Table 2 Codes, definitions and examples for adaptation activities reported by participants

Modification of key characteristics: Changes to activities and delivery methods that can be adapted to meet the needs of the implementing organization or the target population.

Adapt to make culturally appropriate; adapting language used; having materials in language used by target population or community

Adaptation of intervention forms; adapting existing materials from other agencies

Adaptation of scheduling of sessions; number of sessions; duration of intervention

Adapting intervention to be manageable by staff with existing resources and strengths

Adding activities to session; changing the curriculum; taking core elements of program to make a new program

Incentives for participation and retention; providing food at intervention sessions

Integrating intervention with other client services; integrating with other programs and HIV testing; providing comprehensive services and programs

Locating interventions at a site that is accessible or at other social venues

Marketing intervention to better appeal to target population or to a community; tailor outreach

Piloting program with clients and staff

Providing childcare for women in intervention

Recruit from existing groups, other programs, gay community events, agency -led events; recruiting partners; recruit online/the Internet

Reinvention: Changes to the core elements responsible for the effectiveness of the intervention. Core elements cannot be deleted, added to or changed.

Add core element to meet funder requirements, i.e., to add sessions

Have open sessions with non-target group members

Modifying core element; reinvention

Other ongoing adaptations; adaptations which reduce intervention effectiveness