Table 3

Verbatim quotations of participants

Acceptability Perception among implementation stakeholders that a given treatment, service, practice or innovation is agreeable, palatable or satisfactory.
‘Actually, I’d say that many health care attendees, not 100%, or even 50%, rather 30% to 40%, are very happy. Not just happy, but very very happy… We are talking about individual interviews, aren’t we? With health care attendee and health professional’ (female physician, Basque Country). ‘Feeling more confident about it yes, because probably I was not confident at all, see? I was talking about that. I have integrated it now, because I felt a bit insecure, and now, well, now I know I’m doing the right thing’ (woman, 52*, healthcare attendee, Castilla-La Mancha). ‘I think it’s fine. The questions I’m asked, the blood tests with results that I know very well and that other issue’. (man, 70, healthcare attendee, Andalusia). ‘Generally speaking I’m happy with the intervention, I believe that with the EIRA project I have acquired tools to evaluate my daily work. They have been useful to us professionals because it has helped to structure, plan and prioritize our intervention. Motivation and decision-making with the patient have really contributed to achieve the objectives’ (female nurse, 40 years, Catalonia). ‘I have found it truly interesting, but also very long and difficult to implement with our current work overload’ (female physician, 42 years, Catalonia).
Appropriateness and feasibility Appropriateness is the perceived fit, relevance or compatibility of the innovation or evidence based practice for a given practice setting, provider or consumer; and/or perceived fit of the innovation to address a particular issue. Feasibility is the extent to which a new treatment or innovation can be successfully used within a given agency or setting.
Training conducted prior intervention	‘I think that the training on motivational interviewing has been interesting’ (female physician, 42 years, Catalonia). ‘I would say no, we did not learn anything new. If it was meant to provide the same baseline for everybody, well, then fine. But we did not see it as what we actually had to deliver for the project, I mean, we saw it as something that they tell you and then you have to face the real thing’ (female nurse, 61 years, Castilla-La Mancha). ‘Well, whenever we receive specific training we benefit, we become aware of many things that we don’t do… we become more aware, we realise that we overlook some issues, in this sense it has been useful, sure’ (female physician, 42 years, Balearic Islands).
Coordination	‘Let’s see, I really believe that this was planned top-down, and as a research project, well, it has been carried out in a hurry like all research projects, so the truth is we need more time for reflection’ (female nurse, 62 years, Aragon). ‘I think that in our health centre all this work has mainly focused on the nurses… we have not been as involved… I think that we should have coordinated better, I think that’s a fair point’ (male physician, Basque Country).
Recruitment	‘The recruitment bit was the worst, seeing the patients between consultations, explaining about consent, that took a long time, and sometimes they did not even participate’ (female nurse, 39 years, Catalonia). ‘The recruitment should be different, another model, because the participants are regular attendees, and they manage, they more or less manage their health’ (female nurse, 61 years, Castilla-La Mancha).
Baseline visit of allocated health professional	‘And what did you decide to work on? Mainly, the diet to lower cholesterol. And I have succeeded’ (man, 59 years, healthcare attendee, Catalonia). ‘Some have started with one and then become involved and used to it… this here started walking and exercising and he finally has come for quitting smoking, he is a multiplier. I really think that this approach is very useful, to make them commit, when we talked about contract. The contract is crucial, when they realise that they have to sign the commitment form’ (male physician, 61 years, Andalusia). ‘I thought it was fantastic, very good, wonderful, having a tool (ie, prioritisation algorithm) like that to assist you’ (female nurse, 26 years, Castilla-León).
Individual intervention	‘… but the test of arteries and all that, they were really delighted with this. And also the people got confused, like with depression, mainly in patients with diabetes or that have been advised on diet and lifestyles for ages, they also mixed this with the study’ (female professional, 39 years, assistant researcher, Balearic Islands). ‘I think it has been too short, basically a short question. Just a couple of interviews and that’s it’ (man, 51 years, healthcare attendee, Aragon).
Group intervention	‘For sharing and all that. It’s wonderful. I think that in these matters the people benefit from the group’ (woman, 75 years, healthcare attendee, Basque Country). ‘… the conflict of some doctors that have not quite grasped why the nurse went for a walk and protested “now I don’t have a nurse, I want her to stay here”, and these apparent trifles that if all perhaps… just having patients from 5 GPs out of 11 has not worked out very well, maybe… the whole health centre should have participated…’ (male physician, 42 years, Balearic Islands).
Community intervention	‘And in relation to community activities, like other times, it’s always the same, it’s difficult to get them started, it was hard to get them going, but it is eventually rewarding because they already ask when they will be happening again’ (female physician, Basque Country). ‘Yes, but now it has stopped because it’s unpredictable, it depends on the policies of the council, so now we have it and later we don’t, and now they even have changed coordinator so my expectations…’ (male nurse, 40 years, Catalonia). ‘And the community assets should be better exploited. Here in our neighbourhood there are things available that we don’t know about and then maybe talking I learn that a neighbourhood association organises fitness sessions. And the Council, they also have initiatives, the City Council has a programme with a doctor, let’s say in charge of the programme, they have done it for a while and sometimes they have wanted to come, they even came here’ (male physician, 62 years, Castilla-León).
Patient information leaflets	‘That on depression too, what is anxiety, how to manage sleeplessness, patients have found it very interesting’ (female physician, 43 years, Andalusia). ‘The information is very good, that on sleeplessness is outstanding’ (male physician, 61 years, Andalusia).
SMS and webpage to support advice provided	‘Yes, yes, yes. Because it’s a reminder that… that is good, and it’s there. I don’t delete it, it’s there and sometimes I say, come on, I’ll go and have a look. Yes, it’s a reminder that’s available. For me it’s quite…good’ (woman, 52 years, healthcare attendee, Castilla-La Mancha). ‘Well, I very well, because I read that and really integrated that information. Sometimes I even laughed’ (woman, 47 years, healthcare attendee, Catalonia). ‘Just being as thoughtful as to send an encouraging message, it’s great because sometimes it reaches you just when you most need it’ (woman, 55 years, healthcare attendee, Catalonia). ‘Even with the mobile phone and messages, the mobile phone, “my mobile is only to phone and to receive calls, no messages”. Well, it’s more difficult than anticipated’ (female nurse, 45 years, Aragon). ‘Text messaging is really good, it’s a very good idea and I think it has been used a great deal… the platform was meant for an age group of health care attendees with not very advanced IT skills. I really believe that our health care attendees, very few will have used this platform because they are not used to, they don’t know how to use it and therefore, the platform has probably not been very useful, what do you think? I mean, you receive the message and you see it, and it seems that the mobile is easier to manage, while internet access… If you don’t have internet access at home where are you going to read it?’ (female nurse, 31 years, Castilla-La Mancha).
Case Report Form (CRF)	‘You cannot register the commitment with the patient in the CRF, it’s not even practical. It is not adapted to the commitment you make with the patient and that suggested is so cumbersome that it’s impossible to see it through, that of physical exercise planned the, the objectives attainable in a week, during the week, during every day of the week’ (physician, Balearic Islands).
Follow-up	‘Many have refused to undertake the final evaluation because they had the baseline evaluation and did not implement the intervention or maybe, perhaps at the time they had problems to come to the health centre or had something else going on and they already disconnected, you and the patient, from the study and the evaluation and follow up never took place; and others that dropped out because they are not interested, they say not now because it’s complicated, I have problems etc., I don’t want to do it or…’ (female professional, 39 years, assistant researcher, Balearic Islands).
Evaluation of intervention (baseline and final). Role of assistant researchers	‘… [I]t is essential to remain within the centre (laughs) because otherwise we left things undone and the possibility to be face to face, talking with them about things that I’m missing, that need completing…the coordination with them has worked well’ (female professional, 39 years, assistant researcher, Balearic Islands). ‘I’m also having trouble with the internet connection because I don’t have my own password and I don’t have my own physical workspace, which results in work overload’ (female professional, assistant researcher, Castilla-La Mancha).
Sustainability The extent to which a newly implemented treatment is maintained or institutionalised within ongoing, stable operations of a service setting.
‘Yes, I really think so, I think that with time it’s doable’ (female nurse, Castilla-León). ‘If you specifically mean this project, I think that I would consider depression separately’ (female physician, 55 years, Aragon). ‘I liked it, well it’s my opinion, it’s one of these things that, I enjoyed doing and I would like to continue because there are aspects that, I don’t know, that I find very positive’ (female nurse, Balearic Islands). ‘We have talked about this in the Community Health Meeting that has just taken place and it seems that it mainly hinges on political will … to include purposefully the activities in the portfolio of services, some proposals suggested to include community health in the portfolio of services, because otherwise it’s always some kind of favour and that the… and therefore I believe that the top management should really rally behind it, to be able to expand, I think’ (female nurse, 62 years, Aragon). ‘The project can be extended to other centres, but it’s crucial to adapt the schedule of the professionals that are in charge of these interventions, which might cause conflict with other professionals or additional burden for participants. Best to carry out the project with the whole team’ (female nurse, Catalonia).
Penetration: changes implemented by healthcare attendees and professionals after the intervention. Integration of a practice within a service setting and its subsystems.
Healthcare attendees	‘… every now and then it’s good to get it out even if it’s by answering questions …. I used to think about the questions that he asked, which since my life is so hectic I had not even considered’ (woman, 55 years, healthcare attendee, Catalonia). ‘I feel very well, very well. More fit and all that. Well, at first to climb to the eight floor was so very challenging. I feel better. All in all, it has worked for me’ (woman, 62 years, healthcare attendee, Basque Country). ‘… it has helped, before I used to smoke anything I could find and now I smoke 5 or 6 or 7 more or less. But before I used to smoke much more’ (woman, 47 years, healthcare attendee, Catalonia). ‘Yes, let’s see, before I didn’t have nuts and now I know that they are good for me. So now I feel good when I eat them, because I eat them now. Fruit? Well, I didn’t have that much and… and now I eat more’ (woman, 52 years, healthcare attendee, Castilla-La Mancha). ‘Do you think that all this has been helpful? I think so, more so because I lacked willpower, and taking all literally and it has been like a push, a push’ (man, 59 years, healthcare attendee, Catalonia). ‘Yes, it has helped… it also helped a lot mentally, for my own reflection. I needed it badly, because I felt very unhappy, unemployed, I carried a lot of luggage. My family far away, I was suffering… I still have lots to do, it was very very very useful’ (woman, 47 years, healthcare attendee, Catalonia). ‘I even spoke to my children after that (…) and I told them: If you are going to give me something give it to me while I’m alive, love, affection… don’t do, you don’t have to do anything for me’ (woman, 55 years, healthcare attendee, Catalonia). ‘About walking, I’ve tried, it has been a very complicated period because I’ve had very difficult family issues… but I’ve tried to walk a bit more’ (Woman, 58 years, healthcare attendee, Castilla-León).
Health professionals	‘… to be more aware maybe toward the patient. I think it has been useful, perhaps not for everybody, I don’t know, the feeling is that, we act sensibly and that yes, that we have to encourage it more, but I don’t know how’ (female physician, 42 years, Balearic Islands).

These quotations were translated by a professional scientific bilingual translator. Anonymity, confidentiality and data protection were guaranteed. It is impossible to identify participants; for example, Catalonia is a Mediterranean region with more than 7 million of inhabitants.