Background
depressive disorder, anxiety
CHRONIC DISEASES, DISEASE, DISORDERS
Common mental health disorders such as depressive disorder and anxiety account for a large proportion of the global burden of disease [When an organization decides to adopt iCBT treatments, implementation strategies are often focused on the technical infrastructure and educational training of service providers. Service providers commonly receive technical training that focuses on how to use the web-based iCBT platform. Although important, these strategies may not necessarily address the most urgent barriers to implementation. Often, it requires learning new communication skills [In general, iCBT services are not implemented and delivered in isolation. They impact and interact with various aspects of the health care service delivery system. Implementing iCBT services in routine mental health care practice is a complex process that affects multiple actors, such as service providers, clinical directors, policy makers, insurers, managers, administrators, and patients, and does so at multiple levels [Implementation, seen as a process by which people bring new or modified practices into operation [To date, mostly expert-driven models of tailored implementation have been developed and studied. In models that involve expert-driven tailoring, experienced implementation researchers or implementation practitioners play a prominent role in guiding the tailoring process, designing the implementation strategy, and applying the strategy. Generally, these experts are external to the organization, not involved in the development of the intervention or guideline that is to be implemented, and they do not necessarily have in-depth knowledge of or experience with the specific context such as mental health care. Their primary field of expertise lies in facilitating, advising, or evaluating the implementation of complex interventions in various medical fields including primary and specialized health care. An example of expert-driven tailoring was applied in the Tailored Implementation for Chronic Diseases project [Given this evidence base, there were limitations to the expert-driven model of tailored implementation. For example, external experts may be less adept at identifying context-specific barriers than local implementers, possibly leading to less effective implementation strategies. In addition, external experts may not know or have access to relevant local stakeholders, or they may be regarded as outsiders, possibly limiting the acceptability of specific implementation strategies by local stakeholders. Furthermore, expert-driven models of tailoring might have scalability issues and practical constraints because of the limited availability of experts to coordinate and facilitate tailoring of implementation strategies. Alternatively, tailoring more intensively to specific settings can be an alternative to improving the effectiveness of tailored implementation, but it is likely to be very costly [To overcome these limitations and to potentially improve the effectiveness of tailored implementation strategies, the integrated theory-based Framework for intervention tailoring strategies toolkit (ItFits-toolkit) was developed. As part of the Horizon 2020 ImpleMentAll (IMA) project [