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Table 2 Description of REP, REP + EF, and REP + EF/IF implementation strategies to enhance the uptake of the life goals (LG) evidence-based practice

From: Protocol: Adaptive Implementation of Effective Programs Trial (ADEPT): cluster randomized SMART trial comparing a standard versus enhanced implementation strategy to improve outcomes of a mood disorders program

Implementation component REP REP + EF REP + EF/IF
REP (REP) All sites Randomize to non-responding sites Randomize to non-responding sites
Step 1: Market LG, disseminate LG package. (a) Marketing (pre-implementation): hold pre-implementation meetings with site representatives to describe the benefits of LG and identify potential LG providers and internal facilitators (IF). (b) Dissemination: regional in-services to disseminate LG implementation guide to providers, schedule trainings.
Step 2: Train site providers in LG. Conduct regionalized 8-h training for LG providers covering LG session content and delivery via LG website as well as patient tracking and monitoring over time.
Step 3: As-needed program assistance and LG uptake monitoring via secure web-based reporting sheets. Ad hoc program support available by study program support assistant.
REP + External Facilitator (REP + EF)    
Step 1: Initiation and benchmarking: EF contacts each LG provider, works with LG provider to identify potential barriers and facilitators to LG uptake from the LG provider’s perspective, and sets measurable goals to uptake.  
Step 2: Coaching: EF makes calls on a biweekly basis to site’s LG providers to develop rapport and provide specific guidance on overcoming barriers in implementing LG components by aligning LG’s strengths with LG’s available influence at the site. If needed, EF refers LG provider to study LG program support assistant.  
Step 3: Public recognition of “bright spots” (high-performing sites): EF provides state-specific report on sites’ progress and disseminates LG provider success stories.  
REP + External and Internal Facilitator (REP + EF/IF)    
Step 1: Initiation and benchmarking: EF contacts each LG provider and holds call with LG provider and IF to give background on LG, review potential barriers and facilitators to LG uptake, and set measurable goals to LG uptake.   
Step 2: Leveraging: IF meets with LG provider biweekly, identifies local site priorities per leadership input, identifies other LG program champions, and helps LG provider summarize and describe added value of LG to leadership and site providers (e.g., consistency with other initiatives, support from leadership).   
Step 3: Coaching: IF, EF, and LG hold biweekly calls to develop rapport; EF provides guidance to LG on overcoming specific barriers to LG uptake by aligning LG’s strengths with LG’s available influence at the site (EF), and IF aligns goals of LG provider with existing site priorities, based on feedback from site leadership. If needed, EF refers LG provider to study LG program support assistant.   
Step 4: Ongoing marketing: IF, leadership, and LG provider summarize progress and develop business and sustainability plans.