Table 1 Implementation support strategies provided to each study arm’s CHCs

Spring 2015: Identify a study “Point Person” and/or a “Clinician Champion” [21]. Diverse staff filled these roles.

Identify and prepare champions

X

X

X

June 2015: Clinics receive “CVD bundle implementation toolkit’ on how to find/use the CVD bundle components, and practice change techniques.

Develop/distribute educational materials

X

X

X

June 2015: Webinar on the CVD bundle.

Conduct ongoing training

X

X

X

June 2016: Webinar on minor changes made to the CVD bundle and the toolkit.

Conduct ongoing training

X

X

X

July 2015: 2–3 clinic representatives attend 2-day in-person training, all costs covered. Training covered lessons from our prior trial, hands-on practice using the CVD bundle and implementation toolkit, change management techniques.

Conduct ongoing training/make training dynamic

X

X

September 2015-August 2016: Quarterly webinars with content based on identified training needs.

Conduct ongoing training

X

X

September 2015–April 2018: Offered practice facilitation > = 2 onsite visits in the first year; > = 3 visits over the 2nd and 3rd years. Purpose was to help address barriers to implementing the CVD bundle. PF visits included meetings with point people, clinician champions, and clinic leadership, interviews with clinic employees to understand clinic functioning and capacity, and training on the guidelines underlying the CVD bundle. At initial visit, PF also spoke at staff/provider meetings. After that visit, PF provided virtual coaching tailored to each organization’s needs, including monthly emails with study point people, webinars for clinic staff, and connecting staff to other resources (e.g., technical support). A second visit occurred at all arm 3 CHCs in March–May 2016; these visits’ content varied in response to clinic needs.

Facilitation

X