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Table 1 Percentage of IPOs who use the strategy and rank it within their five most successful

From: Intermediary/purveyor organizations for evidence-based interventions in the US child mental health: characteristics and implementation strategies

# Implementation strategy % of IPOs who use % of IPOs who listed as top five most successful
Educate domain
20 Distribute educational materials (e.g., guidelines, manuals, and toolkits) in person, by mail, and/or electronically 96.30 29.63
23 Vary training methods for different learning styles or shape the training to be interactive 90.74 24.07
18 Develop educational materials to make it easier for stakeholders to learn to implement or learn about the EBI 88.89 33.33
26 Provide clinicians with ongoing consultation from an expert in the intervention 88.89 35.19
22 Conduct training in the EBI that included follow-up training, advanced training, booster training, or training to competence 85.19 46.30
21 Conduct educational meetings targeted toward providers, administrators, or other stakeholders to teach them about the EBI 74.07 9.26
24 Use a trained person to educate providers in the adopting organization about the EBI in an effort to change their practice 70.37 5.56
25 Use a train-the-trainer approach 68.52 12.96
30 Use mass media, social media, or promotional materials to reach large numbers of providers or clients the area to spread the word about the intervention 50.00 3.70
33 Encourage educational institutions to train clinicians in the EBI 48.15 1.85
28 Develop a learning collaborative of providers and/or organizations that are also implementing the EBI, and develop ways to learn from one another to foster better implementation 46.30 5.56
29 Have providers shadow other providers who are expert in delivering and implementing the intervention 46.30 3.70
19 Provide a glossary defining key terms related to implementation to promote a common understanding among stakeholders 44.44 3.70
27 Identify certain providers as opinion leaders about the EBI in the hopes that they would influence their colleagues to adopt it 44.44 0.00
32 Attempt to increase demand by influencing the market for the EBI 40.74 1.85
31 Prepare clients to ask questions about available evidence-supported programs/treatments 22.22 0.00
Plan domain
5 Tailor implementation strategies to address barriers or honor preferences identified through information you had about this agency or the provider(s) 85.19 29.63
10 Engage people who can champion the EBI and spread the word of its need 83.33 35.19
2 Assess the organization’s or the provider’s readiness to implement the EBI, including barriers that may impede implementation, and strengths that could be leveraged for the implementation effort 75.93 29.63
12 Recruit, designate, and train leaders specifically for the changes involved in the adoption/implementation effort 72.22 7.41
14 Encourage adopters to find partners who will share the cost 72.22 5.56
4 Develop a formal implementation plan 70.37 35.19
15 Develop partnerships with organizations that have resources needed to implement the EBI 68.52 11.11
6 Phase implementation, by starting with a small pilot or demonstration project and gradually move to a broader roll-out 66.67 14.81
8 Convene discussions with providers and other stakeholders about the importance of the clinical problems and whether the EBI addresses it appropriately 64.81 1.85
11 Engage clients who might benefit from the EBI in the implementation effort, including advocacy for the implementation 61.11 1.85
9 Involve governing structures, such as a board of directors, in the implementation effort 55.56 3.70
1 Conduct a local needs assessment (collecting and analyzing data related to the need for the EBI in this agency) 53.70 7.41
3 Suggest that the agency visit other sites where a similar implementation effort was considered successful 46.30 5.56
17 Suggest a partnership with a university or academic unit to bring additional skills to the implementation effort 44.44 1.85
16 Obtain, or ask that the agency obtains, written commitments from partners that explicitly stated what they would do to help you implement the EBI 31.48 1.85
13 Suggest mandating use of the EBI 24.07 1.85
7 Suggest or conduct a modeling or simulation of the impact of implementing the EBI prior to implementation 18.52 1.85
Quality management domain
56 Obtain client feedback on the adoption/implementation effort 77.78 7.41
50 Develop and introduce quality monitoring standards specific to the EBI 74.07 11.11
49 Develop clinical or outcome monitoring procedures for the purpose of quality assurance 70.37 7.41
61 Purposefully re-examine the implementation of the EBI and adjust the implementation strategies as needed 70.37 1.85
64 Capture and share local knowledge about how implementers and clinicians made the EBI work in their setting and then share it with other sites 62.96 3.70
55 Provide clinicians with ongoing supervision in the EBI 61.11 3.70
63 Seek guidance from experts in implementation science (university-affiliated faculty members, quality improvement experts, or implementation professionals) 57.41 1.85
52 Use a centralized technical assistance resource to assist with implementation 51.85 5.56
53 Use audit and feedback (i.e., collecting and summarizing performance data and then giving it to clinicians and administrators) in hopes of changing provider behavior 48.15 3.70
57 Encourage the agency to intervene with clients to increase their adherence to the EBI treatment protocol 44.44 0.00
60 Develop teams of clinicians who are implementing the EBI and encourage the agency to give them protected time to reflect on the implementation effort, share lessons learned, and support one another’s learning 42.59 5.56
59 Involve, hire, and/or consult experts in data management to shape the use of data related to the implementation effort 40.74 0.00
62 Implement cycles of change, small pilots, or plan-study-do-act (PDSA) quality improvements, using small tests of change and refining the implementation based upon what is learned 35.19 3.70
51 Involve advisory boards of different stakeholder groups to oversee implementation 29.63 1.85
54 Develop reminder systems designed to prompt clinicians to deliver the intervention 25.93 0.00
58 Use data warehousing techniques to integrate clinical records across organizations in order to facilitate implementation 16.67 0.00
Finance domain
39 Encourage the agency to access new funding to facilitate the implementation process 68.52 1.85
41 Work with government or other service payers through requests for proposals (RFPs), to support the delivery of the EBI 48.15 3.70
34 Help the agency develop payment structures to incentivize the adoption of the EBI 25.93 1.85
40 Work with the agency to ensure that the EBI was fully reimbursable 25.93 3.70
42 Suggest that the agency make it easier to bill for services related to the EBI 16.67 0.00
35 Encourage paying providers a set amount per patient for delivering the EBI 9.26 0.00
37 Encourage introduction of other payment schemes such as pre-payment and prospective payment for service, provider salaried service, aligning payment rates with patient outcomes, or removing billing limits 7.41 0.00
38 Encourage the agency to change fees, such that the EBI had lower payment fees 3.70 0.00
36 Encourage the agency to penalize providers financially for failing to deliver the EBI 0.00 0.00
Restructure domain
43 Shift or revise roles among professionals in order to provide the intervention and eliminate barriers 42.59 0.00
47 Encourage the agency to change the composition of the intervention teams, including different disciplines and skills to make the EBI delivery more likely 37.04 0.00
46 Ask the agency to change record systems to better reflect assessment of implementation of the EBI 31.48 0.00
45 Prompt the use of the EBI by collecting new clinical information from clients and relaying it to the provider 29.63 0.00
44 Increase access to the EBI by suggesting that the agency change the location of service (e.g., co-locating services) 25.93 0.00
48 Change the physical structure or space in the agency (e.g., installing one-way mirrors, making group rooms) 12.96 0.00