Table 1

Specification of the process evaluation

RE-AIM dimensionDefinitionQuestionProcess indicators (mapped to logic model)
ReachPer cent and representativeness of individuals receiving the CYPHP Evelina London Model of Care, of total eligible service users
  • How many CYP participated in or were exposed to the CYPHP programme? What proportion of those targeted were reached?

  • Are those who are most at risk reached by the CYPHP Evelina London Model of Care? Were those reached representative of the overall population?

  • What were the barriers to recruitment/retention? To what extent were stakeholders engaged with and aware of the CYPHP model?

  • # of CYP accessing CYPHP services/# eligible for targeted CYPHP services and method of recruitment; data on CYP characteristics within CYPHP (eg, age, condition, location and socioeconomic breakdown) [R1]

  • Comparison of demographic and health profiles of CYP participating in CYPHP vs CYP eligible vs population of Lambeth and Southwark [R2]

  • Interviews with CYPHP managers, service providers and commissioners (eg, barriers to recruitment/retention) [R3]

EffectivenessImpact of CYPHP Evelina London Model of Care on trial outcomes (reported elsewhere) [E1, E2]; fidelity of delivery
  • What are the conditions and mechanisms that lead to trial outcomes? What explains variation in trial outcomes across sites?

  • What are stakeholder’s perceptions of factors contributing to effectiveness (or ineffectiveness) of trial outcomes?

  • Are there any unintended consequences?

  • # of care plans; adherence to clinical guidelines; time from review to clinical assessment; time from review to clinical assessment; rates of CYP discharge [E2]

  • Interviews/focus groups with CYP, commissioners and service (eg, key components to ensure behavioural change) [E4, E5]

AdoptionProportion and representativeness of settings, commissioners and providers willing to adopt (or commission) the CYPHP Evelina London Model of Care
  • What proportion of targeted GP practices adopted CYPHP? Are there differences between GP practices and service providers that do or do not adopt CYPHP?

  • What affects stakeholder participation?

  • To what extent are intended stakeholders adopting and complying with the CYPHP programme?

  • # of GP practices adopting targeted CYPHP services/# of GP practices targeted for CYPHP; data on GP characteristics within CYPHP (eg, location, staff numbers, patient numbers) [A2]

  • Review of implementation records/logs, NoMAD surveys completed by service providers to guide interviews with high adopters and low adopters. [A1, A3]

ImplementationThe extent to which the CYPHP Evelina London Model of Care is delivered as planned
  • What CYPHP services are delivered to CYP and service providers?

  • To what extent is the CYPHP model being delivered as planned? Who completed the CYPHP intervention work and how this work is done?

  • What is the overall satisfaction with CYPHP services and the willingness to implement/commission CYPHP services again?

  • What activities are needed to implement and maintain the CYPHP programme?

  • What is the acceptability, feasibility and affordability of the programme?

  • # of CYPHP intervention services provided (eg, number of clinics, training sessions, support packs distributed) [I1]

  • # of CYP completing baseline and follow-up health checks in the appropriate time frames; interviews with service providers (eg, implementation processes); NoMAD surveys completed by service providers [I2]

  • Interviews with service providers, CYP and commissioners (eg, satisfaction with service) and service feedback and satisfaction surveys [I3]

  • Data on activities as they occur and compare to activities detailed in the logic model. Discrepancies and potential reasons for these will be noted [I4]

  • Interviews with service providers and commissioners (eg, implementation processes) and economic analysis on cost of implementing the CYPHP Evelina London Model of Care programme (detailed elsewhere8) [I5]

MaintenanceSustainability of the CYPHP Evelina London Model of Care at individual, setting and geographical/administrative levels
  • What are service managers and commissioner intentions to continue integrated care services for CYP, and what are the barriers to maintaining this way of working?

  • How have aspects of the model been incorporated into usual care and/or incorporation of integrated care for CYP into future business planning?

  • Interviews with service providers and commissioners (eg, intentions to continue CYPHP and other integrated care services) [M1]

  • Review of policies and business plans [M2]

ContextHealthcare context throughout the CYPHP Evelina London Model of Care implementation period
  • How has the current healthcare environment across Lambeth and Southwark influenced the outcomes of the CYPHP trial?

  • # and type of healthcare policies introduced to target CYP and service providers across local, national and international, with a focus on tracer conditions [C1]

  • [x] represents process indicators which are mapped onto figure 1.

  • CYP, children and young people; CYPHP, The Children and Young People’s Health Partnership; HCP, healthcare provider; NoMAD, Normalisation Process Theory  Scale.