Figure 3.

Framework of the first- and second-order process evaluation. Sampling quality: description of recruitment and randomization procedures and attendance rate of the training sessions. Intervention quality: indicators for feasibility and relevance of the care program and measurement of the use of the separate steps in the care program. Implementation knowledge: description of the number of implementation components provided and received and a description of the factors that (could) have influenced implementation. If first-order process data confirm the validity of the study (1), effect and cost-effectiveness analysis may be used (2) together with implementation knowledge (3), for further implementation or improvement of the care program. If validity is limited, implementation knowledge might be used to improve the care program (X). Adapted from Leontjevas and colleagues [6] RCT, randomized controlled trial.