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Table 3 Importance Ratings by Trial

From: Implementing LGBTQ-affirmative cognitive-behavioral therapy: implementation strategies across five clinical trials

Implementation Strategies

ESTEEM2

(N = 12–16 overall; N = 9 unique raters)

M (SD)3

EQuIP2

(N = 5–9 overall; N = 1 unique rater)

M (SD)

ESTEEM ConneCT2

(N = 3–4 overall; N = 2 unique raters)

M (SD)

LGBTQ-affirmative ICBT2

(N = 7–9 overall; N = 4 unique raters)

M (SD)

China ICBT2

(N = 6–7 overall; N = 7 unique raters)

M (SD)

High-Priority Strategies1

Intervene with clients to enhance uptake and adherence

1.13 (0.35)

N = 15

1.50 (0.53)

N = 8

1.25 (0.50)

N = 4

1.11 (0.33)

N = 9

1.00 (0.00)

N = 7

Promote adaptability

1.33 (0.49)

N = 15

1.25 (0.46)

N = 8

1.00 (0.00)

N = 3

1.63 (0.74)

N = 8

1.00 (0.00)

N = 7

Prepare clients to be active participants

1.13 (0.35)

N = 15

1.50 (0.53)

N = 8

1.25 (0.50)

N = 4

1.33 (0.50)

N = 9

1.00 (0.00)

N = 7

Tailor strategies

1.60 (0.63)

N = 15

–

1.00 (0.00)

N = 3

1.11 (0.33)

N = 9

1.43 (0.79)

N = 7

Remind clinicians

1.33 (0.49)

N = 15

1.25 (0.46)

N = 8

1.33 (0.58)

N = 3

–

–

Facilitation

1.44 (0.51)

N = 16

1.44 (0.73)

N = 9

1.00 (0.00)

N = 4

1.56 (0.73)

N = 9

1.14 (0.38)

N = 7

Conduct educational meetings

1.19 (0.40)

N = 16

1.67 (0.50)

N = 9

1.00 (0.00)

N = 4

1.75 (0.46)

N = 8

1.14 (0.38)

N = 7

Centralize technical assistance

1.85 (0.80)

N = 13

–

–

1.00 (0.00)

N = 9

1.29 (0.49)

N = 7

Use mass media

1.50 (0.65)

N = 14

1.43 (0.54)

N = 7

1.50 (1.00)

N = 4

1.38 (0.52)

N = 8

1.33 (0.52)

N = 6

Moderate-Priority Strategies

Provide clinical supervision

1.19 (0.40)

N = 16

1.33 (0.50)

N = 9

2.33 (0.56)

N = 3

1.43 (0.54)

N = 7

1.0 (0.00)

N = 7

Identify and prepare champions

1.56 (0.63)

N = 16

1.56 (0.53)

N = 9

1.00 (0.00)

N = 4

1.88 (0.64)

N = 8

1.43 (0.79)

N = 7

Develop educational materials

1.53 (0.52)

N = 15

1.63 (0.52)

N = 8

1.50 (0.71)

N = 2

1.22 (0.44)

N = 9

1.57 (0.54)

N = 7

Make training dynamic

1.60 (0.51)

N = 15

1.57 (0.54)

N = 7

1.50 (0.71)

N = 2

–

–

Recruit, designate, and train for leadership

1.38 (0.50)

N = 16

2.14 (0.69)

N = 7

1.00 (0.00)

N = 4

1.75 (0.71)

N = 8

1.57 (0.79)

N = 7

Create new clinical teams

1.57 (0.51)

N = 14

1.29 (0.49)

N = 7

2.33 (1.16)

N = 3

1.67 (0.82)

N = 6

1.14 (0.38)

N = 7

Organize clinician implementation team meetings

1.81 (0.66)

N = 16

1.78 (0.67)

N = 9

1.25 (0.50)

N = 4

1.63 (0.52)

N = 8

1.57 (0.54)

N = 7

Conduct local consensus discussions

–

–

1.25 (0.50)

N = 4

2.29 (0.76)

N = 7

1.29 (0.49)

N = 7

Conduct ongoing training

1.71 (0.61)

N = 14

1.71 (0.76)

N = 7

2.00 (0.00)

N = 2

1.22 (0.44)

N = 9

1.43 (0.54)

N = 7

Optional Strategies – Use if Resources are Available

Develop and organize quality monitoring systems

1.79 (0.58)

N = 14

2.22 (1.64)

N = 9

1.75 (0.96)

N = 4

1.13 (0.35)

N = 8

1.29 (0.49)

N = 7

Obtain formal commitments

1.81 (0.66)

N = 16

1.75 (0.89)

N = 8

1.50 (0.58)

N = 4

1.75 (1.04)

N = 8

1.50 (0.55)

N = 6

Provide local technical assistance

1.67 (0.62)

N = 15

1.86 (0.69)

N = 7

2.00 (0.82)

N = 4

–

–

Change physical structure and equipment

2.00 (0.73)

N = 16

1.88 (0.99)

N = 8

2.00 (0.82)

N = 4

–

–

Obtain and use consumers' feedback

–

–

2.00 (0.82)

N = 4

1.44 (0.53)

N = 9

3.00 (1.27)

N = 6

Involve clients

2.25 (0.62)

N = 12

2.40 (0.55)

N = 5

2.25 (0.96)

N = 4

1.71 (0.76)

N = 7

–

Shadow other experts

1.93 (0.80)

N = 15

2.38 (0.74)

N = 8

2.50 (0.71)

N = 2

–

–

Visit other sites

2.38 (0.51)

N = 13

–

–

3.00 (1.00)

N = 5

1.57 (0.54)

N = 7

Use train-the-trainer strategies

1.93 (0.62)

N = 14

2.13 (0.64)

N = 8

3.50 (0.71)

N = 2

–

–

Strategies that Could Not Be Categorized for Overall Prioritization Due to Low Use Across Trials

Use data experts

–

–

–

1.86 (1.07)

N = 7

1.71 (0.76)

N = 7

Build a coalition

1.92 (0.52)

N = 12

–

–

–

–

Develop academic partnerships

–

–

1.25 (0.50)

N = 4

–

–

Promote network weaving

–

–

–

–

1.71 (0.76)

N = 7, D5

Audit and provide feedback

2.07 (0.59)

N = 15

2.56 (1.13)

N = 9

–

–

–

Conduct local needs assessment

–

2.56 (1.88)

N = 9

1.75 (0.96)

N = 4

–

–

Develop and implement tools for quality monitoring

2.07 (0.59)

N = 15

2.78 (1.30)

N = 9

–

–

–

  1. 1The rating system for overall importance of strategy for implementing LGBTQ affirmative CBT is as follows: high priority (top third), moderate priority (middle third), and optional, based on availability of resources (bottom third). An additional group of strategies could not be rated on overall importance because the strategy was used in less than three trials
  2. 2These columns show the mean and standard deviation of the importance ratings for each ERIC strategy within each trial of LGBTQ-affirmative CBT. The possible range for the mean importance ratings is from 1 (most essential strategy) to 4 (least essential strategy). Because participants could skip items based on the degree to which they were knowledgeable about the relevance of a given implementation strategy, the N for each strategy varies. Therefore, the N is reported within each cell and the range of the N within each trial is reported at the top of each column
  3. 3Means reported in this table were calculated at the implementer level
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Implementation Science Communications

ISSN: 2662-2211