Table 3.

Implementation strategy component, based on barriers and facilitators from our pilot work with target patient population and clinics

Component	Barriers (B) and facilitators (F) from pilot study addressed through implementation strategy
Standardized capacity-building activities
Education, training, technical assistance	Training staff on iPad and DA use (F); keeping iPads charged (B); IRB concerns (B)
Clinic champion	Staff time shortage/buy-in (B); convincing multiple providers (B); change fatigue (B)
Refresher training course	Knowledge retention (F)
Tailored, clinic-targeted activities
DA reminder in patient intake process	Coordinating/training front desk staff (F); slowing clinic flow (B)
Audit and feedback	Engaging clinic staff and maintaining engagement (F); training front desk staff (F)
Team huddles/clinic meetings	Staff time shortage/buy-in (B); failure to systematically apply DA into existing processes (B)
Tailored, patient-targeted activities
Pre-visit patient portal message with DA link	Length of the DA (B); need to complete other surveys during the visit (B)
Paper-based version of the lupus DA	Too much information at once (B); patient mood, language, background, and understanding (B)
Clinic poster about the lupus DA	Understanding/interest (B)
DA information via waiting room TV/kiosk	Language/literacy/understanding/interest (B)