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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