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Related Experiment Video

Updated: Feb 6, 2026

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Using multi-method approaches to document and assess adaptations in a community-driven COVID-19 testing program.

Linda Salgin1,2,3, Breanna J Reyes4, Maria Balbuena Bojorquez4

  • 1San Ysidro Health, 1601 Precision Park Lane, San Ysidro, CA, 92173, USA. linda.salgin@syhealth.org.

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Tracking intervention adaptations is crucial for public health. This study systematically documented adaptations to a COVID-19 testing intervention, finding most were planned and positively impacted outcomes.

Keywords:
AdaptationCOVID-19 testingCommunity-basedImplementation science

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Area of Science:

  • Public Health
  • Implementation Science
  • Health Equity

Background:

  • Complex public health interventions require adaptation in real-world settings.
  • Systematic documentation of adaptations is critical for assessing intervention impact.
  • The CO-CREATE-Ex project addressed COVID-19 testing disparities at the US/Mexico border.

Purpose of the Study:

  • To describe a systematic approach for tracking, documenting, and evaluating adaptations.
  • To analyze adaptations made during the CO-CREATE-Ex project.

Main Methods:

  • A longitudinal, prospective, multi-method approach was used.
  • Adaptations were tracked across project phases (pre-implementation, implementation, maintenance).
  • Data sources included meeting notes, Advisory Board transcripts, and reflections, entered into a database with 16 characteristics.

Main Results:

  • Eighty-four unique adaptations were identified, mostly occurring during pre-implementation.
  • The majority of adaptations (94%) were planned and expected (75%).
  • Most adaptations (71.2%) positively impacted Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) outcomes, even unexpected ones.

Conclusions:

  • A systematic approach to adaptation documentation is vital for understanding implementation outcomes.
  • Further research is needed to refine adaptation documentation and evaluation methods.
  • Ensuring interventions remain effective, equitable, and responsive to real-world challenges is essential.