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Implementing MDET: Evaluating adaptations and effectiveness1536care recordings from before to after the start of implementation of MDET in care homes (n = 25) and compare these to changes in care home that carried on as usual (n = 25). The interruption was defined as the date on which the MDET method started in the implementation condition. In the analysis, we accounted for the nesting of involuntary care recordings within care homes. Lastly, to examine whether implementation of MDET was notassociated with an increase in incident reports we compared the number of weekly recorded incident reports before and after the MDET start date, moderated by care home condition (intervention vs. CAU), and accounting for the nesting of incident reports within care homes (research question 3).Data collectionParticipants Qualitative StudyMDET coordinators of four participating organisations collaborated in a Community of Practice (CoP) since June 2019 with the aim to exchange insights and ideas about implementation of methods that reduce involuntary care (Bisschops et al., 2023). A CoP is a group of people with a mutual interest in a domain or topic who work and learn together (Wenger et al., 2002). CoP meetings were held every two months. The agenda was set jointly and included topics such as implementation experiences, phasing out involuntary care, changing socio-political context and executing the MDET method. In organisations A and C, MDET coordinators were policy workers. In organisation B, the coordinator was a psychologist. Organisation D had two coordinators: one policy worker and one psychologist. In September 2023 MDET coordinators evaluated their implementation experiences, which included possible adaptations to the method in an interview with the first author. During the last CoP meeting in October 2023, coordinators presented their experiences with MDET to each other and the research team. Both the interviews and presentations by MDET coordinators were analysed to examine the implementation and adaptations to MDET. This qualitative study was approved by the Ethics Committee of the faculty Behavioural and Movement Sciences, Vrije Universiteit Amsterdam VCWE2019-090R1.