Table 1.

Qualitative methods, processes, rationales, and objectives.

Qualitative method, process	Rationale for use	Objectives
Document analysis (100+ documents). Photocopies of policies, protocols, training materials, etc. scanned into database using Optical Character Recognition (OCR)	•Understand development, implementation, and prioritization of CRC screening •Characterize organizational culture, structure, and formal protocols of the CRC screening process, including guideline dissemination and training of care teams	•Identify information that may not be recorded in or easily retrieved from HER •Catalog CRC screening-related policies and protocols •Inform chronology of CRC screening policy implementation •Identify information that may be disseminated systematically (e.g. via email vs. word of mouth)
Participant observation (90+ hours). Detailed descriptive field notes transcribed and entered into database	•Describe organizational structure, a broad range of clinical and non-clinical care behaviors as they relate to organizational protocols for CRC screening processes •Evaluate functionality of the system for referring patients with abnormal screening tests	•Inform flowcharts that depict team members' roles, responsibilities, relationships, and behaviors across range of CRC screening steps and interfaces •Validate extent to which protocols are understood and adhered to, and observe ‘work-arounds’ (deviations)
Semi-structured interviews (n = 41). Audio recordings of interviews and post-interview audio notes by interviewers transcribed and entered into database	•Clarify observations; assess organizational values, beliefs, and norms •Elucidate decision-making pathways for CRC screening processes at the network- and clinic levels •Assess perceptions of organizational protocols and practices (e.g. are they compatible with serving safety-net patients?)	•Solicit feedback about whether protocols are realistic and effective for optimizing CRC outcomes •Solicit feedback about the value of EHR as a barrier and/or facilitator to CRC screening based on experience in practice •Demonstrate degree of concordance between observed behaviors and participants' verbalized understanding of roles and responsibilities •Clarify processes not easily understood during participant-observation (e.g., values, beliefs)