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Table 4 Implementation research outcome framework

From: Implementation outcomes of cognitive behavioural therapy delivered by non-specialists for common mental disorders and substance-use disorders in low- and middle-income countries: a systematic review

Implementation outcome

Definition (Proctor et al. 2011)

Example from included studies

Acceptability

The perception of stakeholders that the intervention is agreeable or satisfactory

Peers seen as acceptable providers for the ‘Thinking Healthy Programme’ by service users due to their similar experience and interpersonal skills (Atif 2016)

Adoption

The process of putting an intervention to use

Adoption was facilitated by perceived usefulness of ‘Problem Management Plus’ to service users, providers and the community (Khan 2017)

Appropriateness

The fit, relevance or compatibility of the intervention for the setting, service provider or service user

CBT components were appropriate as part of the ‘Common Elements Treatment Approach’ as they reflected cultural practices among the Burmese refugees receiving the intervention (Bolton 2014)

Feasibility

The extent to which an intervention can be successfully carried out

The “highly structured format” of CBT was found to make it feasible for delivery by paraprofessionals (Papas 2010)

Fidelity

The extent to which the intervention was implemented according to its original design

Motivated, well-trained lay health workers followed the manual more closely to deliver the intervention as intended

(Munodawafa 2017)

Implementation cost

The overall cost of delivery of an intervention

An economic assessment suggests that ‘Counselling for Alcohol Problems’ is likely to be cost-effective in terms of recovery from alcohol-use disorders (Nadkarni 2017)

Penetration

The integration of the intervention into a routine service or a measure of how many those eligible are receiving it

‘The Friendship Bench’ has provided care to 7000 individuals between 2006 and 2011 (Chibanda 2017)

Sustainability

The maintenance of an intervention and its continued use

The lay health workers have continued to deliver the intervention following the completion on the randomised trial (Chibanda 2017)