Table 3 Implementation strategy component, based on barriers and facilitators from our pilot work with target patient population and clinics
Component | Barriers (B) and facilitators (F) from pilot study addressed through implementation strategy |
|---|---|
Standardized capacity-building activities | |
 Education, training, technical assistance | Training staff on iPad and DA use (F); keeping iPads charged (B); IRB concerns (B) |
 Clinic champion | Staff time shortage/buy-in (B); convincing multiple providers (B); change fatigue (B) |
 Refresher training course | Knowledge retention (F) |
Tailored, clinic-targeted activities | |
 DA reminder in patient intake process | Coordinating/training front desk staff (F); slowing clinic flow (B) |
 Audit and feedback | Engaging clinic staff and maintaining engagement (F); training front desk staff (F) |
 Team huddles/clinic meetings | Staff time shortage/buy-in (B); failure to systematically apply DA into existing processes (B) |
Tailored, patient-targeted activities | |
 Pre-visit patient portal message with DA link | Length of the DA (B); need to complete other surveys during the visit (B) |
 Paper-based version of the lupus DA | Too much information at once (B); patient mood, language, background, and understanding (B) |
 Clinic poster about the lupus DA | Understanding/interest (B) |
 DA information via waiting room TV/kiosk | Language/literacy/understanding/interest (B) |