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This paper refines a model of Sustained Agile Usage to present a comprehensive understanding of the key factors that are pertinent to the sustained usage of agile methodologies. It describes our qualitative study which involves: (i) a focus group with twenty-nine software industry agile practitioners, and (ii) semi-structured interviews with twenty agile practitioners from five different organizational backgrounds. Data from both methods is used to develop the refined model of Sustained Agile Usage. The refined Sustained Agile Usage Model includes the following three categories: Agile Team Factors, Technological Factors, and Organizational Factors. These revisions are discussed in this research. Finally, we see implications for research: the study offers a useful complement to the few studies that have examined the long-term acceptance of agile methods. The refined model can be used as a reference model to guide future studies to understand sustained usage in different agile domains (e.g. Kanban). Additionally, implications for practice include valuable insights that can help agile teams and others (e.g. top management) to better understand and benchmark how agile methods can be effectively sustained in organizations.