Table 4 Description of how the provider-level implementation strategies were conducted

Organizing an implementation team appointed by the facility director

Implementation teams were organized at all facilities. In each facility, the team was composed of members according to the internal conditions of the facility

Interactive assistance using a clear guide that outlines who in the hospital should do what

The directors of the six facilities agreed to participate in the study after receiving explanations of the guide from the researchers as per the specifications

All implementation teams attended the startup meeting as specified and were briefed by the researcher in the guide. The teams then attended regular meetings; many teams were too busy to attend regular meetings because of the COVID-19 pandemic. The implementation teams communicated with the researchers via email on a regular basis, or as needed

Progress monitoring

The implementation teams prepared for the provision of the encouragement according to the guide. The research team received progress reports from the implementation teams in regular meetings or via email

Joint meetings and information sharing among participating sites

Through the meetings, the progress of the participating facilities was shared. In addition, helpful materials developed at participating sites were shared with the other sites

Adaptation of the encouraging methods to the specific context

Researchers adopted the strategy to begin providing encouragement on a smaller scale, depending on the resources of each facility. See “Methods” section patient-level implementation strategies for details

The implementation teams made minor modifications to the materials used for the encouragement to suit the region. The teams determined the range of patients who would be eligible for the encouragement on the basis of their estimates of patient volume. Depending on the facility’s outpatient system, a flow for providing encouragement was developed

Developing educational materials that are accessible to busy medical staff

The implementation teams were able to access educational materials from the study website as per specifications. The implementation teams did not require any additional educational materials other than those prepared by the researcher

Education of on-site medical staff

The implementation teams held a meeting at the facility to inform the on-site medical staff about the study and the flow for providing encouragement. The teams used educational materials to educate on-site medical staff. At some sites, members of the implementation team provided simulated encouragement as a demonstration