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Table 2 Specification overview of the multifaceted Addiction Technology Transfer Center (ATTC) strategy

From: Testing the implementation and sustainment facilitation (ISF) strategy as an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy: study protocol for a cluster randomized trial

Discrete implementation strategies
Defining characteristic according to Proctor et al. [41]
Operational definition of key dimensions for each discrete implementation strategy
Actor(s) Actions(s) Target(s) of the action Temporality Dose Targeted implementation outcome(s) Justification
A. Centralized technical assistance:
Develop and use a system to deliver technical assistance focused on implementation issues
Regional ATTC (e.g., Mid-America, Northwest, Northeast) The overarching discrete implementation strategy that encompasses the other discrete implementation strategies listed below 2 BI staff per ASO The initial kickoff meeting should be within 1 month of completing the exploration phase See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness [36, 42,43,44]
B. Develop educational materials:
Develop and format guidelines, manuals, toolkits, and other supporting materials in ways that make it easier for stakeholders to learn about the innovation and for clinicians to learn how to deliver the clinical innovation
Regional ATTC The Motivational Interviewing-Based Brief Intervention (MIBI) protocol manual, which provides information and knowledge about how the MIBI is intended to be implemented 2 BI staff per ASO Finalization of educational materials (e.g., MIBI protocol manual) should be prior to the initial kickoff meeting See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness [45, 46]
C. Develop and organize quality monitoring system:
Develop and organize systems and procedures that monitor clinical processes and/or outcomes for quality assurance and improvement
Regional ATTC A Web-based system (sat2hivproject.org), that enables secure and efficient sharing of data relevant to the evidence-based practice (EBP) preparation and implementation process 2 BI staff per ASO Finalization of quality monitoring systems (i.e., sat2hivproject.org) should be prior to the initial kickoff meeting See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [49,50,51]
D. Develop tools for quality monitoring:
Develop, test, and introduce quality-monitoring tools with inputs (e.g., measures) specific to the innovation being implemented
Regional ATTC The Independent Tape Rater Scale (ITRS), which enables reliable and valid rating of the extent to which BI staff deliver the EBP with fidelity 2 BI staff per ASO Finalization of tools for quality monitoring (i.e., ITRS) should be prior to the initial kickoff meeting See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [26, 52, 53]
E. Distribute educational materials:
Distribute educational materials (e.g., manuals) in person, by mail, and/or electronically.
Regional ATTC Distribute professionally printed copies of the MIBI protocol manual to each BI staff 2 BI staff per ASO Distribute at the workshop training  See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [45, 46, 54]
F. Conduct educational meetings:
Hold meetings targeted toward providers, administrators, other organizational stakeholders, and community, patient or consumer, and family stakeholders to teach them about the clinical innovation
Regional ATTC In-person and Web-based meetings that enable direct interaction between the actors (ATTC) and targeted users of the EBP (BI staff) 2 BI staff per ASO Educational meetings should begin at least 3 months before the implementation phase begins See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [30, 36, 55, 61]
G. Make training dynamic:
Vary the information delivery methods to cater to different learning styles and work contexts and shape the training in the innovation to be interactive
Regional ATTC Incorporate standardized role plays that enable EBP trainees (BI staff) to practice with each other and that facilitate understanding of the EBP from both staff and client perspectives 2 BI staff per ASO Should begin during the first contact See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [55, 56, 101, 102]
H. Audit and provide feedback:
Collect and summarize clinical performance data over a specified period, and give data to clinicians and administrators in the hopes of changing provider behavior.
Regional ATTC Generate and email standardized feedback reports to EBP trainees (BI staff) using the standardized quality monitoring tool (ITRS) 2 BI staff per ASO Should begin approximately 1–2 weeks following the end of the
in-person educational training workshop
See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [30, 57,58,59,60]
I. Provide ongoing consultation:
Provide clinicians with continued consultation with an expert in the clinical innovation
Regional ATTC Phone-based individualized meetings that enable direct contact between the actor (ATTC trainer) and one EBP trainee (BI staff) 2 BI staff per ASO Should begin approximately 1–2 weeks following the end of the
in-person educational training workshop
See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [30, 36, 61]
J. Create a learning collaborative:
Develop and use groups of providers or provider organizations that will implement the clinical innovation and develop ways to learn from one another to foster better implementation
Regional ATTC Web-based group meetings that enable direct contact between the actor (ATTC trainer) and a group (10–14 targeted users of the EBP, BI staff), who can share lessons learned 2 BI staff per ASO Should begin approximately 3–4 weeks after the implementation phase begins See Tables 4, 5 and 6 Fidelity (i.e., proficiency and implementation effectiveness) [63,64,65]