Table 2.
Strategies, Barriers and Facilitators Reported by Clinics
| Change category | High | Moderate | Low | None | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Clinic | 3 | 7 | 1 | 12 | 2 | 4 | 6 | 9 | 14 | 5 | 10 | 13 | 8 | 11 | 15 | 16 |
| Condition* | I | I | I | I | I | I | I | I | I | I | W | W | W | I | W | W |
| Strategies | ||||||||||||||||
| Local training team meetings | X | X | X | X | X | X | X | X | X | X | ||||||
| Training team meets with other SUD staff | X | X | X | X | X | X | X | X | X | X | ||||||
| Training team meets with other hepatitis clinic staff | X | X | X | X | X | X | X | X | X | X | ||||||
| Training team meets with facility administration | X | X | X | X | X | X | X | X | X | |||||||
| Provide in-service for SUD clinic staff | X | X | X | X | X | X | X | X | X | |||||||
| Provide in-service for hepatitis clinic staff | X | X | X | |||||||||||||
| Contact with other preceptorship participants | X | X | X | |||||||||||||
| Collaborate with additional services (e.g., lab, pharmacy) |
X | X | ||||||||||||||
| Create standardized templates for notes, consults or orders | X | X | X | |||||||||||||
| Collect baseline data to guide goal development/track progress | X | X | X | |||||||||||||
| Utilize materials provided by project (e.g., protocols, educational video) |
X | X | X | X | X | |||||||||||
| Barriers | ||||||||||||||||
| Lack of time/competing priorities | X | X | X | X | X | X | X | X | X | X | X | X | X | |||
| Not enough staff | X | X | X | X | X | X | X | X | X | |||||||
| Poor collaboration with the hepatitis clinic | X | X | X | X | X | X | X | |||||||||
| Patient issues that interfere with appropriate follow-up (e.g., homelessness, no-shows) | X | X | X | X | X | X | X | |||||||||
| SUD clinic in physically separate location from hepatitis clinic | X | X | X | X | ||||||||||||
| Technology issues that prevented use of training materials | X | X | X | |||||||||||||
| Incompatible procedures in other clinics | X | X | X | X | X | |||||||||||
| Lack of support from facility administration | X | X | X | X | ||||||||||||
| Lack of knowledge about hepatitis among SUD staff | X | X | X | |||||||||||||
| Lack of support from SUD clinic staff | X | X | X | |||||||||||||
| Budget constraints | X | X | X | |||||||||||||
| Facilitators | ||||||||||||||||
| Strong collaboration with hepatitis clinic | X | X | X | X | X | X | X | |||||||||
| Interested and knowledgeable staff | X | X | X | X | X | X | ||||||||||
| Felt supported by facility and/or VHA national administration | X | X | ||||||||||||||
| Received help from other services (e.g., lab, pharmacy) | X | X | X | X | ||||||||||||
| Gained additional staff to assist with implementation | X | X | X | X | ||||||||||||
| Coaching calls | X | |||||||||||||||
* I = Intervention, W = Wait-List