Table 1 The PRECEDE framework as conceptualized for this study

Predisposing Factors: the beliefs, knowledge, and attitudes of individuals that predispose them to certain aligned behaviors

Clinician knowledge of evidence in support of the CDSMP

Reinforcing Factors: the community norms, incentives, and infrastructures that shape and reinforce the predisposing factors

Frequency with which clinicians’ peers and administrators discuss the CDSMP

Enabling Factors: the immediate availability of individual and community resources required to carry out aligned behaviors

Availability of staff and technology to facilitate CDSMP referrals

Administrative Issues: the culture and priorities of a community or organization that determine, prescribe and facilitate changes to other factors

Organizational culture and mission that desires to keep people healthy

Policy Issues: the existing rules that require or prevent certain behaviors independent of motivations

Presence of organizational policies that limit external collaboration