Table 1.

Implementation outcomes, definitions, strategies for maximising implementation outcomes, frameworks used and measurement items

Implementation outcome	Strategies used to maximise implementation outcomes	Frameworks used	Data collection instruments, timing, participants
Adoption/uptake (intention or action to try to employ MOHMQuit)	Warm-up and follow-up meetings Community of practice	Proctor29 RE-AIM31 (adoption)	Attendance at warm-up and follow-up meetings 3 months post training—questionnaire with leaders 6 months post training—questionnaire with clinicians 6 months post training—interview with leaders Community of practice peer support meetings attendance
Fidelity (delivered as intended in the Protocol,23 adherence)	Warm-up and follow-up meetings Consistency in the team delivering MOHMQuit training at each site in the first instance Clear plans and materials for content of training	Proctor29 RE-AIM31 (implementation)	Attendance at warm-up and follow-up meetings Training logs of expected and actual attendance at training of leaders and clinicians Fidelity record (which aspects of the planned training were actually delivered) 6 months post training—interview with leaders
Penetration (degree of integration of MOHMQuit practices within the service)	Involving leaders in the training for clinicians for a whole-of-service approach MOHMQuit leadership components include repeated audit and feedback plus action planning; developing and implementing a clinical pathway for SCS; and the development and maintenance of SCS ‘champions’ within each service Train-the-trainer model an integral part of the intervention	Proctor29 RE-AIM31 (adoption)	3 months post training—questionnaire with leaders 6 months post training—interview with leaders
Reach (did MOHMQuit include everyone that it aimed to?)	10-week warm-up meetings to allow time for planning and rostering The train-the-trainer model as an integral part of the intervention to support participation of all relevant existing and new staff	RE-AIM35	Training logs of expected and actual attendance at training of leaders and clinicians recorded at the time of training 3 months post training—questionnaire with leaders 6 months post training—interview with leaders
Sustainability (factors promoting ongoing use of MOHMQuit)	MOHMQuit leadership components include repeated audit and feedback plus action planning; developing and implementing a clinical pathway for SCS; and development and maintenance of SCS ‘champions’ within each service Train-the-trainer model an integral part of the intervention The Community of practice	Proctor29 RE-AIM31 (maintenance) Rogers37	6 months post training—questionnaire with clinicians 6 months post training—interview with leaders Community of practice peer support attendance data
Acceptability (how palatable is MOHMQuit to clinicians and leaders?)	Comprehensive systematic design of MOHMQuit using the Behaviour Change Wheel with input from clinicians and leaders21 22 Feasibility and acceptability trial with subsequent minor amendments to the intervention21 10-week warm-up includes the history of MOHMQuit so leaders are reassured about its quality, relevance and acceptability	Proctor29 Sekhon36	Immediately post training—questionnaire with clinicians 3 months post training—questionnaire with leaders 6 months post training—questionnaire with clinicians 6 months post training—interview with leaders
Appropriateness (perceived fit or relevance of MOHMQuit with the service)	Comprehensive and systematic design of MOHMQuit using the Behaviour Change Wheel integrating input from clinicians and leaders21 22 Feasibility and acceptability trial with subsequent minor amendments to the intervention21 10-week warm-up includes the history of MOHMQuit so leaders are reassured about its quality, relevance and acceptability	Proctor29 Rogers37	6 months post training—interview with leaders
Feasibility (actual fit—the extent to which MOHMQuit can be integrated into usual care in a service)	Comprehensive and systematic design of MOHMQuit using the Behaviour Change Wheel integrating input from clinicians and leaders21 22 Feasibility and acceptability trial with subsequent minor amendments to the intervention21 10-week warm-up includes the history of MOHMQuit so leaders are reassured about its quality, relevance and acceptability	Proctor29 Rogers37	3 months post training—questionnaire with leaders 6 months post training—interview with leaders
HOW behaviour was changed		Moore35	6 months post training—interview with leaders
HOW context affected implementation	Commitment of maternity service leaders in the research as Partner Investigators and members of MOHMQuit Steering Committee and various working groups Warm-up meetings and follow-up meetings Community of practice	Fernandez38	Key contextual information (box 1) completed by research team during the implementation 3 months post training—questionnaire with leaders 6 months post training—questionnaire with clinicians 6 months post training—interview with leaders

Bold typeface indicates outcomes that will be the focus of the process evaluation.

Implementation cost is not included in table 1 as a detailed economic evaluation of MOHMQuit is taking place and is the subject of a separate paper.²⁸ Data to contribute to the economic evaluation will be collected as part of the semistructured interview with leaders.

MOHMQuit, Midwives and Obstetricians Helping Mothers to Quit smoking; RE-AIM, Reach, Efficacy, Adoption, Implementation, Maintenance; SCS, smoking cessation support.