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Table 1 Description of the multi-faceted implementation strategy

From: How to implement Illness Management and Recovery (IMR) in mental health service settings: evaluation of the implementation strategy

Intervention Actor Action Action target Temporalitya Dose Implementation outcome targetedb Justification
Introductory seminar Intervention developer The IMR programme was introduced with introductory video and PowerPoint presentation Motivate clinicians and organizations to prepare for implementation in organizations Preparation One-day seminar Adoption Rogers [22] Knowledge as the first step to change
Initiate leadership External implementation team The external team had individual meetings with leaders to discuss the implementation process and the research project Service leaders initiate change in organization to facilitate quality improvement Preparation One meeting per service Feasibility fidelity Innovative, supportive leaders as important for successful implementation [23]
Coordinator recruitment Service leader Leaders were asked to choose a coordinator among staff to advocate for the programme To have coordinators advocate for or champion the implementation of IMR Preparation   Feasibility fidelity Champions as a driving force behind implementation [24]
Distribute educational materials External implementation team Distribution of the IMR manual [6] to support clinical care To increase clinicians’ knowledge and skills of intervention Implementation   Fidelity Educational materials better than no materials [25]
Ongoing training IMR trainer To teach clinicians about the IMR in an ongoing way To increase clinicians’ knowledge and skills of intervention Implementation Four days of training + two booster sessions Fidelity Ongoing training better than single one-time strategies [26, 27]
Clinical consultations IMR trainer Answer questions, review case implementation, make suggestions, and provide encouragement To increase clinicians’ knowledge and skills to use the innovation Implementation 20 min per week in group by phone for 9 months, then biweekly for 5 months Fidelity Post-training consultations more important than quality of/type of training [28]
Audit and feedback in consultations IMR trainer IMR trainer rated audiotaped sessions and gave verbal and written feedback Clinicians’ understanding and ability to break down the intervention into more doable steps Implementation First session in every module audiotaped and rated Fidelity Feasibility a&f leads to improvements in professional practice [29]
Process monitoring and feedback External implementation team Implementation process was assessed after 6 and 12 months and verbal and written feedback was given To improve the quality of the programme delivery, to prevent drift and maximize effectiveness Implementation After six and 12 months of implementation Fidelity Feasibility Monitoring can prevent drift and maximize effectiveness [30]
Outcome monitoring Clinicians Consumer outcomes (IMRS) were assessed at the end of every module. Clinicians were encouraged to evaluate the outcomes continuously To improve the quality of the programme delivery, to prevent drift and maximize effectiveness Implementation After each module Fidelity feasibility Monitoring can prevent drift and maximize effectiveness [30]
  1. aTemporality: Based on McGovern et al.’s [19] three stages; preparation, implementation, and maintenance
  2. bImplementation outcome targeted: Based on outcomes presented in Proctor et al.’s [4] paper