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Table 4 NPT constructs and components coded per sub-theme

From: Embedding mentoring to support trial processes and implementation fidelity in a randomised controlled trial of vocational rehabilitation for stroke survivors

Themes and sub-themes NPT constructs and components Facilitators to mentoring and RETAKE intervention delivery, coded by NPT components (source of data) Barriers to RETAKE intervention delivery, coded by NPT components (source of data)
Delivery of the mentoring
 Preparation of mentors to deliver the mentoring Coherence:
- Communal specification
Cognitive participation:
- Initiation
Communal specification: RETAKE training increased mentors’ understanding of the RETAKE intervention, ensuring they had a shared understanding of its aims/objectives and expected benefits (Mentor interviews)
Initiation: Attendance of RETAKE training increased mentors’ understanding of the clinical/research processes and OT’s unique contextual challenges. This, along with their VR backgrounds, suggests they were the right people to drive delivery of the RETAKE intervention (Mentor interviews)
 
 Monthly mentoring sessions and additional support Collective action:
- Interactional workability
Interactional workability: The adaptability of the mentors (e.g., devising strategies) and cooperation from and between OTs suggests they interacted well with one another to operationalise the group teleconference format (Mentor interviews)  
The benefits of mentoring for OTs and trial implementation
 Strategies to facilitate recruitment into the RETAKE trial Coherence:
- Internalisation
Cognitive participation:
- Activation
Collective action:
- Interactional workability
Activation: Mentors defined actions with OTs to prompt recruiters and help on wards, thus helping to sustain increase recruitment rates (Mentoring records/emails)
Interactional workability: Following communication with mentors, OTS and Principal Investigators worked together to prompt recruiters and help on wards, thus helping to increase and sustain recruitment (Mentoring records/emails)
Internalisation: Lack of referrals occurred in one site due to staff not understanding the potential value of the RETAKE intervention for stroke survivors with low level impairments (Mentor interviews)
 Support with trial processes Coherence:
- Individual specification
Cognitive participation:
- Activation
Collective action:
- Relational integration
Individual specification: Mentors helped OTs understand their tasks/responsibilities in trial processes, e.g., trial paperwork (Mentor interviews)
Activation: OTs did not always have time to complete RETAKE paperwork. Mentors provided practical solutions to speed up and sustain paperwork completion (Mentoring records/emails)
Relational integration: Regular communication across the central RETAKE team, mentors, and OTs helped build accountability and confidence in each other’s abilities (e.g., OTs avoiding contamination) (Mentor interviews)
 
 Support with applying newly acquired knowledge Coherence:
- Individual specification
Collective action:
- Contextual integration
Individual specification: Mentors helped OTs to understand their specific tasks and responsibilities when creating an individually tailored VR treatment plan (Mentoring records/emails)
Contextual integration: Mentors signposted OTs to relevant local and national resources to support their delivery of the RETAKE intervention (Mentoring records/emails)
 
 Support for delivering the intervention with fidelity Coherence:
- Internalisation
- Differentiation
- Individual specification
Cognitive participation:
- Initiation
- Enrolment
- Legitimation
- Activation
Collective action:
- Interactional workability
Internalisation: All OTs interviewed believed in the value of all or some the RETAKE intervention’s core components (OT interviews)
Individual specification: Mentors helped OTs understand their tasks/responsibilities for delivering the intervention with fidelity, e.g., to start working with participants within 12 weeks of their stroke, to avoid discharging participants as soon as they had returned to work (Mentor interviews, mentoring records/emails)
Legitimation: Mentors reassured OTs that they were “on the right track” and had not failed if a participant had not been able to return to work (Mentor interviews)
Legitimation: OTs felt able to contact mentors if they needed reassurance they had taken the right steps with RETAKE intervention delivery (OT interviews)
Activation: Mentors supported OTs with knowing how to manage interactions with employers, including those who were difficult to engage (Mentor interviews)
Interactional workability: Mentors supported OTs with knowing how to interact with their managers to operationalise RETAKE intervention delivery in their setting (Mentor interviews)
Internalisation and differentiation: Unsupportive managers may not have understood the potential value of the RETAKE intervention, nor understood how it differed from usual care (OT interviews, mentoring records/emails, mentor interviews)
Initiation and enrolment: OTs were sometimes expected to deliver RETAKE in usual hours and were pressurised to stay on top of usual caseloads. Collective contribution to RETAKE intervention delivery may not have always been organised beforehand, and/or key senior staff involved to drive implementation of the intervention (Mentor interviews and mentoring records/emails)
Legitimation: Some unsupportive managers may not have believed their OTs should be involved in RETAKE, e.g., some managers themselves were new had not been formally introduced to RETAKE (OT interviews)
 Facilitation of independent problem-solving and peer support Cognitive participation:
- Activation
Collective action:
- Interactional workability
- Relational integration
Activation: OTs’ learning was supported by mentors’ facilitation of conversations during mentoring sessions, enabling collective problem-solving to take place (OT interviews)
Interactional workability: Some OTs had regular contact with site partners (e.g., peer supervision, joint visits to participants) to support operationalisation of RETAKE intervention delivery in their area (OT interviews)
Relational integration: OTs had regular contact with mentors, other OTs, and site partners to freely discuss caseloads, thus building accountability and confidence in their RETAKE intervention delivery (OT interviews)