Table 4 Data collection for evaluation of the barriers, facilitators, and experiences and expected activities /strategies. Evaluation methods and activities will be adapted to each site’s unique context
| Â | How | Objective | What | Who |
|---|---|---|---|---|
Baseline | ||||
 Evaluation | Organizational Assessment Tool (Adapted from ‘Rooming in Guideline for Perinatal Women using Substances’) [62] | -Determine timeframe for implementation Identify preliminary understanding of current practice Raise awareness and reflection on rooming-in elements | Overall competing system demands; support from hospital administration and executives; urgency; appropriate space; non-pharmacologic management of NAS; champions and leaders; staff training and education; partnerships and linkages with community and children’s services; commitment to stakeholder engagement | Hospital sites management, leaders, and key individuals involved in NAS care |
Interviews | Learn about the journey of building the rooming-in program | The initiation of the program, current practice and the lessons learned | Individuals who were involved in developing rooming-in model of care in established programs | |
 Activities/Strategies | Introductory meetings | -Introduce NASCENT and the rooming-in approach Identify site stakeholders/ implementation team/ champion / timelines -Build relationships | 1. Presentations: NASCENT overview, sharing experiences, Q&A, planning 2. Facilitation: identifying site champions, early adopters 3. Planning Sharing questionnaires findings | Hospital sites: management, leaders, and interested individuals involved in NAS care |
-Introduce NASCENT and the rooming-in approach -Build relationships | Presentations: NASCENT overview, sharing experiences, Q&A | Community stakeholders from programs and services involved in care for women with substance use | ||
Pre- implementation | ||||
 Evaluation | Observation | Enable understanding of the sites’ operating practices | At working hours and site implementation meetings | Sites with an operating rooming-in model of care |
Questionnaire | Identify current knowledge, practice, attitudes, and beliefs | Individual perspectives: knowledge, expectations, barriers and facilitators, education needs, unique site context | Health care providers | |
Focus group | Identify current knowledge, practice, attitudes, and beliefs | Perspectives: knowledge, unit culture, expectations, barriers and facilitators, education needs, unique context (1–2 FG depending on site size 4–6 participants) | Health care providers directly involved with caring for mothers and babies | |
Interviews | Identify current knowledge, practice, attitudes, and beliefs | Individual perspectives: knowledge, experience, unit culture, expectations, barriers and facilitators education needs, unique context (4–6 interviews) | Key stakeholders, operational leadership | |
 Activities/ strategies | Workshops/ meetings (1–2 or as needed) | Identify site implementation team, partners, current practice, context, and needs | - Current NAS practice and culture -Instigate or enhance practices - Identify and establish implementation team that will ensure continuum of care -Understand the site unique context -Asess available and required education -Identify areas of growth | Operational, medical, nursing, and social work, champions, educators, stakeholders, unit managers |
Facilitate site planning for implementation | Creation of site- plan to prepare for NAS care, e.g., space, timelines, mechanisms to refer to the OPD/VOPD program, prenatal recruitment and transitions from and to community, staff resources (e.g., FAQ) | Operational, medical, nursing, and social work, champions, educators, stakeholders, unit managers | ||
Training | Train the trainer (site champions) | Facilitated by the Provincial Clinical Lead and the research team | Site champions | |
Provide informal training | Trauma informed, anti-racist training through lived experience, peer mentoring | Health care providers with site champions educators, and peer support workers | ||
Advance individual and team/unit advancement: competencies, professional development, knowledge | Formal or informal learning opportunities | Health care providers with site champions educators, and peer support workers | ||
Education | Promote individual advancement: competencies, professional development, knowledge | Completion of staff education related to NASCENT interventions | Health care providers with site champion and/or alone (e.g., modules) | |
Provide education to pregnant women about the rooming-in model of care | Raise awareness and inform individuals through engagement with community organizations | Site champion Social workers Mothers | ||
Development of site’s tailored education plan | The Provincial clinical Lead will guide educational programming, onsite and virtual training prior to initiation, roll out of site-specific clinical protocols, virtual mentorship for care teams and individuals | Site champions and educators | ||
Protocols, guidelines, and FAQ | Provide standardized care | Site specific and /or across sites Provide additional support resources | Implementation teams and research team | |
Implementation | ||||
 Evaluation | Observation | Enable additional understanding of the sites’ unit culture, characteristics, challenges, and facilitators that impact implementation | At working hours and site implementation meetings | At all participating sites |
Questionnaire | Identify current knowledge, practice, attitudes and beliefs, proceeding education | Individual perspectives: training and education provided, experience, unit culture, expectations, barriers and facilitators, satisfaction | Health care providers | |
Focus group | Identify current knowledge, practice, attitudes and beliefs, proceeding education | Perspectives: training and education provided experience, unit culture, expectations, barriers and facilitators, experiences (1–2 FG 4–6 participants) | Health care providers, mothers after discharge | |
Interviews/ focus groups | Identify experiences | Individual perspectives: experience, unit culture, expectations, barriers, and facilities, satisfaction | Mothers after discharge | |
 Activities/ Strategies | Planning meetings | -Identify needs, Explore facilitators and barriers -Modify interventions | -Focus on challenges and success Iterative feedback and -Continue to support capacity building through targeted interventions -Support stakeholder relationships within and outside the site | leadership Implementation team, |
Workshops | Provide education | provide ongoing staff education on identified topics | Health care providers | |
Education | Increase team and individual competencies | Refinement based on evaluation | Implementation team, educator and research team | |
Training | Increase team and individual competencies | -Provide learning opportunities -Refinement of training based on evaluation | Implementation team, educator and research team | |
Protocols, guidelines, and resources | Provide standardized care | Refinement of existing guidelines and resources | Implementation team and research team | |
Post implementation | ||||
 Evaluation | Questionnaire | Identify current knowledge, practice, attitudes and beliefs | Individual perspectives: training and education provided, experience- lessons learned, unit culture, expectations for future practice, barriers and facilitators | Health care providers |
Identify experiences | Individual perspectives: experience, unit culture, expectations, barriers, and facilities, satisfaction | Mothers 6Â months after discharge | ||
Focus group | Identify current knowledge, practice, attitudes, and beliefs proceeding implementation | Individual perspectives: training and education provided experience- lessons learned, unit culture, expectations, barriers and facilitators | Health care providers | |
Interviews | Identify current knowledge, practice, attitudes, and beliefs proceeding implementation | Individual perspectives: experience, unit culture, expectations, barriers and facilitators | Key stakeholders, management | |
Observation | Enable understanding of the sites’ unit culture and practice change | Identify challenges, and facilitators that impact implementation uptake and sustainability | At all sites | |
Interviews/ focus groups | Identify experiences | Individual perspectives: experience, unit culture, expectations, barriers, and facilitators, satisfaction | Mothers after discharge | |
 Activities/strategies | Meetings/ workshops 1 or more as needed | Planning for sustainability | Lessons learned. Barriers and facilitators to sustainment. Plans for sustainability | Care team and community partners |