Table 4 Implementation outcomes of interest

Reach

No. of people and percentage of the target population affected and the extent to which the individuals reached are representative and include those most at risk

RE-AIM

• # and % of PLHIV at the facility (i.e., with documented receipt of ART/ HIV care services at a study site) screened for hypertension at 0, 12, and 24 months from TASKPEN introduction

Adoption

No. and % of settings participating, and the extent to which the settings selected are representative of settings that the target population will use or visit

RE-AIM, CFIR

• % of facilities and providers initiating TASKPEN intervention/ integrated care at 0, 12, and 24 months

• Perceived enablers and barriers to TASKPEN implementation and perceived fit with organizational priorities and work flows as assessed through interviews and focus groups at ≥ 6 months from TASKPEN introduction

Implementation

Level of adherence to implementation principles or guidelines, intervention’s protocol, including cost and consistency of delivery as intended

RE-AIM, CFIR

• % of nurses and other non-physician health workers at each site that supported intervention/ integrated care implementation at least once at 0, 12 and 24 months

• Fidelity to TASKPEN guidelines and training materials/ SOPs as assessed by observer assessment during structured observations pre- and post-TASKPEN intervention at each site at ≥ 6 months from TASKPEN introduction

• Site-level adaptations to TASKPEN delivery and its management at different clinics as assessed by structured observations, FGDs, and KIIs done ≥ 6 months from TASKPEN introduction

• Total costs for TASKPEN implementation

Acceptability

Extent to which implementation stakeholders perceive a treatment, service, practice, or innovation to be agreeable, palatable, or satisfactory

RE-AIM, CFIR

• Average (mean) Acceptability of Intervention Measure (AIM) score after TASKPEN implementation at ≥ 6 months from TASKPEN introduction

• Perceptions at ≥ 6 months from TASKPEN introduction among interview and FGD participants regarding the extent to which TASKPEN is agreeable/ desirable to them

Fidelity

Participants with evidence of NCD treatment interruption/ missing a pharmacy refill for anti-hypertensive, anti-diabetic, and/or anti-lipid agents

Proctor’s Outcomes for Implementation Research

• # and % of participants with evidence of missing a pharmacy refill for a documented cardiometabolic NCD at 0, 12, and 24 months

Feasibility

The extent to which a new treatment, or an innovation, can be successfully used or carried out within a given agency or setting

CFIR, Proctor’s Outcomes for Implementation Research

• Average (mean) Feasibility of Intervention Measure (FIM) score after TASKPEN implementation at ≥ 6 months from TASKPEN introduction

• Perceptions at ≥ 6 months from TASKPEN introduction among interview and FGD participants regarding the extent to which TASKPEN can be successfully carried out in their particular clinical setting

Appropriateness

Perceived fit, relevance, or compatibility of the innovation or evidence-based practice for a given practice setting, provider, or consumer; and/or perceived fit of the innovation or evidence-based practice to address an issue

CFIR, Proctor’s Outcomes for Implementation Research

• Average (mean) Intervention Appropriateness Measure (IAM) score after TASKPEN implementation at ≥ 6 months from TASKPEN introduction

• Perceptions at ≥ 6 months from TASKPEN introduction among interview and FGD participants regarding the fit of TASKPEN to address co-morbid cardiometabolic NCDs among PLHIV accessing health services in routine HIV care settings

Sustainability

Extent to which a recently implemented practice is maintained and/or institutionalized within a service setting’s ongoing, stable operations

Proctor’s Outcomes for Implementation Research

• Average (mean) Clinical Sustainability Assessment Tool (CSAT) score after TASKPEN implementation at ≥ 6 months from TASKPEN introduction

• Perceived integration or institutionalization of the TASKPEN intervention as a routine practice, and perceived alignment with MOH policy as assessed through interviews and focus groups at ≥ 6 months from TASKPEN introduction

Cost-effectiveness

Financial impact of an implementation effort and the relative value in quality adjusted life years save of the intervention state over the standard of care state

Proctor’s Outcomes for Implementation Research

• Incremental cost-effectiveness ratios (ICERs) at 0, 12 and 24 months