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Table 1 Implementation fidelity for each intervention component, and moderating factors affecting fidelity

From: A complex culturally targeted intervention to reduce Hispanic disparities in living kidney donor transplantation: an effectiveness-implementation hybrid study protocol

Intervention component ID # Intervention component description NQF dimensions Data source
For patients at the dialysis center:
 1 At the dialysis center, the bilingual (bicultural) outreach staff hold lobby days to introduce, hand out an information folder in Spanish about the HKTP, and invite Hispanic patients to attend the HKTP. Staff provide patient contact information to clinic schedulers to set up a clinic visit for each patient. Workforce diversity and training; Data collection, public accountability, and quality improvement; Community outreach -Observations
 2 Transplant center telephone bilingual* schedulers offer (follow the script) the HKTP clinic as an option to all Hispanic patients calling to schedule transplant evaluation, regardless of the patient’s spoken language. Schedulers encourage patients to bring their family members to the HKTP visit. Integration into management systems and operations; Workforce diversity and training -Audio-Recordings
 3 Establish a Spanish speaking telephone line at the transplant center. Integration into management systems and operations -Survey-Metrics
-Learning Collaborative
 4 The transplant center’s phone line offers (live) Spanish-speaking schedulers when patients call. Integration into management systems and operations -Survey-Metrics
For patients and family who visit the HKTP:
 5 Bicultural Transplant surgeon delivers the 2 back-to-back HKTP education sessions that provide same care as the English program as well as address cultural concerns about transplantation in Spanish. Patient-provider communication; Workforce diversity and training; Integration into management systems and operations -Observation-Site Visit
-Observation-Research Staff
 6 Education sessions address Hispanic cultural and religious concerns & myths. Patient-provider communication -Audio-Recordings
 7 Education sessions include family members in both sessions. Patient-provider communication -Observation-Site Visit
 8 Bicultural transplant surgeon or bilingual transplant nephrologist holds a ‘wrap up’ clinical visit with each patient and asks about available potential living donors. Patient-provider communication -Survey-Metrics
-Observation-site Visit
 9 HKTP bilingual clinical staff and/or outreach staff contact patients who have not completed evaluation within 10–12 weeks. Care delivery and supporting mechanisms -Medical chart review
 10 HKTP Director calls patients and referring MD if patients have not completed pre-transplant evaluation by 8–10 and 12 weeks. Leadership; Care delivery and supporting mechanisms; Community outreach -Medical chart review
 11 Availability of interpreters or interpreter services. Workforce diversity and training -Phone calls
 12 Data collection on patients in a transplant database for quality assurance and identifying areas for improvement. Data collection, public accountability, and quality improvement -Phone calls
For the local nephrology community:
 13 Letters are mailed to nephrologists introducing the HKTP to increase patient referral. Community engagement -Medical chart review
 14 Transplant center holds in-service presentations to local social worker and nephrology organizations to increase awareness of the HKTP to increase patient referral. Community engagement -Survey-Metrics
-Phone calls
For the public:
 15 Transplant center engages in marketing events (e.g., interviews in news and social media) about the HKTP directed to the Hispanic community in Spanish (TV, radio, newspaper). Patient-provider communication; Community engagement -Survey-Metrics
-Phone calls
 16 Transplant center website hosts information about the HKTP in Spanish. Patient-provider communication -Survey-Metrics
-Phone calls