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

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.