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Table 3 Measures and data sources for degree and variation of implementation success (Aim 2)

From: An effectiveness-implementation hybrid type 1 trial assessing the impact of group versus individual antenatal care on maternal and infant outcomes in Malawi

Indicators based on data from the last quarter of sustain independentlySource
ContinuationYes/No indicating ceased or continued to offer group antenatal careBenchmarks
Reach% in group care based on the total number of antenatal care clientsBenchmarks
FidelityQuarterly clinic mean scores; High fidelity indicated by high group engagement, high session management and interpersonal facilitation skills (e.g., controlling negativity, drawing out participants), and overall rating as more like discussion than classroom.Observations
Contextual Factors by CFIR Domain [73] (ongoing)
Intervention• Time: Group vs. usual time required to deliver antenatal careInterviews
Study Notes
• Additional group care expenses: training, equipment and supplies
• Other: factors affecting implementation (space, scheduling)
Outer Setting• Ministry of Health (annually); District Health Office (annually); Safe Motherhood Task Force (Quarterly); Other stakeholders, as neededMeetings
Interviews
Inner Setting• Clinic characteristics and events reported (staff transfers, leadership, interactions)
• Successes, challenges, solutions, decisions, interpersonal interactions, and evaluation of evidence; coded as positive, negative or mixed
Benchmarks
Interviews
Observation
Individual
(Staff)
• Basic demographics, including education level and experienceSurvey
• Maslach Burnout Inventory (9 items; α > .79) [74,75,76];
• Health Worker Motivation (10-item; range 10–50) [77, 78];
• Perspectives on group care (5 items) at baseline and beginning and end of sustain
Process• Quarterly Benchmark Scores: 25 yes/no items (1 point for each yes). Integrates co-facilitators’ self-evaluation of fidelity and time records. Patterns over time: Fail; Interrupted; Sporadic; ContinuousBenchmarks
Self-evaluations
• Fidelity: Quarterly ratingsObservations