Table 2.

Description of the implementation outcomes

Outcome	Detailed description of the outcome	Data type, source and analysis
Acceptability of the interventions and evaluation*	The acceptability of the ePROM interventions and evaluation by families of children with health conditions and treating clinicians including content, complexity, delivery and relative advantage38 and reflecting and evaluating (including the ability to meet needs of people who have difficulty speaking or understanding written English in the future).* ≥80% of families will take <15 min to complete the ePROMs as previous research has identified that PROMs that are fast to complete are most acceptable to clinicians and families.46 ≥50% of families will complete ePROMs across all scheduled consultations that were eligible to be included in the study, where consultations eligible to be included were limited to one consultation over any 1-month period. Based on preintervention phase interviews and field notes of what was considered acceptable for ongoing implementation of the PROMs routinely in clinical practice in the study clinics and evidence indicating completion rates of 75% were achieved for system-wide implementation of PROMs at a Canadian children’s hospital.47 Phone or text reminders for PROM completion were required in ≤50% of families. This outcome was based on feedback from clinicians in the pre-implementation phase indicating that phone call reminders for this type of intervention are a burden to clinicians and may impact uptake by clinicians. Technology-related issues with graphical displays of result summaries or ePROM completion were present for ≤10% of families across all eligible appointments. ≥75% of participants eligible to have ePROM data provided to treating clinicians had intervention ePROMs and graphical displays filed in electronic medical records.	Quantitative: electronic study data and administrative data; descriptive analysis. Qualitative: interview and field note data; thematic analysis including mapping to CFIR innovation constructs (eg, relative advantage, adaptability, complexity, cost in the pre-implementation and implementation stages; and reflecting and evaluating, design quality and packaging, compatibility, and relative priority in the implementation phase).
Sustainability of ePROM interventions and evaluation	The extent to which the ePROM intervention (or a modification of the intervention) was continued or planned to be continued in routine clinical practice at the end of the study, and barriers and facilitators of sustained use.	Qualitative: interviews with child, parent and health professional participants and field notes; analysed using thematic analysis and mapping to CFIR (eg, knowledge and beliefs about the intervention, design quality and packaging, needs and resources).
Cost	The cost of implementing the intervention for patients in the intervention and control groups based on resource use from the perspective of the health service. Data for healthcare resource utilisation for cointerventions for skin treatment (eg, medicines, complementary treatments), and details of hospital presentations, will be included.	Qualitative: interview data relating to cost. Quantitative: study and administrative data, medical records, hospital clinical costings department data.
Fidelity	The extent to which the interventions were delivered and received as intended. Dose of the intervention: child and parent verbal report of the topics on the graphical displays of ePROM results that were discussed during the consultation in the intervention group, immediately after the consultation. Dose of the intervention: percentage of eligible consultations for each participant where ePROM data was completed in advance of the consultation as scheduled. The number (percentage) of participants randomised to receive graphical displays of result summaries vs the number of participants who actually had graphical displays of result summaries delivered to consultations. Amount and type of missing intervention-related ePROM data on Qualtrics.26	Qualitative: verbal fidelity reports and interviews with children and parents, and interviews with health professional participants and field notes. Quantitative: study data, descriptive analysis.
Contextual factors	Barriers and facilitators to multi-level implementation of the intervention and the evaluation; at the individual level, clinic level, hospital level and outside the hospital setting.	Qualitative: interviews with child, parent and health professional participants; and field notes analysed using thematic analysis and mapping to CFIR (eg, culture, networks and communication, implementation cost).

*Children ≥8 years will self-report; parents will provide proxy-reports for children aged <8 years except for satisfaction with treatment which will only be self-reported by parents.

CFIR, Consolidated Framework for Implementation Research; ePROMs, electronic PROMs; PROMs, patient-reported outcome measures.