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Table 9 Summary of identified tensions and implementation fidelity trajectories

From: Implementation fidelity trajectories of a health promotion program in multidisciplinary settings: managing tensions in rehabilitation care

Tensions

Cluster 1

Stable high fidelity

Cluster 2

Moderate and improving fidelity

1. Organization’s vision and program’s fidelity

Organization’s vision focused

- Mainly high or moderate starting positions

- Generally more experienced at start

Program’s fidelity focused

- Mainly low starting positions

2. Active engagement of physicians and buffering physicians’ engagement

Active engagement of physicians

- Mainly small organizations

- Mainly stable organizational circumstances

Buffering physicians’ engagement

- Mainly large organizations

- Relatively more reorganizations

3. High fidelity and cost-efficient implementation

High fidelity implementation

- Stable/linear trajectory

- Mainly high or moderate starting position

- Mainly small organizations

Cost-efficient implementation

- Developmental/incremental trajectory

- Mainly low starting positions

- Mainly large organizations