Program component* | O/W | Goal(s) for adaptation | Reason(s) for adaptation | Health plan-initiated adaptations | Content modification level* | Nature of content modifications* | ||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Reach, engagement | Feasibility/implementation | Fit with recipients | Effectiveness, outcomes | Implementation efficiency | Reduce costs | Satisfaction | Funding policies (incentives) | Service structure | Available resources | Time constraints | Billing constraints | Provider perception of intervention | Organizational (health plan) | Unit (health centers) | Provider | Population (enrollees) | Network systems (e.g., vendor) Community | Tailoring/tweaking/refining** | Adding elements | Removing elements | Re-ordering elements | Condensing timeline | Substituting elements | |||
Identify eligible adults and obtain accurate contact information | W | ● | ● | - Vendor obtained updated contact and enrollment information from member, if needed | ● | ● | ● | ● | ||||||||||||||||||
O | ● | ● | - Increased patient address review in health record and mailing list - Improved capture of prior colorectal screening | ● | ● | ● | ||||||||||||||||||||
Select FIT type | W | ● | ● | ● | ● | - Selected vendor that offered a 1-sample FIT kit (previous vendor used 2-sample kit) | ● | ● | ● | ● | ● | |||||||||||||||
Deliver program components (letters, phone calls, FIT kits) | W | ● | ● | ● | ● | ● | ● | ● | ● | - Vendor mailed introductory letter and attempted up to 3 live calls to obtain patient permission to mail kit | ● | ● | ● | ● | ||||||||||||
- Vendor mailed FITs only to interested members, reached through live call | ● | ● | ● | |||||||||||||||||||||||
- Health plan mailed invitation letter to members having no phone number, asking them to contact the plan to participate | ● | ● | ● | |||||||||||||||||||||||
O | ● | ● | ● | ● | ● | - Sent introductory letters (no FIT kit) to patients with no assigned provider or no clinic visits in last 12 months | ● | ● | ● | ● | ● | ● | ||||||||||||||
O | ● | ● | ● | ● | ● | - Increased delivery of FIT reminders by health center staff (sometimes prioritized to Medicare enrollees) | ● | ● | ● | ● | ||||||||||||||||
Communicate test results | W | ● | ● | ● | ● | ● | ● | ● | - Vendor mailed result letter to member (normal and abnormal) | ● | ● | ● | ● | |||||||||||||
- Vendor concurrently informed PCP of abnormal result so PCP could order follow-up colonoscopy | ● | ● | ● | ● | ||||||||||||||||||||||
- Vendor called enrollees with abnormal FIT results | ● | ● | ● | ● | ||||||||||||||||||||||
Streamline implementation | O | ● | ● | ● | ● | ● | ● | - Directly obtained kits from lab on behalf of clinics - Improved vendor billing process | ● | ● | ● | ● | ● | |||||||||||||
O | ● | ● | ● | ● | ● | - Conducted a one-time (rather than split) mailing per health center | ● | ● | ● | ● | ● | ● |