Adapting Interventions for Occupational Therapy Practice: Application of the FRAME Coding Structure.

Area of Science:

• Occupational therapy
• Telehealth
• Intervention adaptation

Background:

• Evidence-based interventions are often adapted for practice, but these changes are rarely documented.
• The COVID-19 pandemic necessitated rapid shifts to teletherapy, requiring significant intervention modifications.
• Systematic tracking of intervention adaptations is crucial for understanding their impact.

Purpose of the Study:

• To apply the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to document modifications made to a vestibular and bilateral integration (VBI) protocol for teletherapy.
• To describe the nature and frequency of adaptations implemented during the transition of an in-person VBI protocol to a teletherapy service delivery model.

Main Methods:

• An embedded multiple case study design was employed.
• The "Modification and Adaptation Checklist" was utilized to systematically record adaptations to the VBI protocol.
• Descriptive analyses were performed on the collected adaptation data.

Main Results:

• A total of 63 adaptations were made to the VBI protocol during its transition to teletherapy.
• The most frequent adaptation involved "Repeating protocol activities."
• The least common adaptation was "Integrating another treatment approach with the VBI protocol."

Conclusions:

• The Framework for Reporting Adaptations and Modifications-Expanded (FRAME) provides a systematic method for documenting intervention adaptations.
• Tracking adaptations is essential for evaluating their influence on intervention effectiveness in teletherapy settings.
• This study highlights the extent of modifications required when implementing in-person protocols via telehealth.