Stepped-wedge rollout and transitions

Assign sequences periods and transitions

Randomize transition sequences and record assigned and actual transition dates. A delayed implementation is a deviation to analyze, not a reason to silently rewrite the randomized sequence.

Flow diagram

Stepped-wedge rollout and transitionsF1.S1Define periods and transitionsequencesF1.S2Randomize clusters to sequencesF1.S3Plan intervention transitionsF1.S4Specify sequence-period scheduleF1.S5Track rollout deviations andfidelityF1.N1Sequence-period scheduleSequenceInitial periodTransition ruleLater periodsDeviationhandlingSequence ASequence BSequence CF1.N2Assumptions and rationaleF1.N3Method and protocol evidenceF1.S0 Start flowStepped-wedge rollout and transitionsF1.S999 End flowEnd flow

Steps

Define periods and transition sequences

Specify period length, number of steps and transition timing.

Randomize clusters to sequences

Document restrictions, concealment and allocation responsibilities.

Plan intervention transitions

Record implementation, wash-in and delayed effect assumptions.

Specify sequence-period schedule

Map control, transition and intervention states for each sequence.

Track rollout deviations and fidelity

Document delays, contamination and cluster departures.

Stepped-wedge rollout and transitions

End flow

Tables and supporting information

Sequence-period schedule

Sequence-period scheduleSequenceInitial periodTransition ruleLater periodsDeviationhandlingSequence ASequence BSequence C

Replace period columns and sequences with the actual schedule; cells remain blank for author decisions.

Assumptions and rationale

The rollout schedule is randomized; secular trends and exposure duration must still be addressed.

Method and protocol evidence

Attach the protocol, methodological sources and versioned software specification supporting these decisions. Record citations and provenance; do not enter participant identifiers.

Sources