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Table 1 Standardized versus tailored protocol and focus

From: Implementing measurement-based care (iMBC) for depression in community mental health: a dynamic cluster randomized trial study protocol

Contextual factor

Implementation strategies

Standardized focus

Tailored focus

Resources

Paper-based PHQ-9 with score entered in EHR for clinician review

Client completion of PHQ-9 on paper and score entered in EHR for review by the clinician

Client completion of PHQ-9 on paper and score entered in EHR for review by the clinician

Networks and linkages

Form implementation teams for each site consisting of the site administrator, a clinician identified as an opinion leader, a self-nominated MBC champion, an office professional staff member, and research staff using data from the initial needs assessment. Each team will meet triweekly over the course of the active implementation period

Team meetings focus on monitoring and promoting MBC fidelity per the guideline

Team meetings focus on identifying remaining barriers

Policies and incentives

Guideline for PHQ-9 administration frequency

Each session w/client

Determined by site

Norms and attitudes

Initial MBC training

Standardized training material

Tailored training material targeting identified barriers from the needs assessment

Structure and process

Progress note modifications

For clinician score review

For clinician score review

Media and change agents

Triweekly consultation with experts

Consultation focuses on MBC fidelity, particularly on incorporating clinician PHQ-9 score review into sessions, encouraging discussion of scores with clients, and providing tips on targeting lack of progress

Consultation focuses on targeting identified barriers in addition to MBC fidelity. However, emphasis will be placed on tailoring review, discussion, and targeting lack of progress to the site-specific PHQ-9 guidelines to address contextual and other barriers as they are identified throughout the course of implementation