We developed a core discussion guide that would enable us to address key topics in a consistent manner across case studies, along with a set of probes that could be used to direct the discussion. The discussions were organized around the following sequence: introductions, the context for the discussion, in-depth exploration of salient knowledge of and experience with the release and subsequent diffusion of the CER findings, a discussion of the individual’s dissemination activities at his/her own institution, and key lessons learned about the impact of the CER results. The following discussion topics served as the foundation for our conversations:
· Impressions of the dissemination of results and subsequent changes in clinical practice
— Whether or not the CER study changed clinical practice
— The most influential stakeholders in communicating the messages of the CER study
— The most effective dissemination activities
— Key barriers to or enablers of change to clinical practice
· Dissemination strategies pursued by the individual discussant or his/her organization
— Dissemination channels used
— The target audience for dissemination initiatives
— The success of dissemination initiatives
— Key dissemination challenges
· Key lessons learned about what impacts dissemination of CER results
· Recommendations of other discussants with relevant perspectives.
Consistency of topics across discussions allowed us to draw contrasts between different stakeholder perspectives. However, we also tailored specific discussion topics to individual stakeholder types. The nature of the topics evolved organically, based on our emerging understanding of issues within each case study.