The implementation of standards into clinical routine in our study was not satisfactory and still needs improvement; however, taken both mediators together, treatment standards were more strictly implemented in trial hospitals than in non-trial hospitals.
Two townships in the intervention group and four in the control group had a prepayment maternal care scheme implemented during our trial, introduced already in the 1990s: every pregnant woman paid 200 RMB (about 24 dollars) in advance to the township hospital, which covered prenatal care, hospital delivery and postnatal care.
In addition, TNM staging should be implemented in clinical trial stratification and in tumor registry accession in order to allow future refinement of appropriate therapeutic options (Table 1).
Individualized health coaching by telephony, as implemented in the trial was unable to achieve majority of the disease management clinical measures.
The initial telephone screening procedure implemented in this trial was appropriate, and only one patient required attendance for further screening before a descision could be made; furthermore only one patient refused consent to participate in the trial.
Furthermore, the MLU intervention described in the trial protocol and implemented in the trial itself for women allocated to the MLU arm can be regarded as standard practice for MLU care in the two study sites, since the relevant procedures were established in the context of the MidU trial.
Integrating the findings from the qualitative interviews with the modelling thus identified the components of the screening test intervention that could be implemented in a trial from a service perspective.
ISRCTN: ISRCTN93576146 Understanding how interventions are implemented in trial settings is important for interpreting the main trial results and indicating how the intervention might function beyond the trial [ 1, 2].
