Table 4.

Implementation fidelity checkpoint documentation for the PharmNet study through day 22.

Timeframe	Outcome
Day 10—Calls to all intervention pharmacies	Pharmacy 1: The pharmacist who answered the phone reported that they were not the usual pharmacist and only work 1 day a week, but that the pharmacy did have the yard signs and the no-cost naloxone. However, they reported that the yard signs were not placed outside the store. They also indicated that the managing pharmacist was on leave and that they recommend calling when they returned the following week to follow-up about the yard signs. Pharmacy 2: The pharmacist reported they were not the usual pharmacist and only work at the pharmacy 2 times a month, and that the regular pharmacist who works at that store would be back the following week. They did not know about PharmNet nor about the no-cost naloxone, yard signs, or harm reduction referral sheets. Pharmacy 3: LAE spoke with the same pharmacist as previously (the startup verification). The pharmacist reported that they did not think they had received PharmNet supplies, but that they were ready to start the intervention as soon as they received the supplies. Pharmacy 4: We spoke with the same pharmacist as previously (the startup verification). The pharmacist reported that they did not think they had received PharmNet supplies.
Day 14—Attempt to coordinate with the pharmacies	LAE attempted to reach the managing pharmacist at 2 separate pharmacies. A pharmacy technician called an additional 5 pharmacies but was unable to locate them. We left a voicemail at their office. We later learned that they were on leave during this period.
Days 16, 17, and 21—Follow-up calls, after which we learned about illnesses or leaves among the pharmacists	We called the original pilot pharmacy attempting to contact the leadership team. LAE left a voicemail and sent them an email on each of the 3 days.
Day 22—Calls to all intervention pharmacies	LAE learned that the managing pharmacist had returned to the office, but they were in a meeting when we called. A pharmacy technician took a message. Calls were also made to each of the pharmacies in the intervention arm. Pharmacy 1: When LAE called and requested to speak to a pharmacist, the pharmacy technician transferred her to the original pilot pharmacy location (which was not part of the study). LAE spoke with a pharmacist at this location, and this pharmacist reported they were unaware of the status of PharmNet at pharmacy 1 as they never worked at that site. They transferred the researcher back to pharmacy 1, where the pharmacy technician forwarded the researcher to voicemail. LAE left a message. Pharmacy 2: We spoke with a pharmacist who confirmed that the supplies had been received and that the intervention had begun. Pharmacy 3: The pharmacist reported that they still were not aware of having received the PharmNet supplies. Pharmacy 4: The pharmacist reported that they still had not received the PharmNet supplies. The pharmacist reported they had reached out to their leadership about the supplies and were informed that their supplies were located at pharmacy 1 and would be delivered after Thanksgiving.