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Documenting adaptations across the Accelerating Colorectal Cancer Screening and follow-up through Implementation

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Adaptations are crucial for implementing health programs. This study documented 96 adaptations across eight research programs, revealing varied documentation methods and common pre-implementation changes.

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Area of Science:

  • Implementation Science
  • Public Health Program Adaptation
  • Health Services Research

Background:

  • Adaptations are essential for the successful implementation of clinical and public health programs.
  • Systematic documentation and guidance on program adaptations are lacking.
  • Understanding adaptations contextualizes findings and supports future program scale-up.

Purpose of the Study:

  • To systematically document and analyze adaptations made to interventions and implementation strategies within the Accelerating Colorectal Cancer Screening and follow-up through Implementation Science (ACCSIS) Initiative.
  • To explore how different research programs within ACCSIS documented and analyzed these adaptations.
  • To provide a template for assessing adaptations in large, multi-site research initiatives.

Main Methods:

  • Utilized an iterative data gathering approach including surveys, data abstraction, and validation across eight ACCSIS research programs.
  • Employed a rapid qualitative analytic approach for reviewing, coding, and summarizing adaptation data.
  • An analytic team representing multiple ACCSIS programs conducted the data analysis.

Main Results:

  • Significant variation existed in how ACCSIS programs defined and documented adaptations, with common methods including meeting minutes and periodic reflections.
  • Nine analytic methods were reported, with rapid qualitative methods, descriptive statistics, and mixed-methods analysis being most frequent.
  • A total of 96 adaptations were reported, primarily during the pre-implementation stage (68%) or to program format (71%); 36% were pandemic-related.

Conclusions:

  • A systematic, multi-method approach enabled exploration and comparison of adaptation documentation and analysis across ACCSIS programs.
  • Findings inform the science of adaptations, highlighting the need for and impact of adaptations on implementation efforts.
  • The described methods offer a transferable template for adaptation assessment in other large-scale research initiatives.