Appendix Table A.

Theoretical constructs (Atun et al., 2010; Pathman et al., 1996; Andersen, 2007) and sample interview guide questions

Construct	Definition (Atun et al., 2010; Pathman et al., 1996; Andersen, 2007)	Sample interview guide question(s)	Theoretical framework
Problem	Adopting stakeholders’ perceptions of the urgency of the problem and its economic and other burdens	Thinking about the patients you see and their medical issues, where would you rank prediabetes in terms of clinical importance?	Atun et al.’s framework
Intervention	Adopting stakeholders’ perceptions of intervention complexity, relative advantage, and cost	Once a patient screens positive for prediabetes, what generally are your next steps? Why?	Atun et al.’s framework
Adopting system	Stakeholders who decide whether to adopt and the distribution of decision-making power among them	To what extent do you think other providers you work with screen for abnormal blood glucose according the guideline? To what extent do you think that other providers you work with refer to or provide intensive behavioral counseling to patients with prediabetes? To what extent do others you work with support you following this recommendation? To what extent do you feel under pressure from anyone to do this? Or not to do it?	Atun et al.’s framework
Health system charateristics	Regulatory, organizational, and financial factors that constrain or support intervention adoption	What are the incentives for following these recommendations? Are there systems in place that support you following this recommendation?	Atun, et al.’s framework
Context	Interplay of demographic, economic, socio-cultural, and technological factors in the broader community	To what extent might you offer different services to different patients? What factors influence this decision?	Atun et al.’s framework
Environment	Organizational resources and physical, political and economic factors	Do you or your clinic currently have an established referral relationship with community resources for diabetes prevention services?	Andersen’ s behavioral model
Evaluated need	Professional judgement about people’s health status and their need for medical care	How do you decide which patients you screen for prediabetes? How do you decide which service or services you will offer your patient?	Andersen’ s behavioral model
Predisposing demographics	Socio-demographic predispositions such as race, gender, age	How do you decide which patients you screen for prediabetes? Probes: To what extent do you consider patient age in deciding who to screen? To what extent do you consider patient gender? How about race—To what extent do you consider patient race in deciding who to screen? What other factors do you consider when deciding whether to screen a patient for prediabetes?	Andersen’ s behavioral model
Enabling resources	Factors SUCH as health insurance coverage, health system reimbursement and incentives or other factors that support intervention use	What are the incentives for following these recommendations? Are there systems in place that support you following this recommendation?	Andersen’ s behavioral model
Awareness	Providers’ awareness of any clinical guideline related to diabetes prevention and specifically the 2015 USPSTF abnormal blood glucose recommendation	There are several diabetes-related screening guideline recommendations. Now I would like to ask you about your views of a specific practice guideline recommendation. In late 2015, the USPSTF revised their abnormal blood glucose guidelines, how familiar are you with this recommendation? Can you tell me about this recommendation?	Awareness-to-adherence model
Agreement	Providers’ agreement (or disagreement) with published clinical guidelines for diabetes screening and prediabetes treatment	What are your general views of these guideline recommendations? To what extent do you agree or disagree with them?	Awareness-to-adherence model
Adoption	The extent to which providers follow the guideline/recommendation in their clinical practice	What factors do you think exist that might make it more or less likely for you to follow these guidelines with a given patient?	Awareness-to-adherence model
Adherence	The extent to which providers succeed in adhering to it (or follow it consistently at appropriate times).	To what extent would you say, as a percentage, you adhere to the screening part of the recommendation? How about the prediabetes treatment recommendations? What is your sense of strategies that could be used to increase the proportion of clinicians in the UNC health system who adhere to these recommendations regularly?	Awareness-to-adherence model