Figure 1. CONSORT Stepped-Wedge Allocation of Trial Subjects.

For clinics under the control condition, intervention indicates the intervention text was mistakenly included in the image report. For clinics under the intervention condition, intervention indicates that the intervention text was successfully included in the image report and no intervention indicates that the intervention text was not included.

^aTwo small clinics randomized to groups 2 and 5 were dropped before the first data submission because of clinic closure and are not included in the clinic counts.

^bBy pretrial design, for 1 clinic, step 0 extended through May 2014, and step 1 began June 1, 2014.