Table 1 Focusing questions for the exploration and preparation phases

Exploration

• Articulate the organizational or system issue that needs to be addressed

• Conduct a needs assessment that describes the problem and its scope

• Identify potential interventions or EBPs

• Assess the fit of the intervention within the organizational or system context

• How many people with mental illnesses are on probation? (Inner context)

• What unique supervision adherence-related challenges are faced by people with mental illnesses? (Inner context)

• What unique health access-related challenges are faced by people on probation? (External context)

• How effective are specialized mental health probation caseloads? (Innovation factors)

• Where have specialized mental health probation caseloads been implemented? (Innovation factors)

• In what ways are the contexts of these settings different from/similar to my agency or service system setting? (Inner context)

• What staffing capacity does the intervention require? (Inner context/innovation factors)

• Does the agency/service system have the capacity to implement specialized mental health caseloads at this time? (Inner context)

• What resources would the agency/system need in order to implement these caseloads? (Inner context)

• What type of funding would be needed to implement these caseloads, and what is the sustainability of the funding source? (Innovation factors, outer context)

• What are the staff perceptions about mental health caseloads? (Inner context)

• Overall, what is the morale among staff at the agency? (Inner context)

• What other interventions, programs, or expectations are the staff currently focused on? (Inner context)

• Do people at the agency believe that we need to address mental illness among the people on probation? (Inner context)

Ultimate questions for exploration phase

• Are mental health probation caseloads the right fit for our agency/system right now?

• What adaptations to the model should be considered?

Preparation

• Assess potential factors that can impact implementation

• Plan implementation strategies to address challenges and enhance uptake of intervention

• Develop data monitoring and evaluation plan

• What services are available in the behavioral health service system in province, territory, and state? (Outer context)

• What are the existing relationships between probation and behavioral health service systems? (Outer context, bridging factors)

• What needs to be improved in terms of interorganizational relationships? (Outer context)

• What skills and knowledge do the mental health probation officers need to have in order to effectively supervise these caseloads? (Inner context)

• What skills and knowledge do behavioral health service providers need to have to effectively collaborate with probation officers supervising mental health caseloads? (Outer context)

• Who are the agency/service system staff members that are championing/would champion these caseloads? (Inner context)

• Who are the staff members not currently in support of mental health caseloads? (Inner context)

• Who are the service provider partners that are championing/would champion mental health caseloads? (Outer context)

• If these caseloads are implemented, what are the potential implementation challenges? (Inner context, outer context)

• If these caseloads are implemented, what are the potential resources that can help address challenges? (Inner context, outer context)

• Considering the potential challenges, how can we leverage identified resources to build strategies to enhance implementation? (Inner context, outer context)

Ultimate questions for preparation phase

• What implementation strategies should we use to promote adoption of mental health caseloads?

• What specific adaptations should be made to promote uptake of specialized mental health caseloads?

• How will we know when specialized mental health caseloads are implemented as intended?