CENTER-IT: a novel methodology for adapting multi-level interventions using the Consolidated Framework for...

Area of Science:

• Implementation Science
• Health Services Research
• Public Health

Background:

• Implementation science frameworks emphasize multi-level partner engagement for evidence-based practice (EBP) adoption.
• Limited guidance exists on incorporating provider and patient/caregiver perspectives into systems-level adaptations.

Purpose of the Study:

• To present a novel methodology for engaging multi-level partners in adapting EBPs, ensuring systems-level changes reflect end-user input.
• To illustrate this methodology using the Asthma Link intervention as a case example.

Main Methods:

• A 4-step methodology grounded in the Consolidated Framework for Implementation Research (CFIR) was developed.
• Interviews with providers, patients, and caregivers identified barriers; systems-level partners provided solutions.
• Deductive reasoning and theoretical sampling guided the adaptation of the Asthma Link intervention.

Main Results:

• Key barriers included obtaining dual inhalers, inconsistent school delivery, and lack of school nurses.
• Systems-level partners proposed solutions: Medicaid policy for dual inhalers, pharmacy-school delivery, and non-nurse medication supervisors.
• The iterative process resulted in an adapted Asthma Link intervention ready for implementation.

Conclusions:

• The novel CFIR-grounded methodology ensures systems-level adaptations incorporate voices of EBP deliverers and receivers.
• This approach highlights the interplay of CFIR domains, advancing implementation science.
• The adapted Asthma Link intervention is better positioned for successful uptake.