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Related Experiment Video

Updated: Jun 28, 2026

Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm

Assessment of Stress Effects on Cognitive Flexibility using an Operant Strategy Shifting Paradigm

Published on: May 4, 2020

Fidelity versus flexibility: translating evidence-based research into practice.

Deborah J Cohen¹, Benjamin F Crabtree, Rebecca S Etz

¹Department of Family Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Somerset, New Jersey 08873, USA. cohendj@umdnj.edu

American Journal of Preventive Medicine

|October 24, 2008

Summary

This summary is machine-generated.

Interventions often change during implementation. Research teams are crucial for successful translation of evidence into practice by supporting adaptations and providing motivation.

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Area of Science:

Health Services Research
Translational Science
Implementation Science

Background:

Limited understanding exists regarding the process of translating research into practice.
This study investigated how health interventions evolve during the implementation phase.

Purpose of the Study:

To examine the nature and extent of changes in health interventions during implementation.
To identify factors influencing intervention adaptation in primary care settings.

Main Methods:

A qualitative analysis of data from ten health promotion interventions in primary care practices.
Data collection occurred from July 2005 to September 2007, using surveys, interviews, site visits, and project diaries.
Iterative group process used for real-time, cross-case comparison to identify intervention adaptations.

Main Results:

All implemented interventions required modifications, which varied by project and practice, and were often unanticipated.
Adaptations were made to accommodate practice circumstances, patient needs, and personnel costs.
Research teams significantly facilitated intervention uptake through personal influence, motivation, retraining, and instrumental support.

Conclusions:

Intervention changes are a common and expected part of implementation into practice settings.
Successful translation of evidence into practice requires acknowledging and understanding intervention adaptations.
Modifying research design and reporting standards is necessary to better capture implementation efforts and adaptations for quality improvement.