Table 2 Main components of INDI program for the management of depression in primary care and the implementation strategy based on the PARIHS (Promoting Action on Research Implementation in Health Services) framework

INDI program

 Redefinition of practitioner roles and care pathways within the primary care team

 Optimized management of depression. Interactive computerized clinical guideline to support patient monitoring and decision-making

 Introduction of the figure of care manager assigned to primary care nurses

 Patient psychoeducation program

 Improved liaison between primary care and psychiatry services. Shared care

Implementation strategy

 Compilation and analysis of implicit evidence (knowledge and reflections of health care professionals and patients targeted by the program) and explicit evidence (clinical trials, economic evaluations, meta-analyses)

 Analysis of institutional setting and characteristics (e.g., organizational aspects, innovation culture, quality, continuous professional development) that could negatively or positively affect the implementation of the program

 Internal facilitators

  − Regional leaders of INDI program linked to clinical management in both health care districts as a driver for local implementation

  − Leading health care professionals to champion the program at each primary care center

 External facilitators provided by research team: online training for health care professionals, support and guidance, evaluation, feedback, local adaptation of intervention, accreditation of centers and practitioners, interinstitutional coordination.