Table 1 Nine mechanisms of closer collaboration

M1: Local end-user driven—Local end-users are placed at the heart of AHR. They are involved in driving research, so that it focuses on real-life issues that are relevant and important to them, and throughout the research life cycle

M2: Meeting of minds—End-users and researchers find a common and coherent objective around which they coalesce. Their commitment and enthusiasm is matched with strategic support from their respective organisations

M3: Knowledge appetite—End-users and researchers are open and receptive to melding different forms of knowledge and expertise. This includes clinicians’ knowledge of routine clinical practice, patients’ experiential knowledge, and researchers’ methodological expertise. Each recognises and values what the other partners can contribute

M4: Game changers—End-users and researchers find new and more productive ways of doing and implementing research through working in collaboration. They see wider potential for the new way of working

M5: Facilitative leadership—Project teams are led by one or more leaders, who are regarded within and outside the team as credible and having real clout, connections, drive, enthusiasm, and tenacity. A facilitative style of leadership works well to involve partners, and to co-produce and mobilise knowledge for implementation

M6: Small strategic core—Project teams are formed around a small strategic core of end-users and researchers from the partner organisations involved in the project

M7: Creative assets—Partners harness existing and build up new assets to facilitate the conduct and implementation of AHR. ‘Assets’ include people with particular knowledge and skills; continuing professional development opportunities; routine data; websites for sharing learning; publications

M8: Relational adaptive capacity—Learning from local AHR is actively shared with and adapted to kindred settings or populations in other areas (locally, nationally, internationally)

M9: End-user is king!—Partners recognise that the key change agents are not the program ‘makers and shakers’ and the strategies they introduce but rather the agents on the ground and how they respond to the opportunities afforded by the program to change how AHR is routinely carried out and implemented