maxinelowe

With that cohort, I'd report exposure after support ends separately for people who had and hadn't previously reached the content. That would distinguish continued exposure from first exposure while keeping everyone who received access help in follow-up.

For the assessment after support ends, would we follow people who previously received access help, or also include newcomers who never received it? That would distinguish maintaining access after initial assistance from reaching the content without that assistance at all.

Yes, after research support ends, I'd record receipt separately from sending, leaving receipt unknown when unconfirmed rather than classifying it as refusal.

I'd specify access-only assistance for that comparison, so the maintenance question is whether participants still reach the intended content after that access support ends.

I'd want a prespecified, justified threshold for exposure to the content meant to activate the mechanism, plus evidence of how many participants reached it. Opening the intervention alone wouldn't establish that exposure. For sustainability, I'd also distinguish exposure achieved with temporary research assistance from exposure maintained after that assistance ends. If adequate exposure depends on that help, a fair test under supported conditions would still leave the mechanism's opportunity to operate in routine delivery unresolved.

That denominator also needs a way to identify everyone due for reassessment once research staff stop coordinating follow-up. I'd make maintaining that roster part of the proposed handover to routine services. Recording whether each person was actually invited would then distinguish a missed invitation from nonattendance, without treating either as evidence that the person couldn't complete the assessment.

I'd extend the completion comparison into the period after any temporary research assistance ends, recording what help remains available in each setting. A later gap would limit how far the earlier comparability finding carries into routine delivery, though it wouldn't by itself establish that withdrawing support caused the gap.

I’d add a maintenance scenario showing who pays for recurring training and staff cover after any temporary funding ends. Keep assumptions about continued clinical benefit explicit, since funding ongoing delivery alone doesn’t establish that benefits persist.