Table 1.

Description of the multi-faceted implementation strategy

Intervention	Actor	Action	Action target	Temporalitya	Dose	Implementation outcome targetedb	Justification
Introductory seminar	Intervention developer	The IMR programme was introduced with introductory video and PowerPoint presentation	Motivate clinicians and organizations to prepare for implementation in organizations	Preparation	One-day seminar	Adoption	Rogers [22] Knowledge as the first step to change
Initiate leadership	External implementation team	The external team had individual meetings with leaders to discuss the implementation process and the research project	Service leaders initiate change in organization to facilitate quality improvement	Preparation	One meeting per service	Feasibility fidelity	Innovative, supportive leaders as important for successful implementation [23]
Coordinator recruitment	Service leader	Leaders were asked to choose a coordinator among staff to advocate for the programme	To have coordinators advocate for or champion the implementation of IMR	Preparation		Feasibility fidelity	Champions as a driving force behind implementation [24]
Distribute educational materials	External implementation team	Distribution of the IMR manual [6] to support clinical care	To increase clinicians’ knowledge and skills of intervention	Implementation		Fidelity	Educational materials better than no materials [25]
Ongoing training	IMR trainer	To teach clinicians about the IMR in an ongoing way	To increase clinicians’ knowledge and skills of intervention	Implementation	Four days of training + two booster sessions	Fidelity	Ongoing training better than single one-time strategies [26, 27]
Clinical consultations	IMR trainer	Answer questions, review case implementation, make suggestions, and provide encouragement	To increase clinicians’ knowledge and skills to use the innovation	Implementation	20 min per week in group by phone for 9 months, then biweekly for 5 months	Fidelity	Post-training consultations more important than quality of/type of training [28]
Audit and feedback in consultations	IMR trainer	IMR trainer rated audiotaped sessions and gave verbal and written feedback	Clinicians’ understanding and ability to break down the intervention into more doable steps	Implementation	First session in every module audiotaped and rated	Fidelity Feasibility	a&f leads to improvements in professional practice [29]
Process monitoring and feedback	External implementation team	Implementation process was assessed after 6 and 12 months and verbal and written feedback was given	To improve the quality of the programme delivery, to prevent drift and maximize effectiveness	Implementation	After six and 12 months of implementation	Fidelity Feasibility	Monitoring can prevent drift and maximize effectiveness [30]
Outcome monitoring	Clinicians	Consumer outcomes (IMRS) were assessed at the end of every module. Clinicians were encouraged to evaluate the outcomes continuously	To improve the quality of the programme delivery, to prevent drift and maximize effectiveness	Implementation	After each module	Fidelity feasibility	Monitoring can prevent drift and maximize effectiveness [30]

^aTemporality: Based on McGovern et al.’s [19] three stages; preparation, implementation, and maintenance

^bImplementation outcome targeted: Based on outcomes presented in Proctor et al.’s [4] paper