Implementation qualitative barrier and facilitator assessment
word of mouth
RECRUITMENT, APPENDIX
Focus groups were conducted to identify ongoing barriers and facilitators to the implementation of Bio-K + ® prescribing throughout the duration of the Prevent CDI-55 + study. A series of semi-structured focus groups were conducted with pharmacists, physicians, and nurses, to understand their experiences with implementing probiotics during the Prevent CDI-55 + study time frame. Volunteers were recruited using purposive sampling (selected wards or units where high rates of antibiotic prescribing occurred which were predominantly medical, surgical and critical care wards/units) via email, word of mouth by the site champions and research team, and through a recruitment poster displayed in each hospital, to ensure the participants were representative of the hospital units included in Prevent CDI-55 + . The first focus groups were conducted following initiation of the Prevent CDI-55 + study at the first study site, SHC (March 1, 2017), and subsequent focus groups were conducted at the additional study sites based on the initiation of the Prevent CDI-55 + study at each site (RGH: September 1, 2017; PLC: March 1, 2018; FMC: September 1, 2018). The timing of the focus groups at each site was planned to ensure adequate exposure to the Prevent CDI-55 + study at each respective site to allow for informed responses regarding the barriers and facilitators to initiation. Focus groups were conducted by two members from the research team, and the discussions were recorded, transcribed, and de-identified. The script used for the semi-structured interview is provided in Appendix 