat_user_guide()` before using operational or research data.

## Inspect the instrument and mappings

    pcat_items("both")
    #>    item_id             item_key
    #> 1        1        patient_needs
    #> 2        2       communications
    #> 3        3        data_tracking
    #> 4        4     leadership_goals
    #> 5        5     clinician_values
    #> 6        6   clinical_processes
    #> 7        7  structures_policies
    #> 8        8                space
    #> 9        9                 time
    #> 10      10      other_resources
    #> 11      11   tension_for_change
    #> 12      12   relative_advantage
    #> 13      13 higher_level_leaders
    #> 14      14      closest_leaders
    #>                                                                                                      item_text
    #> 1  People here regularly seek to understand the needs of patients and make changes to better meet those needs.
    #> 2                                  I have open lines of communication with everyone needed to make the change.
    #> 3                                                     I have access to data to help track changes in outcomes.
    #> 4                                                                 The change is aligned with leadership goals.
    #> 5                                                                 The change is aligned with clinician values.
    #> 6                                                   The change is compatible with existing clinical processes.
    #> 7                                      The structures and policies in place here enable us to make the change.
    #> 8                                                          We have sufficient space to accommodate the change.
    #> 9                                                        We have sufficient time dedicated to make the change.
    #> 10                           We have other needed resources to make the change (staff, money, supplies, etc.).
    #> 11                         People here see the current situation as intolerable and that the change is needed.
    #> 12                     People here see the advantage of implementing this change versus an alternative change.
    #> 13                  Higher level leaders are committed, involved, and accountable for the planned improvement.
    #> 14      Leaders I work with most closely are committed, involved, and accountable for the planned improvement.
    #>            cfir_original_domain    cfir_original_construct cfir_2022_domain
    #> 1                 Outer Setting  Patient Needs & Resources    Inner Setting
    #> 2                 Inner Setting  Networks & Communications    Inner Setting
    #> 3                       Process    Reflecting & Evaluating          Process
    #> 4                 Inner Setting           Goals & Feedback    Inner Setting
    #> 5                 Inner Setting              Compatibility      Individuals
    #> 6                 Inner Setting              Compatibility    Inner Setting
    #> 7                 Inner Setting Structural Characteristics    Inner Setting
    #> 8                 Inner Setting        Available Resources    Inner Setting
    #> 9                 Inner Setting        Available Resources      Individuals
    #> 10                Inner Setting        Available Resources    Inner Setting
    #> 11                Inner Setting         Tension for Change    Inner Setting
    #> 12 Intervention Characteristics         Relative Advantage       Innovation
    #> 13                Inner Setting      Leadership Engagement      Individuals
    #> 14                Inner Setting      Leadership Engagement      Individuals
    #>        cfir_2022_subdomain                             cfir_2022_construct
    #> 1                     <NA>                 Culture: Recipient-Centeredness
    #> 2                     <NA>                                  Communications
    #> 3                     <NA>                         Reflecting & Evaluating
    #> 4                     <NA>                               Mission Alignment
    #> 5  Roles & Characteristics               Innovation Deliverers: Capability
    #> 6                     <NA>                                   Compatibility
    #> 7                     <NA> Structural Characteristics: Work Infrastructure
    #> 8                     <NA>                      Available Resources: Space
    #> 9  Roles & Characteristics              Innovation Deliverers: Opportunity
    #> 10                    <NA>      Available Resources: Materials & Equipment
    #> 11                    <NA>                              Tension for Change
    #> 12                    <NA>                   Innovation Relative Advantage
    #> 13 Roles & Characteristics                  High-Level Leaders: Motivation
    #> 14 Roles & Characteristics                   Mid-Level Leaders: Motivation
    #>    cfir_2022_secondary_construct
    #> 1                           <NA>
    #> 2                           <NA>
    #> 3                           <NA>
    #> 4                           <NA>
    #> 5                           <NA>
    #> 6                           <NA>
    #> 7                           <NA>
    #> 8                           <NA>
    #> 9                           <NA>
    #> 10  Available Resources: Funding
    #> 11                          <NA>
    #> 12                          <NA>
    #> 13                          <NA>
    #> 14                          <NA>
    #>                                                     cfir_2022_construct_all
    #> 1                                           Culture: Recipient-Centeredness
    #> 2                                                            Communications
    #> 3                                                   Reflecting & Evaluating
    #> 4                                                         Mission Alignment
    #> 5                                         Innovation Deliverers: Capability
    #> 6                                                             Compatibility
    #> 7                           Structural Characteristics: Work Infrastructure
    #> 8                                                Available Resources: Space
    #> 9                                        Innovation Deliverers: Opportunity
    #> 10 Available Resources: Materials & Equipment; Available Resources: Funding
    #> 11                                                       Tension for Change
    #> 12                                            Innovation Relative Advantage
    #> 13                                           High-Level Leaders: Motivation
    #> 14                                            Mid-Level Leaders: Motivation
    #>    cfir_2022_mapping_count
    #> 1                        1
    #> 2                        1
    #> 3                        1
    #> 4                        1
    #> 5                        1
    #> 6                        1
    #> 7                        1
    #> 8                        1
    #> 9                        1
    #> 10                       2
    #> 11                       1
    #> 12                       1
    #> 13                       1
    #> 14                       1
    #>                                                                                                                                                                    cfir_2022_mapping_note
    #> 1                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 2                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 3                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 4                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 5                                 The article main-text list uses "Innovation Deliverers: Capability"; Supplementary Table S3 uses the singular label "Innovation Deliverer: Capability".
    #> 6                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 7                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 8                                                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 9                               The article main-text list uses "Innovation Deliverers: Opportunity"; Supplementary Table S3 uses the singular label "Innovation Deliverer: Opportunity".
    #> 10 Supplementary Table S3 maps this item to both Available Resources: Materials & Equipment and Funding; the article main-text list of 14 primary constructs names Materials & Equipment.
    #> 11                                                                                                                  One primary updated-CFIR construct per the article main-text mapping.
    #> 12                                                   The article main-text list uses "Innovation Relative Advantage"; Supplementary Table S3 uses the shorter label "Relative Advantage".
    #> 13                                                                                                                  One primary updated-CFIR construct per the article main-text mapping.
    #> 14                                                                                                                  One primary updated-CFIR construct per the article main-text mapping.
    #>            instrument_version      instrument_source_doi
    #> 1  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 2  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 3  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 4  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 5  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 6  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 7  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 8  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 9  pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 10 pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 11 pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 12 pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 13 pCAT 14-item final version 10.1186/s43058-022-00380-5
    #> 14 pCAT 14-item final version 10.1186/s43058-022-00380-5
    #>            mapping_source_doi content_license
    #> 1  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 2  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 3  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 4  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 5  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 6  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 7  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 8  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 9  10.1186/s43058-026-00956-5       CC BY 4.0
    #> 10 10.1186/s43058-026-00956-5       CC BY 4.0
    #> 11 10.1186/s43058-026-00956-5       CC BY 4.0
    #> 12 10.1186/s43058-026-00956-5       CC BY 4.0
    #> 13 10.1186/s43058-026-00956-5       CC BY 4.0
    #> 14 10.1186/s43058-026-00956-5       CC BY 4.0
    pcat_construct_map("2022", include_secondary = TRUE)
    #>    item_id             item_key cfir_version   cfir_domain
    #> 1        1        patient_needs         2022 Inner Setting
    #> 2        2       communications         2022 Inner Setting
    #> 3        3        data_tracking         2022       Process
    #> 4        4     leadership_goals         2022 Inner Setting
    #> 5        5     clinician_values         2022   Individuals
    #> 6        6   clinical_processes         2022 Inner Setting
    #> 7        7  structures_policies         2022 Inner Setting
    #> 8        8                space         2022 Inner Setting
    #> 9        9                 time         2022   Individuals
    #> 10      10      other_resources         2022 Inner Setting
    #> 11      10      other_resources         2022 Inner Setting
    #> 12      11   tension_for_change         2022 Inner Setting
    #> 13      12   relative_advantage         2022    Innovation
    #> 14      13 higher_level_leaders         2022   Individuals
    #> 15      14      closest_leaders         2022   Individuals
    #>             cfir_subdomain                                  cfir_construct
    #> 1                     <NA>                 Culture: Recipient-Centeredness
    #> 2                     <NA>                                  Communications
    #> 3                     <NA>                         Reflecting & Evaluating
    #> 4                     <NA>                               Mission Alignment
    #> 5  Roles & Characteristics               Innovation Deliverers: Capability
    #> 6                     <NA>                                   Compatibility
    #> 7                     <NA> Structural Characteristics: Work Infrastructure
    #> 8                     <NA>                      Available Resources: Space
    #> 9  Roles & Characteristics              Innovation Deliverers: Opportunity
    #> 10                    <NA>      Available Resources: Materials & Equipment
    #> 11                    <NA>                    Available Resources: Funding
    #> 12                    <NA>                              Tension for Change
    #> 13                    <NA>                   Innovation Relative Advantage
    #> 14 Roles & Characteristics                  High-Level Leaders: Motivation
    #> 15 Roles & Characteristics                   Mid-Level Leaders: Motivation
    #>    mapping_role
    #> 1       primary
    #> 2       primary
    #> 3       primary
    #> 4       primary
    #> 5       primary
    #> 6       primary
    #> 7       primary
    #> 8       primary
    #> 9       primary
    #> 10      primary
    #> 11    secondary
    #> 12      primary
    #> 13      primary
    #> 14      primary
    #> 15      primary
    #>                                                         source_detail
    #> 1  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 2  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 3  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 4  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 5  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 6  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 7  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 8  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 9  Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 10 Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 11                       Domlyn et al. (2026), Supplementary Table S3
    #> 12 Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 13 Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 14 Domlyn et al. (2026), article main text and Supplementary Table S3
    #> 15 Domlyn et al. (2026), article main text and Supplementary Table S3
    #>                    source_doi
    #> 1  10.1186/s43058-026-00956-5
    #> 2  10.1186/s43058-026-00956-5
    #> 3  10.1186/s43058-026-00956-5
    #> 4  10.1186/s43058-026-00956-5
    #> 5  10.1186/s43058-026-00956-5
    #> 6  10.1186/s43058-026-00956-5
    #> 7  10.1186/s43058-026-00956-5
    #> 8  10.1186/s43058-026-00956-5
    #> 9  10.1186/s43058-026-00956-5
    #> 10 10.1186/s43058-026-00956-5
    #> 11 10.1186/s43058-026-00956-5
    #> 12 10.1186/s43058-026-00956-5
    #> 13 10.1186/s43058-026-00956-5
    #> 14 10.1186/s43058-026-00956-5
    #> 15 10.1186/s43058-026-00956-5
    #>                                                                                                                                                                              mapping_note
    #> 1                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 2                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 3                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 4                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 5                                 The article main-text list uses "Innovation Deliverers: Capability"; Supplementary Table S3 uses the singular label "Innovation Deliverer: Capability".
    #> 6                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 7                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 8                                                                                                                          Primary one-to-one item mapping used for item-level summaries.
    #> 9                               The article main-text list uses "Innovation Deliverers: Opportunity"; Supplementary Table S3 uses the singular label "Innovation Deliverer: Opportunity".
    #> 10 Supplementary Table S3 maps this item to both Available Resources: Materials & Equipment and Funding; the article main-text list of 14 primary constructs names Materials & Equipment.
    #> 11 Supplementary Table S3 maps this item to both Available Resources: Materials & Equipment and Funding; the article main-text list of 14 primary constructs names Materials & Equipment.
    #> 12                                                                                                                         Primary one-to-one item mapping used for item-level summaries.
    #> 13                                                   The article main-text list uses "Innovation Relative Advantage"; Supplementary Table S3 uses the shorter label "Relative Advantage".
    #> 14                                                                                                                         Primary one-to-one item mapping used for item-level summaries.
    #> 15                                                                                                                         Primary one-to-one item mapping used for item-level summaries.
    pcat_response_options()
    #>    response value          label
    #> 1 direction     1       Disagree
    #> 2 direction     2        Neutral
    #> 3 direction     3          Agree
    #> 4    effect     0 Weak/no effect
    #> 5    effect     1  Strong effect
    #>                                                 interpretation
    #> 1                                            Potential barrier
    #> 2                                            Neutral condition
    #> 3                                        Potential facilitator
    #> 4 Barrier or facilitator is expected to have weak or no effect
    #> 5   Barrier or facilitator is expected to have a strong effect

## Run the standard workflow

    dat <- pcat_example_data()
    analysis <- pcat_analyse(
      dat,
      group_vars = c("site_id", "timepoint"),
      require_complete = TRUE,
      validation_action = "none"
    )
    analysis
    #> <pcat_analysis>
    #>   input rows: 336
    #>   validation errors: 0
    #>   validation warnings: 0
    #>   classified rows: 336
    #>   summary rows: 56
    #>   consensus rows: 56
    #>   action-plan rows: 62
    #>   grouping: site_id, timepoint
    #>   total-score calculation: not performed

Always inspect validation findings, even when validation does not raise a condition.

    pcat_validation_issues(analysis$validation)
    #> [1] .pcat_row  issue_code severity   message
    #> <0 rows> (or 0-length row.names)
    head(analysis$summary)
    #>   site_id timepoint item_id n_rows_input n_rows_eligible n_rows_excluded
    #> 1  SITE_A  planning       1            6               6               0
    #> 2  SITE_A  planning       2            6               6               0
    #> 3  SITE_A  planning       3            6               6               0
    #> 4  SITE_A  planning       4            6               6               0
    #> 5  SITE_A  planning       5            6               6               0
    #> 6  SITE_A  planning       6            6               6               0
    #>   n_respondents n_valid_direction n_complete_class n_barrier n_neutral
    #> 1             6                 6                6         0         0
    #> 2             6                 6                6         0         0
    #> 3             6                 6                6         1         4
    #> 4             6                 6                6         0         1
    #> 5             6                 6                6         0         1
    #> 6             6                 6                6         0         6
    #>   n_facilitator n_strong_barrier n_weak_barrier n_neutral_complete
    #> 1             6                0              0                  0
    #> 2             6                0              0                  0
    #> 3             1                1              0                  4
    #> 4             5                0              0                  1
    #> 5             5                0              0                  1
    #> 6             0                0              0                  6
    #>   n_barrier_effect_missing n_weak_facilitator n_strong_facilitator
    #> 1                        0                  5                    1
    #> 2                        0                  4                    2
    #> 3                        0                  1                    0
    #> 4                        0                  4                    1
    #> 5                        0                  4                    1
    #> 6                        0                  0                    0
    #>   n_facilitator_effect_missing n_invalid_or_missing      modal_class
    #> 1                            0                    0 weak_facilitator
    #> 2                            0                    0 weak_facilitator
    #> 3                            0                    0          neutral
    #> 4                            0                    0 weak_facilitator
    #> 5                            0                    0 weak_facilitator
    #> 6                            0                    0          neutral
    #>   mean_display_code median_display_code pct_barrier pct_neutral pct_facilitator
    #> 1         1.1666667                   1   0.0000000   0.0000000       1.0000000
    #> 2         1.3333333                   1   0.0000000   0.0000000       1.0000000
    #> 3        -0.1666667                   0   0.1666667   0.6666667       0.1666667
    #> 4         1.0000000                   1   0.0000000   0.1666667       0.8333333
    #> 5         1.0000000                   1   0.0000000   0.1666667       0.8333333
    #> 6         0.0000000                   0   0.0000000   1.0000000       0.0000000
    #>   pct_complete_class pct_strong_barrier pct_weak_barrier pct_neutral_complete
    #> 1                  1          0.0000000                0            0.0000000
    #> 2                  1          0.0000000                0            0.0000000
    #> 3                  1          0.1666667                0            0.6666667
    #> 4                  1          0.0000000                0            0.1666667
    #> 5                  1          0.0000000                0            0.1666667
    #> 6                  1          0.0000000                0            1.0000000
    #>   pct_strong_facilitator pct_weak_facilitator pct_effect_missing modal_class_n
    #> 1              0.1666667            0.8333333                  0             5
    #> 2              0.3333333            0.6666667                  0             4
    #> 3              0.0000000            0.1666667                  0             4
    #> 4              0.1666667            0.6666667                  0             4
    #> 5              0.1666667            0.6666667                  0             4
    #> 6              0.0000000            0.0000000                  0             6
    #>   modal_class_share           item_key
    #> 1         0.8333333      patient_needs
    #> 2         0.6666667     communications
    #> 3         0.6666667      data_tracking
    #> 4         0.6666667   leadership_goals
    #> 5         0.6666667   clinician_values
    #> 6         1.0000000 clinical_processes
    #>                                                                                                     item_text
    #> 1 People here regularly seek to understand the needs of patients and make changes to better meet those needs.
    #> 2                                 I have open lines of communication with everyone needed to make the change.
    #> 3                                                    I have access to data to help track changes in outcomes.
    #> 4                                                                The change is aligned with leadership goals.
    #> 5                                                                The change is aligned with clinician values.
    #> 6                                                  The change is compatible with existing clinical processes.
    #>   cfir_original_domain   cfir_original_construct cfir_2022_domain
    #> 1        Outer Setting Patient Needs & Resources    Inner Setting
    #> 2        Inner Setting Networks & Communications    Inner Setting
    #> 3              Process   Reflecting & Evaluating          Process
    #> 4        Inner Setting          Goals & Feedback    Inner Setting
    #> 5        Inner Setting             Compatibility      Individuals
    #> 6        Inner Setting             Compatibility    Inner Setting
    #>       cfir_2022_subdomain               cfir_2022_construct
    #> 1                    <NA>   Culture: Recipient-Centeredness
    #> 2                    <NA>                    Communications
    #> 3                    <NA>           Reflecting & Evaluating
    #> 4                    <NA>                 Mission Alignment
    #> 5 Roles & Characteristics Innovation Deliverers: Capability
    #> 6                    <NA>                     Compatibility
    #>   cfir_2022_secondary_construct           cfir_2022_construct_all
    #> 1                          <NA>   Culture: Recipient-Centeredness
    #> 2                          <NA>                    Communications
    #> 3                          <NA>           Reflecting & Evaluating
    #> 4                          <NA>                 Mission Alignment
    #> 5                          <NA> Innovation Deliverers: Capability
    #> 6                          <NA>                     Compatibility
    #>   cfir_2022_mapping_count
    #> 1                       1
    #> 2                       1
    #> 3                       1
    #> 4                       1
    #> 5                       1
    #> 6                       1
    #>                                                                                                                                    cfir_2022_mapping_note
    #> 1                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 2                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 3                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 4                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 5 The article main-text list uses "Innovation Deliverers: Capability"; Supplementary Table S3 uses the singular label "Innovation Deliverer: Capability".
    #> 6                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #>   suppressed
    #> 1      FALSE
    #> 2      FALSE
    #> 3      FALSE
    #> 4      FALSE
    #> 5      FALSE
    #> 6      FALSE
    head(analysis$consensus)
    #>   site_id timepoint item_id n_rows_input n_rows_eligible n_rows_excluded
    #> 1  SITE_A  planning       1            6               6               0
    #> 2  SITE_A  planning       2            6               6               0
    #> 3  SITE_A  planning       3            6               6               0
    #> 4  SITE_A  planning       4            6               6               0
    #> 5  SITE_A  planning       5            6               6               0
    #> 6  SITE_A  planning       6            6               6               0
    #>   n_respondents n_valid_direction n_complete_class n_barrier n_neutral
    #> 1             6                 6                6         0         0
    #> 2             6                 6                6         0         0
    #> 3             6                 6                6         1         4
    #> 4             6                 6                6         0         1
    #> 5             6                 6                6         0         1
    #> 6             6                 6                6         0         6
    #>   n_facilitator n_strong_barrier n_weak_barrier n_neutral_complete
    #> 1             6                0              0                  0
    #> 2             6                0              0                  0
    #> 3             1                1              0                  4
    #> 4             5                0              0                  1
    #> 5             5                0              0                  1
    #> 6             0                0              0                  6
    #>   n_barrier_effect_missing n_weak_facilitator n_strong_facilitator
    #> 1                        0                  5                    1
    #> 2                        0                  4                    2
    #> 3                        0                  1                    0
    #> 4                        0                  4                    1
    #> 5                        0                  4                    1
    #> 6                        0                  0                    0
    #>   n_facilitator_effect_missing n_invalid_or_missing      modal_class
    #> 1                            0                    0 weak_facilitator
    #> 2                            0                    0 weak_facilitator
    #> 3                            0                    0          neutral
    #> 4                            0                    0 weak_facilitator
    #> 5                            0                    0 weak_facilitator
    #> 6                            0                    0          neutral
    #>   mean_display_code median_display_code pct_barrier pct_neutral pct_facilitator
    #> 1         1.1666667                   1   0.0000000   0.0000000       1.0000000
    #> 2         1.3333333                   1   0.0000000   0.0000000       1.0000000
    #> 3        -0.1666667                   0   0.1666667   0.6666667       0.1666667
    #> 4         1.0000000                   1   0.0000000   0.1666667       0.8333333
    #> 5         1.0000000                   1   0.0000000   0.1666667       0.8333333
    #> 6         0.0000000                   0   0.0000000   1.0000000       0.0000000
    #>   pct_complete_class pct_strong_barrier pct_weak_barrier pct_neutral_complete
    #> 1                  1          0.0000000                0            0.0000000
    #> 2                  1          0.0000000                0            0.0000000
    #> 3                  1          0.1666667                0            0.6666667
    #> 4                  1          0.0000000                0            0.1666667
    #> 5                  1          0.0000000                0            0.1666667
    #> 6                  1          0.0000000                0            1.0000000
    #>   pct_strong_facilitator pct_weak_facilitator pct_effect_missing modal_class_n
    #> 1              0.1666667            0.8333333                  0             5
    #> 2              0.3333333            0.6666667                  0             4
    #> 3              0.0000000            0.1666667                  0             4
    #> 4              0.1666667            0.6666667                  0             4
    #> 5              0.1666667            0.6666667                  0             4
    #> 6              0.0000000            0.0000000                  0             6
    #>   modal_class_share           item_key
    #> 1         0.8333333      patient_needs
    #> 2         0.6666667     communications
    #> 3         0.6666667      data_tracking
    #> 4         0.6666667   leadership_goals
    #> 5         0.6666667   clinician_values
    #> 6         1.0000000 clinical_processes
    #>                                                                                                     item_text
    #> 1 People here regularly seek to understand the needs of patients and make changes to better meet those needs.
    #> 2                                 I have open lines of communication with everyone needed to make the change.
    #> 3                                                    I have access to data to help track changes in outcomes.
    #> 4                                                                The change is aligned with leadership goals.
    #> 5                                                                The change is aligned with clinician values.
    #> 6                                                  The change is compatible with existing clinical processes.
    #>   cfir_original_domain   cfir_original_construct cfir_2022_domain
    #> 1        Outer Setting Patient Needs & Resources    Inner Setting
    #> 2        Inner Setting Networks & Communications    Inner Setting
    #> 3              Process   Reflecting & Evaluating          Process
    #> 4        Inner Setting          Goals & Feedback    Inner Setting
    #> 5        Inner Setting             Compatibility      Individuals
    #> 6        Inner Setting             Compatibility    Inner Setting
    #>       cfir_2022_subdomain               cfir_2022_construct
    #> 1                    <NA>   Culture: Recipient-Centeredness
    #> 2                    <NA>                    Communications
    #> 3                    <NA>           Reflecting & Evaluating
    #> 4                    <NA>                 Mission Alignment
    #> 5 Roles & Characteristics Innovation Deliverers: Capability
    #> 6                    <NA>                     Compatibility
    #>   cfir_2022_secondary_construct           cfir_2022_construct_all
    #> 1                          <NA>   Culture: Recipient-Centeredness
    #> 2                          <NA>                    Communications
    #> 3                          <NA>           Reflecting & Evaluating
    #> 4                          <NA>                 Mission Alignment
    #> 5                          <NA> Innovation Deliverers: Capability
    #> 6                          <NA>                     Compatibility
    #>   cfir_2022_mapping_count
    #> 1                       1
    #> 2                       1
    #> 3                       1
    #> 4                       1
    #> 5                       1
    #> 6                       1
    #>                                                                                                                                    cfir_2022_mapping_note
    #> 1                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 2                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 3                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 4                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #> 5 The article main-text list uses "Innovation Deliverers: Capability"; Supplementary Table S3 uses the singular label "Innovation Deliverer: Capability".
    #> 6                                                                                   One primary updated-CFIR construct per the article main-text mapping.
    #>   suppressed agreement_share dominant_side polarized normalized_entropy
    #> 1      FALSE       1.0000000   facilitator     FALSE          0.0000000
    #> 2      FALSE       1.0000000   facilitator     FALSE          0.0000000
    #> 3      FALSE       0.6666667       neutral     FALSE          0.7896901
    #> 4      FALSE       0.8333333   facilitator     FALSE          0.4101185
    #> 5      FALSE       0.8333333   facilitator     FALSE          0.4101185
    #> 6      FALSE       1.0000000       neutral     FALSE          0.0000000
    #>         consensus_label
    #> 1 consensus_facilitator
    #> 2 consensus_facilitator
    #> 3     consensus_neutral
    #> 4 consensus_facilitator
    #> 5 consensus_facilitator
    #> 6     consensus_neutral

## Visualize item patterns

    plot_pcat_profile(
      analysis$classified,
      group_vars = "timepoint",
      label = "cfir_original_construct"
    )

## Compare repeated assessments

    change <- pcat_change(
      analysis$classified,
      from = "planning",
      to = "mid_implementation"
    )
    head(change)
    #>   project_id site_id respondent_id item_id  from_pcat_class    to_pcat_class
    #> 1  PCAT_DEMO  SITE_A          R001       1 weak_facilitator          neutral
    #> 2  PCAT_DEMO  SITE_A          R001       2 weak_facilitator weak_facilitator
    #> 3  PCAT_DEMO  SITE_A          R001       3          neutral          neutral
    #> 4  PCAT_DEMO  SITE_A          R001       4 weak_facilitator weak_facilitator
    #> 5  PCAT_DEMO  SITE_A          R001       5          neutral weak_facilitator
    #> 6  PCAT_DEMO  SITE_A          R001       6          neutral          neutral
    #>   from_pcat_class5   to_pcat_class5 from_pcat_display_code to_pcat_display_code
    #> 1 weak_facilitator          neutral                      1                    0
    #> 2 weak_facilitator weak_facilitator                      1                    1
    #> 3          neutral          neutral                      0                    0
    #> 4 weak_facilitator weak_facilitator                      1                    1
    #> 5          neutral weak_facilitator                      0                    1
    #> 6          neutral          neutral                      0                    0
    #>   from_pcat_side to_pcat_side paired_complete delta_display_code
    #> 1    facilitator      neutral            TRUE                 -1
    #> 2    facilitator  facilitator            TRUE                  0
    #> 3        neutral      neutral            TRUE                  0
    #> 4    facilitator  facilitator            TRUE                  0
    #> 5        neutral  facilitator            TRUE                  1
    #> 6        neutral      neutral            TRUE                  0
    #>            transition                    transition_detail from_timepoint
    #> 1      toward_barrier          weak_facilitator -> neutral       planning
    #> 2      no_code_change weak_facilitator -> weak_facilitator       planning
    #> 3      no_code_change                   neutral -> neutral       planning
    #> 4      no_code_change weak_facilitator -> weak_facilitator       planning
    #> 5 toward_facilitation          neutral -> weak_facilitator       planning
    #> 6      no_code_change                   neutral -> neutral       planning
    #>         to_timepoint
    #> 1 mid_implementation
    #> 2 mid_implementation
    #> 3 mid_implementation
    #> 4 mid_implementation
    #> 5 mid_implementation
    #> 6 mid_implementation
    #>                                                                                                     item_text
    #> 1 People here regularly seek to understand the needs of patients and make changes to better meet those needs.
    #> 2                                 I have open lines of communication with everyone needed to make the change.
    #> 3                                                    I have access to data to help track changes in outcomes.
    #> 4                                                                The change is aligned with leadership goals.
    #> 5                                                                The change is aligned with clinician values.
    #> 6                                                  The change is compatible with existing clinical processes.
    #>     cfir_original_construct               cfir_2022_construct
    #> 1 Patient Needs & Resources   Culture: Recipient-Centeredness
    #> 2 Networks & Communications                    Communications
    #> 3   Reflecting & Evaluating           Reflecting & Evaluating
    #> 4          Goals & Feedback                 Mission Alignment
    #> 5             Compatibility Innovation Deliverers: Capability
    #> 6             Compatibility                     Compatibility

## Export reproducible results

    output_dir <- tempfile("pcat_analysis_", tmpdir = tempdir())

    pcat_write_analysis(
      analysis,
      path = output_dir,
      overwrite = TRUE
    )

    unlink(output_dir, recursive = TRUE, force = TRUE)

The export includes an analysis manifest, validation findings, classified responses, item summaries, consensus diagnostics, an action-plan worksheet, and an optional multi-page profile PDF. The profile exporter validates every page before writing a temporary PDF and replaces the requested path only after the complete temporary file is nonempty.

The temporary path keeps this documentation example out of the current working directory. For real analyses, choose an explicit, approved project output directory.