Table 1.

Implementation study activities of Meta Salud Diabetes across layers of context (40).

Method	Layer(s) of context	Description	Timeline
Health center evaluations	•Local or district •Health care setting	Staff directories, informal observation, and conversations with health center staff to evaluate interest and ability in intervention	Pre intervention
Health center stakeholder meetings	•Health care setting	Participatory meetings designed to elicit priorities of health center staff and to identify strategies and scenarios for integration of MSD	Pre and post intervention
MSD observation	•Health care setting •Local community •Patient, family, and work unit	Structured observation of 13 MSD sessions to document fidelity, as well as factors related to the participant and staff interactions, group dynamics, and how participants and staff responded to the intervention.	During intervention
MSD facilitator meetings	•Health care setting •Patient, family, and work unit	Structured discussions with facilitators from 11 centers related to MSD training needs and facilitators and barriers to implementation.	Midway and post intervention
Center case studies (4)	•Local or district •Health care setting •Patient, family, and community	Participant focus groups and health center personnel interviews designed to identify facilitators and barriers to MSD implementation and scale up as well as to sustained participant self-management.	Post intervention
Decision-maker interviews	•National, state and international •Health care setting •Patient, family, and community	Semi-structured interviews with Ministry of Health personnel and key informants from other non/governmental agencies to identify facilitators and barriers to scale up of MSD within state and federal health system	Post intervention