Table 2 Unique adaptations identified across time points and various constructs of the modified adaptation framework
Adaptation constructs | Pre-I | Early-I | Mid-I | Late-I | Sustainment | Total |
|---|---|---|---|---|---|---|
Elements | ||||||
Format | 0 | 0 | 2 | 1 | 0 | 3 |
Personnel involved | 1 | 0 | 7 | 1 | 0 | 9 |
Target population | 0 | 4 | 16 | 2 | 0 | 22 |
Intervention presentation | 0 | 2 | 4 | 0 | 0 | 6 |
Others | 0 | 0 | 1 | 0 | 0 | 1 |
What was changed | ||||||
Tailoring to individuals | 0 | 0 | 3 | 2 | 0 | 5 |
Adding a component | 0 | 0 | 0 | 0 | 0 | 0 |
Removing a component | 0 | 0 | 0 | 0 | 0 | 0 |
Condensing a component | 0 | 0 | 0 | 0 | 0 | 0 |
Extending a component | 0 | 0 | 1 | 0 | 0 | 1 |
Substituting for a component | 0 | 0 | 1 | 0 | 0 | 1 |
Changing the order of components | 0 | 0 | 0 | 0 | 0 | 0 |
Integrating with other programs | 0 | 3 | 1 | 0 | 0 | 4 |
Repeating a component | 0 | 0 | 0 | 0 | 0 | 0 |
Loosening the structure or protocol | 0 | 0 | 0 | 0 | 0 | 0 |
Otherwise changing the intervention | 1 | 3 | 24 | 2 | 0 | 30 |
Who was responsible for this change | ||||||
Entire or most of the team | 0 | 3 | 9 | 0 | 0 | 12 |
Provider (TN/SC) | 1 | 3 | 16 | 0 | 0 | 20 |
Administrator | 0 | 0 | 3 | 1 | 0 | 4 |
Researcher | 0 | 0 | 0 | 3 | 0 | 3 |
Developer | 0 | 0 | 0 | 0 | 0 | 0 |
Stakeholder | 0 | 0 | 1 | 0 | 0 | 1 |
Coalition | 0 | 0 | 1 | 0 | 0 | 1 |
How or on what basis were these changes made | ||||||
Based on our vision or values | 0 | 0 | 1 | 2 | 0 | 3 |
Based on a framework | 0 | 0 | 0 | 0 | 0 | 0 |
Based on our knowledge or experience | 0 | 1 | 7 | 0 | 0 | 8 |
Based on QI data, summary information, or results | 0 | 0 | 0 | 0 | 0 | 0 |
Based on pragmatic/practical considerations | 1 | 3 | 18 | 1 | 0 | 23 |
Based on financial incentives/payments | 0 | 0 | 0 | 0 | 0 | 0 |
Based on feedback or suggestions | 0 | 1 | 3 | 1 | 0 | 5 |
Others | 0 | 1 | 1 | 0 | 0 | 2 |
Why was the change made | ||||||
To increase the number or type of patients contacted (Reach) | 0 | 1 | 10 | 3 | 0 | 14 |
To enhance the impact or success of the intervention for all or important subgroups (Effectiveness) | 0 | 2 | 6 | 0 | 0 | 8 |
To make it possible to involve more teams, team members, or staff (Adoption) | 0 | 0 | 0 | 0 | 0 | 0 |
To make the intervention delivered more consistently; to better fit our practice, patient flow, or EHR; for practical reasons (Implementation) | 0 | 2 | 7 | 1 | 0 | 10 |
To save money or other resources (Implementation) | 0 | 0 | 0 | 0 | 0 | 0 |
To institutionalize or sustain the intervention (Maintenance) | 0 | 0 | 0 | 0 | 0 | 0 |
To respond to external pressures or policy | 0 | 0 | 1 | 0 | 0 | 1 |
Others | 1 | 1 | 6 | 0 | 0 | 8 |
Short-term impact of the change | ||||||
Positive | 0 | 5 | 18 | 3 | 0 | 26 |
Negative | 0 | 0 | 3 | 0 | 0 | 3 |
Unknown | 1 | 1 | 9 | 1 | 0 | 12 |