Table 2 Consolidated Framework for Implementation Research (CFIR) interview domains, subdomains, and example questions

Domain: intervention characteristics

Evidence strength and quality: Can you tell me about any evidence that you are aware of that shows that completing case reviews for high risk patients will result in better outcomes for Veterans?

Relative advantage: How does the case review process required by the policy notice compare to other similar existing processes or tools in your setting?

Domain: outer setting

Patient needs and resources: How well do you think the policy notice is helping to meet the needs of Veterans?

Peer pressure: Are you aware of how your team is doing compared to other medical centers and CBOCS in complying with the policy notice?

External policies and incentives: Why do you think the policy notice was implemented?

Domain: inner setting

Structural characteristics: Tell me about any changes that were needed to accommodate the policy notice?

Networks and communications: Can you describe your relationship with influential stakeholders and others who have worked with you to implement the policy notice?

Implementation Climate

Tension for change: Why do you think the policy notice was implemented?

Compatibility: Describe how doing case reviews for high risk Veterans has been integrated into the current workflow.

Relative priority: Compared to other high-priority initiatives going on at your medical center, how important was it to comply with the policy notice?

Goals and feedback: What goals did your facility have in place to reduce adverse outcomes from opioid use prior to the implementation of the policy notice?

Leadership engagement: What level of endorsement or support have you seen or heard from your local leadership?

Available resources: What resources have you needed to implement and carry out the policy notice?

Access to knowledge and information: What kind of training did you receive about the policy notice?

Domain: process

Planning: Were you involved in developing a plan for implementing the policy notice at your facility?

Engaging: What steps were taken to encourage individuals to perform case reviews for Veterans identified as high risk by STORM?

Opinion leaders: What key individuals needed to be on board with the policy notice?

Formally appointed internal implementation leaders: Tell me about your role in the implementation of the policy notice.

Reflecting and evaluating: Tell me about the feedback reports that you receive from VA central office about your progress implementing the policy notice.