Table 1.

Provider-endorsed Factors Affecting Implementation of the VA CALM Program in VA CBOCs

Intervention Characteristics Attributes of VA CALM
Barriers	Amount of content to cover in each session Computerized delivery Time needed to master the materials (ie, the “learning curve”) Perceived advantage of other EBPs (especially for PTSD)
Facilitators	Patient-centered care Evidence-based treatment of anxiety disorders Broad applicability (treats multiple types of disorders) Provision of structure for therapy Behavioral theoretical orientation Computerized delivery Perceived effectiveness Perceived acceptability
Outer Setting Factors external to the institution (eg, patient preferences)
Barriers	Individual treatment preferences Missed appointments Reluctance to participate in a study Willingness/ability to commit to weekly sessions
Inner Setting Factors inside the institution (eg, policies)
Barriers	Characteristics of the treatment setting Leadership/supervisor support Peer support Availability of weekly appointments Lack of resources
Facilitators	Characteristics of the treatment setting Leadership/supervisor support Peer support
Characteristics of Individuals Attributes of providers
Barriers	Pacing of individualized sessions Perceived effectiveness Prior experience delivering CBT
Facilitators	Positive attitude toward change Comfort with using a manual during patient sessions Prior knowledge of CBT Provider behaviors