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Table 3 Process evaluation research questions and data collection methods by Consolidated Framework for Implementation Research (CFIR) domain

From: A screen-based simulation training program to improve palliative care of people with advanced dementia living in residential aged care facilities and reduce hospital transfers: study protocol for the IMproving Palliative care Education and Training Using Simulation in Dementia (IMPETUS-D) cluster randomised controlled trial

Research question CFIR domain Data sources and timeline
What contextual factors (barriers and facilitators) influence the delivery and impact of the intervention? Outer setting
• External policy and incentives
Pre-intervention/baseline
Website search and discussions with Project Advisory Group experts to identify palliative care external policy and incentives, accreditation and standards.
Inner setting
• Structural characteristics
• Learning climate
• Networks and communications
• Readiness for implementation
Pre-intervention/baseline
Survey general managers to collect data on structural characteristics, learning climate and readiness for implementation.
Project Coordinators to collect information on additional structural characteristics.
Group/individual interviews with senior staff to explore current practice, networks and communications, and learning climate.
During early stages of training period
Project Coordinators to collect information on barriers and facilitators to implementing intervention at each intervention care home.
Characteristics of individuals
• Knowledge and beliefs
Pre-intervention/baseline
Survey (qPAD) care staff to assess knowledge and beliefs on advanced dementia palliative care; barriers and enablers to providing quality advanced dementia care.
To what degree is the intervention implemented as planned? Assess recruitment, reach, dose (quantity), fidelity (quality). Process
• Planning
• Engaging
• Executing
During 2-month training period
Participation and module completion rates via the LMS.
Survey embedded in modules to assess participant satisfaction and module feedback.
Project coordinator documentation of implementation activities undertaken, local challenges and strategies used to overcome issues.
Shortly after the training period
Semi-structured interviews with Project coordinators to explore their experience of implementation.
Semi-structured group/individual interviews with staff from the intervention group to assess their experience of implementation.
How does the delivered intervention produce change? Assess participants’ responses to and interactions with the intervention, mediators and unexpected pathways and consequences. Characteristics of individuals
• Knowledge and beliefs
• Individual stage of change
6-months follow up
Semi-structured group/individual interviews with staff from the intervention group about their experience with and impact of the intervention.
Repeat survey (qPAD) of care staff to assess knowledge and beliefs on advanced dementia palliative care.
  1. Abbreviations: LMS learning management system, qPAD questionnaire of palliative care in advanced dementia