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Table 2 Paired and unpaired themes across facility adherence status by Conceptual Framework of Implementation Fidelity domains

From: Understanding implementation fidelity in a pragmatic randomized clinical trial in the nursing home setting:a mixed-methods examination

Modified Conceptual Framework of Implementation Fidelity domainPaired-convergentPaired-divergentUnpaired
Intervention Complexity• Intervention was simply designed (high and low)  
Participant Responsiveness• Patients and families often changed advance directives after viewing the video (high and low)• Patients and families were open (high) vs. reluctant (low) to view the video• ACP video program is useful only on an as-needed basis (low)
• Champions have personal investment in ACP (high)
Recruitment • Champion’s efforts to recruit patients and families were strategic (high) vs. tentative (low) 
Quality of Delivery  • Champions actively combined showing the video with an ACP conversation (high)
Context  • Facilities had resource challenges (low)
• Facilities had pre-existing ACP processes (low)
• Facilities challenged by their ACP processes would benefit from the ACP video program (high)
Strategies to Facilitate Implementation • Champions felt confident in their role (high) vs. not (low)• Research team facilitation was helpful (high)
  1. Facility adherence status: high = falls within top quintile for adherence within the health-care system; low = falls within bottom quintile for adherence within the health-care system
  2. Conceptual Framework of Implementation Fidelity domains are from Hasson et al. (2010)
  3. Paired-convergent indicates that the theme was represented in both high- and low-adherence facilities with similar findings. Paired-divergent indicates that the theme was represented in both high- and low-adherence facilities with dissimilar findings. Unpaired indicates that the theme was represented in only high- or only low-adherence facilities