Table 2 Study measures by aim

Aim 1: implementation

Penetration (primary)

Proportion of caregivers who received consults for VA caregiver education and training services who attended at least one class

EHR data

12 months

Number of classes delivered by site

EHR data

12 months

Adoption

Minimum of four training classes delivered to at least five caregivers

EHR data

12 months

Fidelity

Proportion of number of recommended classes delivered by site

EHR data

12 months

Number of caregivers attended at least one class by site

EHR data

12 months

Mean number of classes attended per caregiver

EHR data

12 months

Aim 2: effectiveness

Quality metric

Inclusion of Caregivers FIRST in VA medical center performance plans

VA Network Director and Facility Director Performance Plan

12 month fiscal year

Number of caregivers enrolled in the Program of General Caregiver Support Services (PGCSS)

EHR data

12 months

Effectiveness outcome

Veteran days in the community (e.g., not in a hospital or nursing home) after caregiver participation in Caregivers FIRST

EHR data

6 months

Aim 3: cost

Delivery costs

Number of hours staff spent delivering one round of Caregivers FIRST training

Survey

Baseline, 6 months, 12 months

Implementation costs

Number of hours staff spent participating in implementation strategies

Survey

Attendance logs

Meeting notes

Baseline, 6 months, 12 months

Contextual and experimental factors

Implementation climate

Leadership and Motivation to Implement

Survey

Qualitative interviews

Baseline

Implementation Climate Scale [30]

Survey

Baseline

Organizational Resilience [31]

Survey

Baseline, 6 months, 12 months

Challenging and Helpful Implementation Factors

Survey

Qualitative interviews

Baseline, 6 months, 12 months

Readiness for implementation

Organizational Readiness for Implementing Change [32]

Survey

Baseline, 6 months, 12 months

Adaptations

Framework for Reporting Adaptions and Modifications Expanded (FRAME) [33]

Survey

Baseline, 6 months, 12 months

Process

Implementation Process and Experience

Survey

Qualitative interviews

6 months, 12 months

Policy and incentives

Program Sustainability Index [34]

Survey

6 months, 12 months