Using end user feedback to specify an adaptive implementation strategy.

Area of Science:

• Implementation Science
• Health Services Research
• Program Evaluation

Background:

• Adaptive implementation strategies offer tailored support, enhancing efficiency and fit compared to uniform approaches.
• Limited practical guidance exists for identifying decision points and tailoring variables in adaptive strategies.
• This study aimed to address this gap by collecting end-user and partner input.

Purpose of the Study:

• To specify decision points and tailoring variables for an adaptive implementation strategy.
• To enhance the delivery of the evidence-based nutrition program, Together, We Inspire Smart Eating (WISE).
• To provide a practical framework for tailoring implementation strategies to specific settings.

Main Methods:

• Qualitative study involving semi-structured interviews and focus groups.
• Recruited end-users and implementation partners with prior experience in the WISE program.
• Data collection focused on eliciting feedback to define adaptive strategy components.

Main Results:

• Three key decisions for the adaptive strategy were identified: initial low-intensity support, a 3-month assessment point, and escalated support for non-responsive sites.
• Universal need for facilitation was emphasized, with intensity varying by site needs.
• Tailoring variables included a 60% fidelity threshold to trigger high-intensity support.

Conclusions:

• The study successfully illustrated a process for defining adaptive implementation strategy elements using stakeholder feedback.
• This approach has significant potential for specifying strategies to scale health-related evidence effectively.
• The findings provide a practical model for adapting implementation strategies in real-world settings.