{"doi":"10.3389/fpsyg.2023.1178560","title":"An international consensus definition for contextual factors: findings from a nominal group technique","abstract":"Objective: Emerging literature suggests contextual factors are important components of therapeutic encounters and may substantially influence clinical outcomes of a treatment intervention. At present, a single consensus definition of contextual factors, which is universal across all health-related conditions is lacking. The objective of this study was to create a consensus definition of contextual factors to better refine this concept for clinicians and researchers. Design: The study used a multi-stage virtual Nominal Group Technique (vNGT) to create and rank contextual factor definitions. Nominal group techniques are a form of consensus-based research, and are beneficial for identifying problems, exploring solutions and establishing priorities. Setting: International. Main outcome measures: The initial stages of the vNGT resulted in the creation of 14 independent contextual factor definitions. After a prolonged discussion period, the initial definitions were heavily modified, and 12 final definitions were rank ordered by the vNGT participants from first to last. Participants: The 10 international vNGT participants had a variety of clinical backgrounds and research specializations and were all specialists in contextual factors research. Results: A sixth round was used to identify a final consensus, which reflected the complexity of contextual factors and included three primary domains: (1) an overall definition; (2) qualifiers that serve as examples of the key areas of the definition; and (3) how contextual factors may influence clinical outcomes. Conclusion: Our consensus definition of contextual factors seeks to improve the understanding and communication between clinicians and researchers. These are especially important in recognizing their potential role in moderating and/or mediating clinical outcomes.","journal":"Frontiers in Psychology","year":2023,"id":317576,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":76,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9525,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":505217,"name":"Antoine Bailliard","orcid":"0000-0001-7809-9301","position":1,"is_corresponding":false},{"id":1023185,"name":"Jennifer Bent","orcid":"0000-0001-5315-0983","position":2,"is_corresponding":false},{"id":722107,"name":"Joel E. Bialosky","orcid":"0000-0002-0137-2653","position":3,"is_corresponding":false},{"id":1019843,"name":"Elisa Carlino","orcid":"0000-0001-8472-656X","position":4,"is_corresponding":false},{"id":385168,"name":"Luana Colloca","orcid":"0000-0002-6503-4709","position":5,"is_corresponding":false},{"id":1023186,"name":"Jorge E. Esteves","orcid":"0000-0001-9637-678X","position":6,"is_corresponding":false},{"id":1019858,"name":"David Newell","orcid":"0000-0003-1462-3586","position":7,"is_corresponding":false},{"id":1023187,"name":"Alvisa Palese","orcid":"0000-0002-3508-844X","position":8,"is_corresponding":false},{"id":348847,"name":"William Reed","orcid":"0000-0002-4580-485X","position":9,"is_corresponding":false},{"id":910058,"name":"Jennifer Plumb Vilardaga","orcid":"0000-0001-5174-3849","position":10,"is_corresponding":false},{"id":1019863,"name":"Giacomo Rossettini","orcid":"0000-0002-1623-7681","position":11,"is_corresponding":false},{"id":427761,"name":"Chad Cook","orcid":"0000-0001-8622-8361","position":0,"is_corresponding":true}],"reference_count":34,"raw_metadata":null,"created_at":"2026-07-19T01:06:50.336418Z","pmid":"37465492","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}