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Frames01:30

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Frames are essential components of various mechanical and structural systems used daily. These structures are known for their stability and ability to bear heavy loads. A frame is constructed using two-force and multi-force members, interconnected using pin joints. In contrast, trusses are made entirely of two-force members.
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Related Experiment Video

Updated: Jun 24, 2025

Operation of the Collaborative Composite Manufacturing CCM System
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Application of the FRAME-IS to a multifaceted implementation strategy.

Antoinette Schoenthaler1, Franze De La Calle2, Elaine De Leon2,3

  • 1Institute for Excellence in Health Equity, NYU Langone Health, 180 Madison Avenue, 752, New York, NY, 10016, USA. Antoinette.Schoenthaler@nyulangone.org.

BMC Health Services Research
|May 31, 2024
PubMed
Summary

This study adapted the Framework for Reporting Adaptations and Modifications for Implementation Strategies (FRAME-IS) to document 27 adaptations to practice facilitation for hypertension control in a federally qualified health center (FQHC). Findings highlight the need for refined tracking systems for complex implementation strategies.

Keywords:
AdaptationFederally qualified health centerImplementation strategyPractice facilitation

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Area of Science:

  • Implementation Science
  • Health Services Research
  • Health Equity

Background:

  • Documenting adaptations to implementation strategies is crucial for integrating evidence-based interventions into practice.
  • Existing frameworks like FRAME-IS are limited in capturing the complexity of multifaceted strategies, such as practice facilitation.
  • This study applied a modified FRAME-IS to a trial evaluating practice facilitation (PF) for hypertension control in a federally qualified health center (FQHC).

Purpose of the Study:

  • To evaluate the effectiveness of practice facilitation (PF) on implementation fidelity.
  • To document adaptations made to the PF strategy using a modified Framework for Reporting Adaptations and Modifications for Implementation Strategies (FRAME-IS).
  • To assess the applicability and value of FRAME-IS for multifaceted implementation strategies.

Main Methods:

  • Utilized three data sources: implementation committee minutes, practice facilitator reports, and root cause analysis/Plan-Do-Study-Act worksheets.
  • Extracted text data according to FRAME-IS modules and inputted into a master matrix for content analysis.
  • Modified FRAME-IS to include detailed tracking of adaptations and conducted member checking for validation.

Main Results:

  • Identified 27 adaptations, with 88.9% supporting patient identification and referral.
  • Over half (52.9%) of adaptations modified the PF strategy's context, format, or target audience (e.g., group-based, community health workers, nurses).
  • Adaptations were widespread (83.9%), mostly reactive (84.6%) but derived from systematic data review, involving the FQHC in decision-making.

Conclusions:

  • The modified FRAME-IS effectively documented adaptation data, demonstrating its applicability for diverse implementation strategies.
  • Refinement of tracking systems is recommended to support practical documentation of iterative, ongoing, and multifaceted adaptations.
  • This study underscores the importance of systematic adaptation documentation in implementation science.