Adaptation of Evidence-Based Interventions: Perspectives, Research and Resources

This Roundtable Discussion will bring together individuals representing a range of perspectives including federal agencies, foundations, researchers, developers, and implementation experts to discuss making adaptations to evidence-based interventions.

In public health, evidence-based interventions (EBIs) often refer to prevention strategies that have been tested with a specific population in one or more evaluation studies.  The increasing number of EBIs across health topics has prompted considerable research that examines how EBIs are implemented, disseminated and sustained within similar contexts (i.e., scale-up) and in local contexts that vary from the evaluation settings in which they were tested (i.e., external validity). Factors such as perceived relevancy among a target population, organizational capacity to implement and implementers’ understanding of an intervention’s internal logic influence whether or not EBIs are adopted by a target group and the extent to which they are fully implemented. Implementers may make changes or adaptations to EBIs to improve usability and relevancy for a target group and to address capacity issues, but these changes are usually not documented within practice settings. In addition, the term adaptation is used to refer to all types of modifications from minor adjustments to deep-level changes that may alter an intervention’s effect on desired outcomes.  Hence, defining adaptation and understanding how it influences implementation and outcomes has become a major focus within dissemination research. 

In this roundtable session panelists will discuss this important issue and invite dialogue from the audience.  Specific topics to be discussed include: 1) how adaptations are perceived by stakeholders (i.e., intervention researchers and developers, technical assistance providers and intermediary organizations, implementers and community stakeholders); 2) which adaptations are most common and perceived as important; 3) when adaptations tend to occur, and 4) current guidance on making adaptations provided by developers and funders.  Participants will also discuss how developers identify EBI core components and how core components are linked to fidelity, and summarize an environmental scan of adaptation guidance currently available to implementers who want to adapt an EBI. Finally, discussants will discuss limitations in research related to adaptations of EBIs.