Table 2.

Implementation framework elements guide process evaluation questions and tools

Element	Questions	Data sources	Tools
RE-AIM
Reach	What percentage of patients approached agree to participate in the intervention?	Recruitment rates.	Patient screening database.
	Do those that agree to participate differ systematically from those that do not?	Demographics of those agreeing vs. those refusing participation.	Chart review of administrative data.
	What do patients like and dislike about the intervention?	Perceptions of patients.	Post-intervention patient surveys.
Effectivenessa	What is the effect of the intervention on patient outcomes?	Main study outcomes comparing control to intervention patients.	Rates of negative urine screens.
			Study retention.
Adoption	What are the greatest barriers to adopting the intervention?	Perceptions of staff and leadership.	Research team observational log.
			Post-intervention staff interviews.
	What supports will need to be in place for clinics to adopt the intervention?		Post-intervention leadership interviews.
Implementation	What supports need to be in place to ensure consistent delivery of the intervention?	Perceptions of staff and leadership.	Post-intervention staff interviews.
			Post-intervention leadership interviews.
	What tools will be needed to deliver the intervention consistently?	Perceptions of research staff	Training protocols for research staff.
	What does the intervention cost?	Cost data.	Records of incentives awarded, costs of intervention supplies and staff time required.
Maintenance	What resources will be needed to maintain the intervention in the long run?	Perceptions of leadership.	Research team observational log.
			Post-intervention leadership interviews.
	What adaptations will need to be made to integrate the intervention into regular practice?
PARIHS
Evidence	What are staff perceptions of the evidence supporting the intervention?	Perceptions of staff and leadership.	Organizational Readiness to Change Assessment (ORCA) Evidence Scales
	What are their attitudes toward the intervention?
	Does the intervention fit with their current clinical practice?
	Does the intervention meet a perceived need of their patients?
Context	What are the characteristics of the culture in the clinic?	Organizational readiness measure collected from staff and leadership.	Organizational Readiness to Change Assessment (ORCA) Context Scales
	What are the characteristics of the leadership of the clinic?
	What resources are available to the clinic?

^aEffectiveness outcomes are reported elsewhere [19].