Table 5 Simpson Transfer Model stages and corresponding activities

• Secure commitment

Developmental evaluation

• Training and observation of care model by site PIs and regional project managers

• Organizational Readiness for Change (ORC: prior to implementation)

• Review evidence

• Key informant interviews

• Address values

• Identify and prioritize needs and treatment targets

• Begin tailoring care practice protocols

• Kick-off meeting and video conferences on treatments to be implemented

Predisposing activities:

Developmental evaluation

• VISN Implementation Teams

Rogers' adoption questions:

• Product champions

• Complexity

• Continue tailoring care practice protocols

• Relative advantage

• Continue to secure commitment, address values

• Observability

Enabling activities:

Progress-focused evaluation

• Patient self- assessment informatics (PAS) with provision of data to clinicians.

• PAS tracking (ongoing)

• Treatment-specific implementation activities, such as help with wellness groups and liaison with supported employment.

Implementation-focused evaluation

• Discuss and start using provider supports and incentives.

• Project documents (minutes from Implementation Team meetings, project managers' field notes, quality coordinators' logs: all ongoing).

• Provider and clinic manager interviews (mid-implementation)

Reinforcing activities (performance monitoring & feedback):

Interpretive evaluation

• Monthly quality meeting and Quality Reports

• Provider & clinic manager interviews (post-implementation)

• Quarterly conference calls re: treatment target implementation and use

• Computer system usability questionnaire

• Implementation team meetings

• Continue tailoring with provider input

• Finalize provider supports and incentives

• Continue tailoring with leader input

• Stakeholder feedback discussions

Interpretive evaluation

• Level of Institutionalization

• ORC