Table 2 Modifications and adaptations made to programs and interventions

Individual practitioner^a

55

21

Team or group of practitioners

24

9

Administrator

2

<1

Researcher

22

8

Intervention developer or purveyor^b

70

27

Coalition of stakeholders^c

76

29

Unknown/insufficient information

12

5

Contextual modifications (overall kappa = 1.00, n = 41)

Frequency

% of contextual modifications

% of total modifications

Format

8

25

3

Setting

6

19

2

Personnel

10

3

4

Population

8

25

3

Training and evaluation Processes

9

-

3

Content modifications (n = 217)

Frequency

% of content modifications

% of total modifications

Level (overall kappa = 0.79)

Individual recipient

14

6

5

Cohort

14

6

5

Population^d

71

33

28

Provider/facilitator

20

9

8

Unit^e

38

18

15

Hospital/organization

22

10

9

Network/community^f

38

18

15

Nature of modification (overall kappa = 0.87)

Tailoring/tweaking/refining^f

73

34

28

Adding elements^g

62

29

24

Removing elements^g

33

15

13

Shortening/condensing^h

17

8

7

Lengthening/extending

12

6

5

Substituting elements

5

2

2

Re-ordering elements

4

2

2

Integrating another approach into the intervention

3

1

1

Integrating the intervention into another approach

2

1

1

Departing from the intervention (“Drift”)

1

<1

<1

Loosening structure

1

<1

<1

Repeating elements

1

<1

<1