Table 3.

Summary of reach, effectiveness, adoption, implementation and maintenance framework criteria

Reach (participant representativeness)	The representativeness of individuals enrolled in the study to the characteristics of the intended population. 1=Limited generalisability: highly selected subsample that is not typical of the intended population, high number of exclusionary criteria, and/or a recruitment strategy that is likely to result in a biassed sample. 2=Moderately generalisable: participants match intended population on key characteristics (eg, sex/gender, diagnosis, age), but are still a selected subsample due to exclusion criteria and recruitment strategies. 3=Generalisable: participants are typical of the intended population, limited or no exclusion criteria and/or recruitment strategies is not selective and are unlikely to result in a biassed sample.
Effectiveness (outcome representativeness)	Measured outcomes are important and meaningful to all stakeholders involved, including potential negative effects, quality of life and economic outcomes. 1=Limited generalisability: primary outcomes restricted to an estimate of the overall effect of the intervention on a single metric of health, limited attention to process outcomes, quality of life, patient and staff satisfaction, patient engagement, unintended harms, or functional rehabilitation. 2=Moderate generalisability: primary outcomes focus on overall effect of intervention on health, some inclusion of measures that are meaningful to stakeholders or process outcomes. 3=Generalisable outcomes: primary outcomes include mix of impact of intervention on health and outcomes that are meaningful to patients and other stakeholders (including qualitative evaluations), explicit discussion around prevention of harms to participants, process outcomes, patient engagement, acceptability and satisfaction.
Adoption (setting representativeness)	The representativeness of settings and the individuals within those settings who deliver the programme. 1=Limited generalisability: highly selected settings and staff and/or only includes ‘best’ sites and staff, that is, well-resourced, credentialed or seasoned interventionists, many exclusion criteria; or limited information to determine context of study or intervention. 2=Moderate generalisability: intervention tested in contexts outside of ‘best’ sites and staff, but adoption is still limited to selected settings that are well resourced with some expertise in intervention trials. 3=Generalisable: sites and staff are randomly selected, few or no exclusion criteria and/or trialled in diverse settings.
Implementation (fidelity/adaptation, and cost/feasibility)	Fidelity to the intervention and adaptations made to intervention during study/programme. 1=Limited information on the implementation: no details on adaptation to local context, no details related to core element of interventions, or an evaluation of the consistency of implementation across settings staff, and patients. 2=Moderate reporting of fidelity/adaptations: core elements described but details missing, or fidelity was monitored but no details on measurement tools. 3=Detailed report of modifications made, adaptations to local context, and rationale for modification, an outline of core elements and evaluation of the fidelity to core elements of the model.
	The cost of the intervention in terms of time and money. 1=No details on time, cost and resources, no efforts to contain costs, and use of state-of-the-art resources and procedures such that costs of intervention are likely to be high. 2=Details on time, cost and resources is still limited but more than for a rating of 1. The intervention has minimal impact on time, cost and resources. 3=Explicit efforts to contain costs and to make the intervention feasible in low resource settings.
Maintenance (sustainment)	The extent to which an intervention becomes institutionalised or part of the routine organisational practices and policies and the extent to which behaviour is sustained for more than 6 months. 1=Limited sustainability efforts or details of such efforts: no report of efforts to continue an intervention after the completion of study, or no reports of continued use. 2=Moderate sustainment: limited discussion regarding the sustainability of an intervention, some evidence of continued use. 3=Sustainment: long-term outcomes reported, explicit plans for handing off intervention to setting/sites, details of methods to encourage sustainable implementation or embedding within routine organisational practices and policies or evidence of sustained use for 6 months or more.