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Table 2 Overview of outcome domains and subdomains of the quantitative process evaluation

From: Implementation, mechanisms of change and contextual factors of a complex intervention to improve interprofessional collaboration and the quality of medical care for nursing home residents: study protocol of the process evaluation of the interprof ACT intervention package

Domains Subdomains Dimensions Target population and measurement points Measurement instruments (existing tools useda)
IPAVs RNs NHDs NHRs GPs STM
Implementation strategies and activities
 Implementation strategies Kick-off meeting Attitudes, quality, and satisfaction (T0b) (T0b) (T0b) (T0b) (T0b) (T0b) Questionnaires, minutes
IPAV characteristics E.g., roles and self-efficacy T0b T0b Questionnaires, minutes
IPAV training Duration, adaptations, quality, and satisfaction T0b T0b Questionnaires, minutes
IPAV supervision Quality and satisfaction T0b T0b Questionnaires, minutes
 IPAV work Collaboration IPAV and IPAV substitutes Quality and satisfaction T1, T2 Questionnaires
IPAV activities, e.g., in-house training courses and discussions with target groups Current practice T1, T2 T1, T2 Questionnaires
 Implementational work within team (normalization process theory) Coherence, cognitive participation, collective action, reflexive monitoring T1, T2 T2 Questionnaires (NoMAD questionnaire)
interprof ACT intervention package
 Intervention package as a whole Dose and reach T1, T2 Questionnaires (NoMAD questionnaire), minutes
 Name badges   Choice and adaptation, dose and reach, local policies, current practice T1, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 CRF, questionnaire, minutes
 Mandatory availability rules Choice and adaptation, dose and reach, attitudes, current practice, quality, and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 CRF, questionnaire, minutes (Koverdem, InDemA)
 Designated contact persons   Choice and adaptation, dose and reach, attitudes, local policies, current practice, quality and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 CRF, questionnaire, minutes (InDemA)
 Standardized home visits   Choice and adaptation, dose and reach, attitudes, current practice, quality, and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 CRF, questionnaire, minutes (InDemA)
 Pro re nata medication   Choice and adaptation, dose and reach, current practice, quality and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 CRF, questionnaires, minutes
 Shared goal setting   Choice and adaptation, dose and reach, attitudes, current practice, quality, and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 CRF, questionnaire, minutes (InDemA, Koverdem, PSAT)
Key elements of interprofessional collaboration
 Interprofessional communication   Attitudes, current practice, quality, and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires (CPAT, Koverdem)
 Involvement of NHR   Current practice, quality, and satisfaction T2 T0a, T2 T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires (ZAP)
 Contribution of involved professions   Attitudes, current practice, quality, and satisfaction T1, T2 T0a, T2 T0a, T2 Questionnaires (CPAT, InDemA, Jefferson Scale, PSAT)
 Coordination of care decision and care planning   Attitudes, current practice T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires (InDemA)
Further domains related to interprofessional collaboration and medical care
 General interprofessional collaboration   Attitudes, quality and satisfaction, time resources T1, T2 T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires (InDemA, Koverdem)
 General (medical) care for NHR   Quality and satisfaction utilization of emergency or hospital services (self-reported changes), adverse outcomes T2 T2 T2 T0a, T2 T2 CRF, questionnaires (ZAP, EUROPEP)
 Further outcomes   Staff outcome, marketing outcome T0a, T2 CRF
Contextual factors
 Meso: organizational level Time resources   T1, T2 Minutes
Leadership and work environment   T1, T2 T2 T0a, T2 Questionnaires (PES Nursing Work Index, NoMAD), minutes
Financial and staff resources   T1, T2 T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires, minutes
Structures of collaboration and medical care Attitudes, current practice, quality, and satisfaction T1, T2 T0a, T2 T0a, T2 T0a, T2 Questionnaires (InDemA adapted)
GP office and NH characteristics   T0a, T2 T0a, T2 CRF, questionnaires (Koverdem), minutes
 Micro: staff level Sociodemographic characteristics of all persons involved in implementation   T0b T0a, (T0b), T2 T0a, (T0b), T2 T0a, (T0b) Questionnaires, minutes
Expected effects of high quality RN-GP collaboration   T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires (Koverdem)
Competences of RNs, GPs, and IPAV   T2 T0a, T2 T0a, T2 T0a, T2 CRF, questionnaires (Koverdem), minutes
 Micro: NHR level Utilization of GP office (formal characteristics)   T0a, T2 Questionnaires (ZAP)
Family involvement in medical care   T0a, T2 Questionnaires (Koverdem)
 Multiple levels Unmet implementation support needs (IPAV)   T1, T2 Questionnaires
Other factors (open-ended questions)   T0b, T1, T2 T0a, T2 T0a, T2 T0a, T2 T1, T2 Questionnaires, minutes
  1. Instruments: Zufriedenheit in der Arztpraxis (“Satisfaction in GPs office”, ZAP) [25]. Survey instruments of the research project “Optimization of the cooperation between general practitioners and home care services” Koverdem [26]. Measures of the European Project on Patient Evaluation of General Practice Care (EUROPEP) [27]. Measures of interprofessional collaboration designed for the pre-post evaluation study “Interdisciplinary Implementation of Quality Instruments for the Care of residents with Dementia in Nursing Homes” (InDemA) [28]. Normalization Measure Development QUES (NoMAD) [29, 30]. Partnership Self-Assessment Tool (PSAT) [31]. Jefferson Scale of Attitudes toward Physician–Nurse Collaboration [32]. Collaborative Practice Assessment Tool (CPAT) [33]. Practice Environment Scale of the Nursing Work Index (PES-NWI) [34, 35]
  2. Abbreviations: CRF case report form, GPs general practitioners, IPAVs interprof ACT agents, NHD nursing home directors, NHRs nursing home residents, T0a before randomization, T0b after randomization, (T0b) as participants and moderator of kick-off meeting, T1 follow-up after 6 months, T2 follow-up after 12 months, RNs registered nurses, STM study team member
  3. aSingle items or subscales of reported tools are used for the outcome domains in question. In addition, self-developed items are used for the measurement of all outcome domains