Table 3 Examples of challenges from provider views of the intervention

“I think it’s good. It’s really good. I just find it’s a little bit long and it pulls us away from our clinics quite a bit and I know that’s a contentious issue with Dr. X that I’m not there as often… and that I’m part-time so I have to find a way to give that time, I find maybe if it was condensed maybe a little more, it might be a little more applicable. I, I don’t know”

A2, nurse

“Well I’m really excited about it. I mean I, I live the experience of being overweight myself and what a struggle it is, you know but I get the sense that it’s allowing us to explore and really putting out there, it’s giving us a framework to work within even if we’re dealing with our own things and that allows us to, to be better when we’re looking at our clients This week has, has gone so quick and yeah, I mean I guess my only, the only regret is that time away from the clinic but knowing that in the end of it all or though the process of it all, as I acquire more, more knowledge about myself and the program, I will be able to bring that value back to the clinic”

A3 nurse

“I’ve been really enjoying them. Some things I find are really new. Other things are refreshers but refreshers are always good. Just collaborating at the end, having an open discussion, getting perspectives from different health care professionals is always good too and like even for today, we identified gaps in terms of the classes that we were offering for nutrition so it brought to light something like change right that can happen so it’s good. I’ve, I’ve really enjoyed it… I mean it’s definitely time consuming and normally that’s not a big issue is just because it’s taking time away from clinic so to me it’s not a problem. The only problem that had come up was because it’s always the same time slot, like the two Thursdays every month, it, it affects the same clinic each and every time so this particular clinic is actually _______ and I’m only there two days a month so this takes out half a day twice a month so then I got a call a few weeks ago saying a patient really wanted to see me, it was kind of like an urgent issue but I wasn’t available until like February so because it affected the same clinic each and every time, it presented an issue but normally I wouldn’t have said that it would have been a problem at all… I really like that you know we kind of get like an education session and then a chance to kind of brainstorm, discuss afterwards”

B4, dietician

“Definitely an interest. I mean some of the speakers that we’ve had have been really great and I mean I am learning things from that perspective. How much is applicable, again people aren’t coming to see me specifically for weight management…I wouldn’t say I’ve had a hard time because the clinics are very accommodating and I’ve just booked it out of my schedule, however that, for me that is probably on a Thursday every two weeks, that’s probably anywhere from five to six patients that I could have been seeing right ‘cause, ‘cause I see on average about 10 or 12 a day so it, it, just in, in that respect. Nobody has, nobody has said anything or complained about it but I, I feel it”

C3, mental health worker

[Regarding the learning collaborative prior to the re-organization]

“I think the [group] facilitator should rotate or I don’t think you’re going, I think the group altogether is too big so I think they should try to rematch the groups a bit because there’s certain, like the group I’m in is a very quiet group … and you know I’m not going to, I could pipe up a lot but I’m not going to do that right so whereas the other group has a lot of really talkative verbal people so I think they need to either remix it or maybe alternate facilitators. That might be an option”

A10, nurse

[Initial skepticism of the front-line providers, highlights importance of monitoring internally and provider-centred intervention]

“I think it’s great. I think I’ve said that enough. I initially thought what am I, what have I been pushed into, what are we going to do here and I think a lot of us had that feeling actually because we did discuss it, we’re thinking what are put up, what are we going to do but as it is going on, I think it’s great…

[Regarding the learning collaborative prior to the reorganization]

“No I think what I take away from these meetings is a lot. Apart from the actual when we divide into groups [learning collaboratives], I don’t find that beneficial at all except for the last one we did was better but I don’t know, I was having a very difficult time and even realizing while we were sitting in that group and that’s why I had asked can we sit together as one big group ‘cause it seems like when we, every time we’d come back in the room, they [the other learning collaborative group] had this amazing conversation going on about what’s, what they’re supposed to be doing and it felt like we weren’t getting that and I thought then why are we here if we can’t get the full picture and the full education”

A15, nurse

“No, so far I’m really enjoying it. There’s been a, like maybe one of the talks where they used terms like what was it? I don’t think I’d want to put it wrong but almost like taking that parenting role with the patient, that really does not fit well with my approach and sort of is against the grain. I, I mean I understand what was meant but I think putting it in those terms perhaps isn’t the best way of explaining it. You, you definitely don’t want to take that approach on patients. I wouldn’t go over well at all or at least not from my experience. Other than that, that’s kind of the only thing that I went “oh” about. I really enjoyed it a lot more than I thought I would enjoy it and I think for the most part it has been, even in a lot of the mental health tools and things that I have, these are much more looking at that whole biopsychosocial perspective for patients, not focusing on calories, not focusing on numbers, that kind of thing and even the tools that I have still sort of reference that so”

C8, mental health worker