Table 3.

RAPICE Informed Implementation Process Assessment ^111–116

RE-AIM Domain	Study Quantitative Assessment	Previously described implementation barriers for RAPICE assessment	RAPICE participant observation questions	Potential Policy Summit Questions/ Themes Derived from RAPICE
Reach	• n enrolled divided by N in target population	• Prior studies, describe patients who prefer not to have care coordinated	• What factors explain site Reach variations? • What are the reasons patients opt out of the trial? • What are the barriers to enrolling patients?	• Does Reach/breadth of applicability/ of the intervention warrant organizational, regional or national policy requirements?
Effectiveness	• Comparison of Intervention vs Control outcomes	• Lack of patient engagement • Lack of ability of team to implement intervention elements	• What factors explain variations in effectiveness across sites?	• Are there policy changes that occurred during the study that introduced variability in the intervention delivery? • Do these policy changes differentially impact control versus intervention conditions?
Adoption	• % Provider and/or clinical service participation	• Negative staff attitudes toward system change • Lack of staff/peers with adequate skills to intervention	• What impacts provider participation? • What impacts staff/peer baseline aptitudes and skill acquisition?	• Will there be sites that spontaneously adopt the intervention without policy requirements? • What characterizes these innovator/early adopter sites?
Implementation	• Documentation of intervention adaptations across sites • Quantification of provider and site variability in the use of collaborative care or care transition CPT codes	• Implementation of intervention strains existing resources • Lack of access related to adequate provider CC supervision and support	• What were the barriers to implementation of the intervention • What was the nature of the adaptations to the intervention that occurred over time? • Why did adaptations to the intervention occur?	• What organizational, regional and national policies might assist with site implementation of the intervention?
Maintenance	• Maintenance of intervention as delivered in the investigation (Yes/No) • If only partially maintained quantification of adaptations to the intervention	• Lack of ongoing funding as a barrier to sustainability	• What are modifications made by providers after the study? • In what form will the components of the intervention be sustained? • What are the barriers to maintaining the peer intervention program?	• What policy levers such as health care system mandates or CPT code availability might facilitate site/ organizational maintenance of the intervention?