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Table 1 Implementation components of standard REP and enhanced REP

From: Cluster randomized adaptive implementation trial comparing a standard versus enhanced implementation intervention to improve uptake of an effective re-engagement program for patients with serious mental illness

Component Description Standard REP Enhanced REP
Package Implementation guide was disseminated to all providers at eligible sites, describing the Re-Engage program, a list of frequently asked questions, sample documents for program tasks, program policies, data security, and related research.
Training Three 1.5-hour national conference call trainings of mental health providers on how to conduct program. Program materials made available on mental health provider website. Research staff available to answer questions via email or telephone.
Technical Assistance Ongoing assistance via 1-hour biweekly conference calls led by study staff for mental health providers to answer technical questions on Re-Engage program implementation and study staff were available on an ad-hoc basis to answer questions from individual providers. Monthly reports were generated to track Re-Engage uptake (% patients with updated clinical status documented).
Sites receiving standard REP technical assistance in phases one and two did not receive calls but study staff were available if they were contacted on an as –needed basis to address technical questions regarding Re-Engage implementation.
External Facilitation    
Gather information Facilitators gather information from various sources (monthly evaluation reports, VISN Mental Health Leadership, mental health providers, VA Mental Health Services Leadership) to identify potential facility-specific barriers and facilitators to implementation.  
Ongoing partnership support Weekly phone calls with Facilitators, Technical Assistance staff, and VA national leaders involved in national Re-Engage program and VA mental health services. Facilitators maintain open communication with VA leaders regarding implementation nationally and at specific sites through these phone calls and email communication. Facilitators also maintain ongoing contact with one another through separate weekly meetings.  
Garner regional and local support Facilitators initiate contact with regional mental health leadership affiliated with local sites, providing information regarding Re-Engage program implementation and added value. Maintain ongoing contact and request support from regional leadership as indicated.  
Identify barriers and facilitators Facilitators and mental health providers hold monthly calls for six months and collaboratively identify each facility’s specific challenges (e.g., time, resources) to program implementation as well as potential assets (e.g., consistency with other initiatives, support from local leadership) to program implementation.  
Collaboratively develop action plans Facilitators assist mental health providers in identifying what specific actions they can take to implement program.  
Feedback and Link to available resources Facilitators provide feedback to mental health providers regarding implementation and action plan progress. Facilitators refer mental health providers to existing resources, including the Technical Assistance available through standard REP, existing documents regarding the program intervention, facility-level, regional, or national leadership.