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Table 1 Distinct SAIA-MH implementation strategies coded to the Expert Recommendations for Implementing Change (ERIC) framework [31]

From: Systems analysis and improvement approach to optimize outpatient mental health treatment cascades in Mozambique (SAIA-MH): study protocol for a cluster randomized trial

Distinct SAIA-MH Implementation Strategy coded to ERIC Individual, organizational, or contextual barrier(s) addressed
External facilitation Lack of knowledge of quality improvement and SAIA-MH implementation strategy
Provide ongoing clinical consultation Clinical knowledge gaps; gaps in clinical evaluation and reporting
Organize service provider implementation team meetings Limited teamwork: lower-level providers afraid to innovate without approval; siloing of services and providers; issues with role clarity
Step 1: Cascade analysis (ERIC: Audit and feedback; Model and simulate change; facilitate relay of clinical data to providers) Lack of knowledge of problems; no data for prioritization; data only collected/reported but limited feedback; limited accountability
Step 2: Process mapping (ERIC: Conduct local needs assessment; assess readiness for change and identify barriers/facilitators; conduct local consensus discussions) Lack of consensus on current system; limited teamwork; limited discussion on full system, goals, barriers, and facilitators; hard to conceptualize potential modifications
Steps 3–5: Conduct cyclical tests of change (ERIC: Conduct cyclical small tests of change; tailor strategies; develop a formal implementation blueprint; purposely reexamine the implementation) Limited culture of quality; providers rigidly follow guidelines with no ability to innovate and improve