Table 1 Taxonomy of implementation outcomes
Level of analysis (measurement) | ||||
|---|---|---|---|---|
Outcome | Definition | Consumer level | Healthcare provider level | Setting level |
Acceptability | Stakeholder perception that Athena is acceptable | What needs to change in Athena design and delivery? | What needs to change in Athena design and delivery? | Acceptability of Athena delivery of integrated PrEP/MOUD |
Adoption | Intention to employ Athena in practice | Interaction time/frequency and quality | Barriers/facilitators to staff using Athena for WICL in each setting | Barriers/facilitators to using Athena for WICL in each setting |
Feasibility | Extent to which Athena can be successfully used in settings serving WICL | Logistical constraints and structural barriers to Athena | Logistical constraints and structural barriers to Athena | Logistical constraints and structural barriers to Athena |
Fidelity | Degree to which Athena was implemented as planned | Was Athena delivered as intended? | Was Athena delivered as intended? Athena clinicians will complete pre-session checklists and post-session quality assurance forms | |
Implementation cost | Cost of implementing Athena to promote sustainability | Social (stigma), economic cost of participation in Athena | Time, staffing cost of providing Athena | Economic cost of delivering Athena (e.g., reimbursement concerns) |
Penetration/Reach | Integration of Athena within settings serving WICL | Recruitment rate; Completion rate; reasons for nonparticipation | Clinician agreement to recommend Athena in settings serving WICL | Administrators’ agreement to employ Athena in settings serving WICL |
Sustainability potential | Extent to which Athena becomes institutionalized or is used continuously after study completion in settings serving WICL | What are barriers to Athena continuation after study completion? What would need to change to continue Athena? | What gets in the way of incorporating Athena into current clinical practice and what would need to change? | What are the barriers to scaling up and out Athena beyond the current study? Sustainment measurement system scale |