Table 5.

Simpson Transfer Model stages and corresponding activities

STM stages	Intervention components and tools	Formative evaluation
Exposure	• Secure commitment	Developmental evaluation
	• Training and observation of care model by site PIs and regional project managers	• Organizational Readiness for Change (ORC: prior to implementation)
	• Review evidence	• Key informant interviews
	• Address values
	• Identify and prioritize needs and treatment targets
	• Begin tailoring care practice protocols
	• Kick-off meeting and video conferences on treatments to be implemented
Adoption	Predisposing activities:	Developmental evaluation
	• VISN Implementation Teams	Rogers' adoption questions:
	• Product champions	• Complexity
	• Continue tailoring care practice protocols	• Relative advantage
	• Continue to secure commitment, address values	• Observability
Implementation	Enabling activities:	Progress-focused evaluation
	• Patient self- assessment informatics (PAS) with provision of data to clinicians.	• PAS tracking (ongoing)
	• Treatment-specific implementation activities, such as help with wellness groups and liaison with supported employment.	Implementation-focused evaluation
	• Discuss and start using provider supports and incentives.	• Project documents (minutes from Implementation Team meetings, project managers' field notes, quality coordinators' logs: all ongoing).
		• Provider and clinic manager interviews (mid-implementation)
Practice	Reinforcing activities (performance monitoring & feedback):	Interpretive evaluation
	• Monthly quality meeting and Quality Reports	• Provider & clinic manager interviews (post-implementation)
	• Quarterly conference calls re: treatment target implementation and use	• Computer system usability questionnaire
	• Implementation team meetings
	• Continue tailoring with provider input
	• Finalize provider supports and incentives
	• Continue tailoring with leader input
Sustainability	• Stakeholder feedback discussions	Interpretive evaluation
		• Level of Institutionalization
		• ORC