Table 1 Sources of data on GAP implementation outcomes at implementing sites

Context±

Steckler and Linnan (2002) [28]; CFIR [27]; Pfadenhauer (2012) — for granularity of context [29]

Qualitative data collection instruments incorporated CFIR implementation domains and associated constructs [27]; framework analysis of macro, meso and micro context conducted using the CICI framework [29]

Semi-structured interviews with lead clinicians and frontline staff

Fidelity

Steckler and Linnan (2002) [28]

Adherence to GAP provider training requirement that 75% of staff from each professional group (midwives, sonographers, obstetricians) were trained using both (i) face-to-face and (ii) e-learning methods

Staff training records from the GAP provider

Degree of concordance to Perinatal Institute guideline assessed as follows:

Low: partial or no inclusion of Perinatal Institute’s (PI) recommendations throughout the guidelines, affecting over half of the recommendations.

Medium: Moderately concordant with partial or no inclusion of PI’s recommendations in less than half of the recommendations

High: Very concordant with only occasional differences where PI’s recommendations were partially included

Local clinical guidelines on screening for foetal growth anomalies

Proportion of women correctly risk stratified (according to GAP)

Review of the maternity records of 600 women who gave birth during the trial period (40 from each of December 2018, January and February 2019 in each cluster)

Reach

Steckler and Linnan (2002) [28]

Proportion of women with a GAP-GROW chart in the notes

Maternity records review (see above)

Dose delivered and received

Steckler and Linnan (2002) [28]

Proportion of low-risk women* who had at least the minimum expected fundal height measurements performed and plotted on the chart

Maternity records review (see above)

Proportion of low-risk women* referred for growth scan when indicated

Proportion of high-risk women* who had at least the minimum expected growth scans performed and plotted on the chart

Implementation strength

Schellenberg et al. (2021) [30]

Acceptability

Proctor et al. (2011) [31]

Acceptability of GAP implementation from the perspectives of clinicians

Semi-structured interviews with lead clinicians and frontline staff

Feasibility

Proctor et al. (2011) [31]

The degree to which GAP implementation is feasible, from the perspectives of interview participants