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Program adaptation by health departments.

Louise Farah Saliba1, Peg Allen1, Stephanie L Mazzucca1

  • 1Prevention Research Center, Brown School at Washington University in St. Louis, St. Louis, MO, United States.

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|September 29, 2022
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State health departments adapt public health programs based on data and context. Decisions involve managers and staff, aiming to improve program effectiveness, reach, and funding.

Keywords:
adaptationevidence-based decision makingevidence-based interventionimplementationpublic health practice

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Area of Science:

  • Public Health
  • Health Services Research
  • Intervention Science

Background:

  • Evidence-based interventions are crucial for public health.
  • Interventions require adaptation for diverse populations and contexts.
  • State health departments (SHDs) play a key role in intervention dissemination.

Purpose of the Study:

  • To identify how SHD employees decide to adapt public health programs.
  • To understand the factors influencing adaptation decisions.

Main Methods:

  • Qualitative study involving interviews with 45 SHD employees.
  • Semi-structured interview guide used for data collection.
  • Thematic analysis of transcribed interviews to identify themes, aligning with the Model for Adaptation Design and Impact.

Main Results:

  • Pre-adaptation decisions were influenced by data, outcomes, and evaluations.
  • Organizational and sociopolitical factors drove adaptation reasons.
  • Goals included enhancing effectiveness, reach, satisfaction, funding, and partner engagement.
  • Adaptation processes involved program staff, evaluators, partners, and community input.

Conclusions:

  • Findings offer practical considerations for adapting public health programs.
  • Emphasizes the importance of public health competencies in program evaluation and adaptation.
  • Recommends systematic documentation and evaluation of adaptation processes for future research.