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Table 2 Modifications and adaptations made to programs and interventions

From: Development of a framework and coding system for modifications and adaptations of evidence-based interventions

Decision maker (overall kappa = 0.80, n = 261) Frequency % of total modifications  
Individual practitionera 55 21  
Team or group of practitioners 24 9  
Administrator 2 <1  
Researcher 22 8  
Intervention developer or purveyorb 70 27  
Coalition of stakeholdersc 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
Populationd 71 33 28
Provider/facilitator 20 9 8
Unite 38 18 15
Hospital/organization 22 10 9
Network/communityf 38 18 15
Nature of modification (overall kappa = 0.87)    
Tailoring/tweaking/refiningf 73 34 28
Adding elementsg 62 29 24
Removing elementsg 33 15 13
Shortening/condensingh 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
  1. Note: Three modifications that were identified in the articles did not contain sufficient detail to be rated.
  2. aRaw agreement for this category was 100%.
  3. bRaw agreement for this category was 82%.
  4. cRaw agreement for this category was 73%.
  5. dRaw agreement for this category was 87%.
  6. eRaw agreement for this category was 67%.
  7. fRaw agreement for this category was 91%.
  8. gRaw agreement for these categories was 83%.
  9. hRaw agreement for this category was 86%.