| Title: |
Development of a framework and coding system for modifications and adaptations of evidence-based interventions |
| Authors: |
Stirman, Shannon; Miller, Christopher J; Toder, Katherine; Calloway, Amber |
| Publisher Information: |
BioMed Central Ltd. |
| Publication Year: |
2013 |
| Collection: |
BioMed Central |
| Subject Terms: |
Implementation; Modification; Adaptation; Sustainability |
| Description: |
Background Evidence-based interventions are frequently modified or adapted during the implementation process. Changes may be made to protocols to meet the needs of the target population or address differences between the context in which the intervention was originally designed and the one into which it is implemented [ Addict Behav 2011, 36 (6):630–635]. However, whether modification compromises or enhances the desired benefits of the intervention is not well understood. A challenge to understanding the impact of specific types of modifications is a lack of attention to characterizing the different types of changes that may occur. A system for classifying the types of modifications that are made when interventions and programs are implemented can facilitate efforts to understand the nature of modifications that are made in particular contexts as well as the impact of these modifications on outcomes of interest. Methods We developed a system for classifying modifications made to interventions and programs across a variety of fields and settings. We then coded 258 modifications identified in 32 published articles that described interventions implemented in routine care or community settings. Results We identified modifications made to the content of interventions, as well as to the context in which interventions are delivered. We identified 12 different types of content modifications, and our coding scheme also included ratings for the level at which these modifications were made (ranging from the individual patient level up to a hospital network or community). We identified five types of contextual modifications (changes to the format, setting, or patient population that do not in and of themselves alter the actual content of the intervention). We also developed codes to indicate who made the modifications and identified a smaller subset of modifications made to the ways that training or evaluations occur when evidence-based interventions are implemented. Rater agreement analyses indicated that the ... |
| Document Type: |
report |
| Language: |
English |
| Relation: |
http://www.implementationscience.com/content/8/1/65 |
| Availability: |
http://www.implementationscience.com/content/8/1/65 |
| Rights: |
Copyright 2013 Stirman et al.; licensee BioMed Central Ltd. |
| Accession Number: |
edsbas.BF1DCB50 |
| Database: |
BASE |