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Table 2 Unique adaptations identified across time points and various constructs of the modified adaptation framework

From: Understanding adaptations in the Veteran Health Administration’s Transitions Nurse Program: refining methodology and pragmatic implications for scale-up

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
  1. Pre-I pre-implementation, Early-I early implementation, Imp implementation, Late-I late implementation, Sustainment