Table 4 List of interventions considered and remediability assessment

Logistical difficulties and competing life demands

Coordination support

Salary or time spent from existing personnel assuming coordination responsibilities

Potential need to integrate new role/team member into clinic and disrupt work processes or flow

Sites indicated ability to create this role or hire new personnel with study support; sites indicated flexibility in how role is implemented

Social worker

Salary or time spent from existing personnel assuming additional responsibilities

Potential need to integrate new role/team member into clinic; need to target several logistical challenges and competing life demands for families

Hiring processes may dictate role expectations at local hospitals that conflict with peripheral adaptability of intervention delivery

New patient tracking software

Consulting cost with software developer; monetary cost of maintaining tool; cost of personnel’s time to use the tool

Tracking tool separate from electronic medical record/new process; multiple providers at a single site may need to learn the tool; potential disruption of workflow

Able to customize tracking process to meet local needs

Transportation vouchers

Monetary cost of vouchers; personnel time to distribute vouchers

Range of transportation modes need to be accommodated (e.g., taxi, train, bus)

Depends on ease of using vouchers for specific transportation needs of patients

Gaps in scheduling and coordination

Coordination support

**

**

**

New patient tracking software

**

**

**

Education and information

Educational materials and simplified explanation of TCD screening

Printing materials; consultant for branding and wording

Potential difficulty adopting a new process for education; multiple providers may complicate education

Uniform description of TCD can be used across sites and sites can modify peripheral information as needed (e.g., location); potential difficulty with language barriers

Provider and staff investment and assistance

Coordination support

**

**

**

New patient tracking software

**

**

**

Coordination, scheduling, and reminders

Coordination support with reminders

**

Added complexity to role of coordinator if reminders are added; range of reminder methods; change in workflow processes

**

Convenient location

TCD ultrasound in clinic

TCD equipment and salary for trained technician

Variation in hospital policies for TCD process (e.g., location, billing); change in workflow processes; potentially high number of targeted units and people involved

Uncertain and potentially dependent on relationships with other hospital departments (e.g., radiology)