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Table 3 Illustrations of implementation strategy measures for use in feasibility and pilot implementation studiesa [15, 17, 44, 46, 60, 62, 65, 68, 70,71,72]

From: Guidance for conducting feasibility and pilot studies for implementation trials

Purpose Measures Examples of potential implementation feasibility and pilot study measures (including as part of Hybrid Type 1 trials) Examples of potential implementation pilot trial measures (including as part of Hybrid Type 2 trials)
To assess potential implementation strategy effects Adoption: the proportion and representativeness of settings and staff that adopt the innovation [60] Assessment of implementation strategy effects are not typically part of non-pilot feasibility or Type 1 Hybrid trials b Percent and type of service providers utilising the intervention
Percent and type of support system teams/ staff members undertaking the implementation strategies [60]
Fidelity (adherence): the degree to which the innovation is implemented as intended by developers [70] Measures such as content, frequency, duration, and coverage as prescribed by its designers [70].
Number and type of adaptations made to implementation strategies including information on how and why [68].
Reach (penetration)
Participation rate in the innovation by the intended audience [62]
The proportion of support systems staffs’ participation in the delivery of the implementation strategy [46].
Sustainability (maintenance): continuation or maintenance of the innovation’s desired changes [62] Uptake of implementation strategies by support systems continued at a specified time(s) post the initial intervention [15].
To inform the design or development of the implementation strategy (determinants) Adaptability: the degree to which the innovation can be adapted to meet local needs [65] Organisations’ view of the flexibility required for future implementation strategies. To what extent did support systems find they could tailor or adapt implementation strategies (whilst maintaining core components) [46]
Acceptability: Service providers or support system’s satisfaction with the innovation [62] If service providers and / or support systems approve of proposed future implementation strategies (such as content or proposed delivery) If service providers or support systems found the implementation components agreeable, for example in terms of content or delivery [46, 62]
Feasibility: actual fit or suitability of the innovation for everyday use [62] If service providers and/ or support systems staff agree with the suitability of proposed future implementation strategies If service providers and support systems staff agree that the implementation strategies were able to be successfully undertaken [46].
Compatibility (appropriateness): perceived fit of the innovation with organisation’s values, mission, priorities [71] If support systems agree that any future proposed implementation strategy is in line with organisational priorities If support systems agree that the implementation strategies are in line with organisational priorities [46].
Dose (satisfaction)
Satisfaction with the dose of the innovation received [72]
Implementation strategies typically not delivered in non-pilot feasibility or Hybrid Type 1 trials If support systems are satisfied with the amount of support and resources received as part of implementation strategies [46].
Complexity
Perception of difficulty of implementation/ number of components of the innovation [65]
If service providers or support systems perceive difficulty carrying out proposed future implementation strategies For example, due to duration, scope, intricacy and disruptiveness. If support systems found the implementation strategies difficult to undertake. For example, due to duration, scope, intricacy and disruptiveness [65].
Context
Political, economic or social influences on implementation of the innovation [46]
If any organisational political, economic or social factors would influence the uptake of future implementation strategies. If any organisational political, economic or social factors did influence the uptake of implementation strategies [46].
Culture
Organisational norms, values or basic assumptions influencing implementation of the innovation [65]
If setting or organisational values, norms and assumptions influence may influence the uptake of future implementation strategies. For example, work structures and behaviours. If setting or organisational values, norms influenced the uptake of the implementation strategies For example, work structures and behaviours [65].
Self-efficacy
Self-belief in the ability to execute goals of the innovation [46]
If support systems staff believe in their capacity (e.g. knowledge and skills) to complete any future implementation strategies If support systems staff agree they had the capacity (e.g. knowledge and skills) to undertake implementation strategies [46].
Cost
Measures of the cost or relative cost of implementation of the innovation [62]
Collection of data to help project cost of future implementation. Cost to deliver the innovation [62].
To assess feasibility of trial methods Feasibility of future trial design to conduct a full trial [17] If the organisation and/or support systems perceive proposed future implementation trial design components to be feasible
For example, feasibility of proposed recruitment methods, acceptability of data collection procedures and tools etc.
If the pilot trial design and methods are feasible to replicate as part of a larger implementation trial.
For example, the feasibility of recruitment methods, site and participant retention, implementation data collection procedures and tools etc. [17, 44]
  1. aTable populated based on measures and terminology reported in McKay et al. [46]
  2. bThese factors could be assessed in evidence-based interventions in Hybrid Type 1 trials
  3. Service providers: clinicians, primary health care providers, or other providers of health-related programs who deliver the evidence-based intervention [46]
  4. Support systems: the resource team at the organisational or settings level who support or deliver implementation strategies [46]
  5. Innovation: refers to the intervention in its entirety and is used to encompass the inclusion of measures specific to the delivery of implementation content and, if applicable, the delivery of the intervention as would be the case in hybrid trial designs