Table 1 Using an implementation outcomes framework described by Proctor et al. (2011) [3] to evaluate testing strategies in response to the Covid-19 pandemic
Implementation outcomes | Definitions3 | Evaluation of implementation strategies |
|---|---|---|
Acceptability | Perception that the intervention is agreeable, palatable, or satisfactory | • Community attitudes towards testing |
• Documented barriers and facilitators to testing from qualitative surveys and focus groups | ||
Considered from the perspective of individuals receiving testing | • Input and feedback from community leaders and organizations (not involved in operations) about testing strategies | |
Adoption | The intention to employ or adhere to an intervention | • Number of testing sites and daily testing rate by site |
Considered from the perspective of entities providing testing | • Testing strategies stratified by geographic location and entity | |
Appropriateness | Perceived fit, relevance, or compatibility of intervention for the given setting and problem | • Community and other stakeholders’ attitudes towards local testing strategies |
• Document changes in testing strategies compared to original protocols | ||
Feasibility | The extent to which an intervention can be successfully used or carried out in a particular setting | • Input and feedback from entities operating testing |
• Availability of tests given demand (supply chain) | ||
Fidelity | The degree to which an intervention was implemented as it was originally intended | • Number of improperly collected, transported, or handled samples |
• Whether test results are returned promptly and confidentially | ||
Cost | Cost impact of an implementation effort | • Overall and per-test costs across geographic areas and/or by organizations providing testing |
Penetration (Reach) | Integration of intervention within a setting or its subsystems | • Number of tests, by test type, across key subgroupsa and representativeness of testing†|
• Proportions of communities tested and percent-positive rates in a given time period | ||
Sustainability (Maintenance) | How well an intervention is maintained over time within an organization or setting | • Maintenance of testing capacity and performance for population health over time and across key subgroupsab |