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Table 4 Characteristics of the adaptations (k = 42)

From: A systematic review of adaptations of evidence-based public health interventions globally

First author, year

Adaptation type1

Specific modifications

Adaptation steps2

Evaluation outcomes (k = 36)

Modification/adaptation example

1

2

3

4

5

Content

Context

Delivery

1

2

3

4

5

6

7

8

9

10

Reijneveld, 2003 [53]

x

x

x

x

x

Tailoring

Adding elements

Lengthening

Substitution

Cultural modification

Population

Deliverer

Other

x

x

 

x

x

x

x

x

x

 

Acceptability

Fidelity

Examples regarding safety excluded cycling because few Turkish immigrants cycle

Komro, 2004 [54]

x

x

x

  

Tailoring

Adding elements

Cultural modification

Setting

Population

Mode/medium

Deliverer

x

x

x

x

x

x

x

x

  

Acceptability

Fidelity

Audiotape vignettes re-taped with African American and Hispanic actors

Sarkisian, 2005 [55]

x

 

x

  

Tailoring

Adding elements

Lengthening

Cultural modification

Setting

Population

x

 

x

 

x

     

Acceptability

Expanded focus to more explicitly include family members

Tsey, 2005 [56]

x

x

x

  

Tailoring

Shortening

Loosening structure

Setting

Population

Mode/medium

Deliverer

x

      

x

x

 

Acceptability

Adoption

Sustainability

Individual satisfaction

Students interviewed their role models, explaining why they looked up to that person

Villarruel, 2005 [58]

x

x

 

x

x

Tailoring

Adding elements

Cultural modification

Population

x

x

x

x

x

x

x

x

x

 

Acceptability

Individual satisfaction

Presented the view of machismo that incorporated the values of caring for and protecting others, so condom use could be presented as consistent with machismo

Belanksy, 2006 [59]

x

x

 

x

x

Tailoring

Adding elements

Shortening

Cultural modification

Setting

Population

x

 

x

x

x

x

x

x

x

 

Lessons simplified so that they could be completed during the 1-h classroom period

Hitt, 2006 [60]

x

x

 

x

 

Tailoring

Loosening structure

Setting

Population

x

x

x

x

x

x

 

x

x

 

Acceptability

Adoption

Fidelity

Feasibility

Sustainability

Individual satisfaction

Intervention protocols and supporting materials (tools) were tailored for local circumstances

Somerville, 2006 [62]

x

x

 

x

x

Tailoring

Adding elements

Substitution

Integrating other approach

Cultural modification

Setting

Population

x

x

x

x

x

x

x

x

x

 

Acceptability

Fidelity

Other

Individual satisfaction

A variety of successful Latino-focused HIV prevention training programs were integrated into the adapted intervention

NIMH Collaborative HIV/STD Prevention Trial Group, 2007 [38]

x

x

 

x

x

Tailoring

Cultural modification

Other

x

x

x

x

x

x

x

x

x

x

Adoption

Fidelity

Feasibility

Sustainability

Specific messages used in training were based on findings that emerged from the ethnography with each site’s populations

Tsarouk, 2007 [63]

x

x

   

Tailoring

Removing elements

Shortening

Substitution

Cultural modification

Other

x

 

x

 

x

x

x

 

x

 

Acceptability

Feasibility

Individual satisfaction

Some of the support behaviors, such as applauding in response to a group member’s participation, were removed because teens said that it is not a natural expression of support in this informal situation

Beattie, 2008 [64]

x

x

  

x

Tailoring

Removing elements

Shortening

Integrating other approach

Cultural modification

Setting

Population

x

 

x

x

x

  

x

x

 

Acceptability

Adoption

Sustainability

Some sites used a swim camp model, with several days of training provided often on two or three occasions and typically at a central point for families

traveling long distances

Cornelius, 2008 [28]

x

x

   

Tailoring

Adding elements

Removing elements

Lengthening

Substitution

Setting

Population

x

x

   

x

    

Used videos that included information about HIV in older women

Gitlin, 2008 [30]

x

x

x

  

Tailoring

Adding elements

Cultural modification

Setting

Population

x

 

x

x

 

x

 

x

x

 

Acceptability

Adoption

Fidelity

Feasibility

Sustainability

Other

Individual satisfaction

Introduction of moment of silence at the beginning of each session to recognize spiritual practices and their importance to participants

Lerdboon, 2008 [67]

x

x

   

Tailoring

Adding elements

Integrating other approach

Cultural modification

Setting

x

x

x

x

x

x

x

x

x

 

Acceptability

Adoption

Feasibility

Gender-specific

components were integrated throughout the curriculum through a story line about an

adolescent boy and girl growing up in a fictional Vietnamese family, as well as gender-specific scenarios, activities and messages

Steiker, 2008 [29]

x

x

   

Tailoring

Adding elements

Cultural modification

Setting

Population

x

 

x

 

x

x

x

x

x

 

Acceptability

Adoption

Fidelity

Created four new videos, one for each prevention strategy: refuse, explain, avoid and leave

Burgio, 2009 [68]

x

x

x

x

x

Tailoring

Removing elements

Shortening

Setting

Population

Mode/medium

Deliverer

x

 

x

x

x

x

 

x

x

 

Acceptability

Adoption

Fidelity

Feasibility

Individual satisfaction

Reduced number of home visits and shortened time span of the intervention

Fiscian, 2009 [69]

x

x

x

 

x

Tailoring

Adding elements

Removing elements

Lengthening

Reorder elements

Integrating other approach

Cultural modification

Setting

Population

Mode/medium

x

 

x

x

x

x

 

x

x

 

Acceptability

Fidelity

Individual satisfaction

Modified role-play stories to use African names and settings and simplified scripts to a sixth-grade reading level

Mueller, 2009 [31]

x

x

   

Adding elements

Lengthening

Substitution

Loosening structure

Setting

x

 

x

x

x

x

 

x

  

Acceptability

Feasibility

Sustainability

Individual satisfaction

Adapted from community agency or after-school programs to be integrated into existing school curriculum

Pekmezi, 2009 [70]

x

x

  

x

Tailoring

Cultural modification

Population

x

 

x

  

x

x

x

x

 

Acceptability

Feasibility

Individual satisfaction

Intervention materials and research measures were translated into Spanish through an iterative process involving both translation and back-translation

Stevens, 2009 [71]

x

x

x

 

x

Tailoring

Adding elements

Deliverer

 

x

x

x

x

x

 

x

x

 

Fidelity

Support teams for caregivers were created

DePue, 2010 [72]

x

x

x

x

x

Tailoring

Adding elements

Loosening structure

Cultural modification

Setting

Population

Mode/medium

Deliverer

x

x

x

x

x

x

x

x

x

 

Adoption

Feasibility

Incorporated local cultural features in flipcharts, including quotes from focus groups, culturally relevant examples of healthy behaviors, local sources of stress, and effective local coping strategies

Domenech Rodriguez, 2011 [73]

x

x

x

  

Tailoring

Adding elements

Loosening structure

Cultural modification

Setting

Population

Deliverer

x

x

x

x

x

x

x

x

x

 

Acceptability

Fidelity

Feasibility

Individual satisfaction

Sayings, or dichos, were incorporated generously into treatment manual as parents used them during the parent training sessions

Poulsen, 2010 [39]

Vandenhoubt, 2010 [75]

x

x

x

  

Tailoring

Adding elements

Substitution

Cultural modification

Setting

Population

Other

Mode/medium

Deliverer

x

x

x

x

x

x

x

x

x

x

Acceptability

Adoption

Fidelity

Sustainability

Individual satisfaction

Owing to low literacy rates among local adults, drawings were used to illustrate messages that were originally conveyed through text on posters and handouts

Sadler, 2010 [76]

x

    

Tailoring

Adding elements

Shortening

Reorder elements

Cultural modification

Population

Deliverer

x

    

x

x

   

PowerPoint voice over changed to be in the first person instead of third to inspire comradery and motivation for women battling cancer together through clinical trials

Rotheram-Borus, 2011 [77]

x

x

x

  

Tailoring

Adding elements

Removing elements

Shortening

Substitution

Integrating intervention

Repeating elements

Cultural modification

Setting

Population

Mode/medium

Deliverer

x

    

x

x

x

x

 

Other

The intervention content and framing was adapted to resonate with Buddhist values and idioms around “sound body and sound mind”, as well as Thai values around the importance of family and community in health and well-being

Cardona, 2009 [78]

x

x

x

  

Tailoring

Adding elements

Loosening structure

Cultural modification

Setting

Population

Other

x

x

x

x

x

x

 

x

x

 

Acceptability

Adoption

Fidelity

Feasibility

Individual satisfaction

Substituted a booster session with a session on “Parenting between two cultures” to add relevance to Latino immigrant families

Feinberg, 2012 [79]

x

x

x

x

 

Tailoring

Removing elements

Integrating intervention

Cultural modification

Setting

Population

Mode/medium

Deliverer

Other

x

x

x

x

x

x

x

x

  

Acceptability

Fidelity

Feasibility

Individual satisfaction

Reframed the focus of the intervention from prevention of depression to learning new skills to deal with everyday stress, with an emphasis on parenting

Parker, 2012 [81]

Chen, 2013 [82]

x

x

x

  

Tailoring

Adding elements

Removing elements

Lengthening

Reorder elements

Cultural modification

Population

Mode/medium

x

x

x

 

x

x

    

Acceptability

Adoption

Fidelity

Feasibility

Created “action plan for sustainability” to link participants with exercise/disease self-management programs in neighborhood

Reid, 2012 [83]

x

x

   

Tailoring

Adding elements

Departing

Cultural modification

Setting

Population

Other

x

 

x

x

x

x

x

x

  

Acceptability

Adoption

Fidelity

Feasibility

Individual satisfaction

Sociocultural norms, values, beliefs, and myths were applied to role-play scenarios and exercises

Rosati, 2012 [84]

x

x

   

Tailoring

Adding elements

Loosening structure Cultural modification

Setting

Mode/medium

x

x

 

x

 

x

 

x

x

 

Acceptability

Adoption

Fidelity

Feasibility Individual satisfaction

Added a unit targeting adolescent dating and sexual behavior after conducting focus groups with Thai parents

Tomioka, 2012 [85]

x

x

 

x

x

Tailoring

Adding elements

Lengthening

Cultural modification

Population

x

x

x

x

 

x

 

x

x

 

Acceptability

Adoption

Fidelity

Feasibility

Sustainability

Individual satisfaction

Added opening session with a prayer, a 6-month reunion, and provided certificate of completion

Danielson, 2013 [33]

x

x

x

 

x

Tailoring

Shortening

Loosening structure

Departing

Setting

Population

Mode/medium

    

x

x

 

x

x

 

Adoption

Fidelity

Feasibility

Other

Individual satisfaction

Used a web-based delivery platform instead of small group sessions with 10–12 girls

Fasula, 2013 [86]

x

x

x

x

 

Tailoring

Adding elements

Shortening

Lengthening

Loosening structure

Cultural modification

Setting

Population

Deliverer

x

x

x

x

x

x

x

   

Several intervention elements were added to increase participants’ risk awareness, knowledge, and skills related to substance use, including a group discussion about the pros and cons of substance use, how drugs/alcohol contribute to sexual risk, and strategies for avoiding risk

Parker, 2013a [88]

Parker, 2013b [89]

x

x

x

  

Tailoring

Adding elements

Removing elements

Shortening

Integrating other approach

Cultural modification

Setting

Population

Mode/medium

x

x

x

x

 

x

x

x

x

 

Acceptability

Feasibility

Changed delivery from individual to group so there was peer reinforcement content

Wainer, 2013 [90]

x

x

x

x

x

Shortening

Loosening structure

Setting

Mode/medium

   

x

 

x

x

 

x

 

Acceptability

Fidelity

Feasibility

Therapists completed the online training program on computers in their homes or in the research lab

Williams, 2013 [91]

x

x

x

x

 

Tailoring

Adding elements

Cultural modification

Setting

Population

Deliverer

x

x

x

x

x

 

x

x

  

Adoption

The culturally adapted intervention took a more deliberate and structured approach to including the family in discussion and planning

Baydala,2014 [92]

x

x

  

x

Tailoring

Adding elements

Lengthening

Cultural modification

Population

x

x

x

x

x

x

x

x

x

 

Acceptability

Adoption

Fidelity

Feasibility

Sustainability

Elders suggested inclusion of lessons that embraced Aboriginal spirituality, such as an activity on healing the worried mind where students were encouraged to take their worried mind to Waka

(God/Creator) and engage in wacigebi (prayer)

Broning, 2014 [93]

x

x

   

Tailoring

Cultural modification

Population

   

x

  

x

x

x

 

Intervention was translated and adapted to German culture, taking into account family-based interventions are especially culture-sensitive regarding role-model behavior, values and norms

Cariou, 2014 [94]

x

x

 

x

x

Tailoring

Adding elements

Removing elements

Setting

Population

x

x

x

x

x

x

 

x

x

x

Adoption

Sustainability

Other

Eliminated optional poolside activities and retained the few that were feasible based on available resources

Reback, 2014 [96]

x

x

x

x

x

Tailoring

Adding elements

Removing elements

Shortening

Reorder elements

Cultural modification

Setting

Deliverer

x

 

x

x

x

x

 

x

x

 

Adoption

Feasibility

Sustainability

Gay-specific cultural references were updated to maintain cultural relevancy (i.e., exchanging references to telephone dating lines with references to social networking web sites)

Riggs, 2014 [32]

x

 

x

 

x

Adding elements

Shortening

Mode/medium

Deliverer

x

x

  

x

x

x

x

x

 

Acceptability

Fidelity

Feasibility

Masters-level research interventionists delivered treatment rather than medical staff

Tu, 2014 [98]

x

x

x

x

x

Tailoring

Removing elements

Population

Deliverer

   

x

 

x

 

x

x

 

In-person education from health educator was deleted

  1. 1Adaptation type: (1) content, (2) context, (3) delivery, (4) training, and (5) evaluation
  2. 2Adaptation steps: (1) community assessment, (2) selection, (3) determine level of change, (4) train staff, (5) consult stakeholders/experts, (6) prepare materials, (7) pilot, (8) implement, (9) evaluate, and (10) other