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Table 3 Overview of the aspects of the national implementation that are evaluated and the related measurement

From: GLA:D® Back: implementation of group-based patient education integrated with exercises to support self-management of back pain - protocol for a hybrid effectiveness-implementation study



Data Source

Spread (promotion of GLA:D Back)

Newsletter from professional organisations

Information to GLA:D Knee/Hip deliverers

Description of GLA:D Back in magazine for general practitioners

Information on the GLA:D Back web site

Use of social media

The extent to which the intended promotion activities are delivered (Table 2)

Web sites, social media, e-mails

Clinician reach

The proportion of chiropractors and physiotherapists, on a contract with the universal health insurance, participating in GLA:D Back courses.

Profile of enrolled clinicians.

Course registration

Penetration and adoption (extent of implementation)

Geographical penetration measured as the number of municipalities with at least one GLA:D Back deliverer.

Rate of adoption will be measured as the proportion of clinics with trained clinicians offering GLA:D Back (defined as having entered at least five patients in the clinical registry) within 6 months of course participation.

The number of patients starting GLA:D Back

GLA:D Back registry

Fidelity (quality of implementation)

The extent to which the core elements of the clinical intervention are delivered

Observations in selected clinics

Patient 4 month surveys

Determinants of implementation

The domains of knowledge, skills, beliefs about capability, beliefs about consequences, innovation, patients, intentions, organisation, social influences, social context, and behavioural regulation are captured by the Determinants of Implementation Questionnaire (DIBQ) [16].

Clinician surveys

Patient participation

Proportion of patients enrolled in GLA:D Back that complete the program

Profile of enrolled patients and of completers/non-completers

Reasons that patients do not want to participate

Patient surveys in the GLA:D Back Registry

Clinician surveys