Table 3.

Implementation Outcomes Measurement

Implementation Outcomes	Measurement
Appropriateness	Appropriateness (perceived fit) of the intervention components and the implementation strategies was based on the perception of stakeholders as represented by the advisory group.
Acceptability	Acceptability was assessed formatively through advisory group meetings over the course of the design, implementation, and operation of the main components of the innovation.
Adoption	Adoption was measured by the number of ALCs ever and currently actively enrolled, and the proportion of eligible potential adopters that they represent. Membership in one of the 4 assisted living associations’ quality improvement programs is the main eligibility requirement.
Feasibility	Feasibility (actual fit) was measured by the number of enrolled ALCs that were able to complete at least 1 quarterly quality assessment or administer the annual resident survey at least once.
Fidelity	Fidelity of implementation of the intervention was informed by ALC membership rules that were designed and approved by the advisory group in 2015. Fidelity was assessed in terms of the proportions of member ALCs meeting or exceeding the membership requirements.
Penetration	Penetration was defined in 2 ways, institutionally and demographically. Institutionally, it was defined in terms of the integration of the model into existing structures and systems. Demographically, it was defined in terms of the proportion of eligible residents reached.
Sustainability	Sustainability was defined by continued ALC participation in, and further expansion of, the system and coalition. It was measured by the number of ALCs enrolled or completed quality assessment for more than a certain number of quarters.