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Examining adaptations of evidence-based programs in natural contexts
Julia E Moore1, Brian K Bumbarger, Brittany Rhoades Cooper
1Li Ka Shing Knowledge Institute, St. Michael's Hospital, 30 Bond St., Toronto, ON, M5B 1W8, Canada. moore.juliae@gmail.com
The Journal of Primary Prevention
|April 23, 2013
Summary
Most evidence-based programs (EBPs) are adapted when scaled up. Adaptations often address logistical fit and program procedures, but frequently deviate from original program goals and theory.
Area of Science:
- Public Health
- Implementation Science
- Program Adaptation
Background:
- Evidence-based programs (EBPs) often undergo adaptations when implemented outside research settings.
- The fidelity versus adaptation debate lacks empirical data on real-world adaptations.
- Understanding adaptation types and reasons is crucial for effective program scaling.
Purpose of the Study:
- To introduce a novel taxonomy for classifying program adaptations.
- To empirically examine the types and reasons for adaptations in state-funded EBPs.
- To analyze the valence of adaptations in relation to program goals and theory.
Main Methods:
- A taxonomy was developed to categorize adaptations by fit, timing, and valence.
- Qualitative data from communities delivering EBPs were coded using the taxonomy.
- Quantitative data analyzed adaptation types and reasons under natural conditions.
Main Results:
- 44% of respondents reported making adaptations to EBPs.
- Adaptations most frequently involved procedures, dosage, and content.
- Common reasons for adaptation included time, resources, and participant retention.
Conclusions:
- Most adaptations were reactive, driven by logistical fit issues.
- Adaptations frequently deviated from the original program's goals and theory.
- Further research is needed to guide adaptations that maintain program integrity.
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