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Examining Adaptations of Evidence-Based Programs in Natural Contexts

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Abstract

When evidence-based programs (EBPs) are scaled up in natural, or non-research, settings, adaptations are commonly made. Given the fidelity-versus-adaptation debate, theoretical rationales have been provided for the pros and cons of adaptations. Yet the basis of this debate is theoretical; thus, empirical evidence is needed to understand the types of adaptations made in natural settings. In the present study, we introduce a taxonomy for understanding adaptations. This taxonomy addresses several aspects of adaptations made to programs including the fit (philosophical or logistical), timing (proactive or reactive), and valence, or the degree to which the adaptations align with the program’s goals and theory, (positive, negative, or neutral). Self-reported qualitative data from communities delivering one of ten state-funded EBPs were coded based on the taxonomy constructs; additionally, quantitative data were used to examine the types and reasons for making adaptations under natural conditions. Forty-four percent of respondents reported making adaptations. Adaptations to the procedures, dosage, and content were cited most often. Lack of time, limited resources, and difficulty retaining participants were listed as the most common reasons for making adaptations. Most adaptations were made reactively, as a result of issues of logistical fit, and were not aligned with, or deviated from, the program’s goals and theory.

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References

  • Berkel, C., Mauricio, A. M., Schoenfelder, E., & Sandler, I. N. (2011). Putting the pieces together: An integrated model of program implementation. Prevention Science, 12, 23–33.

    Article  PubMed  Google Scholar 

  • Bernal, G., & Sáez-Santiago, E. (2006). Culturally centered psychosocial interventions. Journal of Community Psychology, 34, 121–132.

    Article  Google Scholar 

  • Blakely, C. H., Mayer, J. P., Gottschalk, R. G., Schmitt, N., Davidson, W. S., Roitman, D. B., et al. (1987). The fidelity-adaptation debate: Implications for the implementation of public sector social programs. American Journal of Community Psychology, 15, 253–268.

    Article  Google Scholar 

  • Castro, F. G., Barrera, M., Jr., & Martinez, C. R., Jr. (2004). The cultural adaptation of prevention interventions: Resolving tensions between fidelity and fit. Prevention Science, 5, 41–45.

    Article  PubMed  Google Scholar 

  • Dane, A. V., & Schneider, B. H. (1998). Program integrity in primary and early secondary prevention: Are implementation effects out of control? Clinical Psychology Review, 18, 23–45.

    Article  PubMed  CAS  Google Scholar 

  • Dariotis, J. K., Bumbarger, B. K., Duncan, L. G., & Greenberg, M. T. (2008). How do implementation efforts relate to program adherence? Examining the role of organizational, implementer, and program factors. Journal of Community Psychology, 36, 744–760.

    Article  Google Scholar 

  • Dillman Carpentier, F. R., Mauricio, A. M., Gonzales, N. A., Millsap, R. E., Meza, C. M., Dumka, L. E., et al. (2007). Engaging Mexican origin families in a school-based preventive intervention. The Journal of Primary Prevention, 28, 521–546.

    Article  PubMed  Google Scholar 

  • Dixon, A. L., Yabiku, S. T., Okamoto, S. K., Tann, S. S., Marsiglia, F. F., Kulis, S., et al. (2007). The efficacy of a multicultural prevention intervention among urban American Indian youth in the southwest US. The Journal of Primary Prevention, 28, 547–568.

    Article  PubMed  Google Scholar 

  • Domitrovich, C. E., & Greenberg, M. T. (2000). The study of implementation: Current findings from effective programs that prevent mental disorders in school-aged children. Journal of Educational and Psychological Consultation, 11, 193–221.

    Article  Google Scholar 

  • Durlak, J. A. (1998). Why program implementation is important. Journal of Prevention & Intervention in the Community, 17, 5–18.

    Article  Google Scholar 

  • Durlak, J. A., & DuPre, E. P. (2008). Implementation matters: A review of research on the influence of implementation on program outcomes and the factors affecting implementation. American Journal of Community Psychology, 41, 327–350.

    Article  PubMed  Google Scholar 

  • Dusenbury, L., Brannigan, R., Hansen, W. B., Walsh, J., & Falco, M. (2005). Quality of implementation: Developing measures crucial to understanding the diffusion of preventive interventions. Health Education Research, 20, 308–313.

    Article  PubMed  Google Scholar 

  • Dusenbury, L., Branningan, R., Falco, M., & Hansen, W. B. (2003). A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Education Research, 18, 237–256.

    Article  PubMed  Google Scholar 

  • Elliott, D. S., & Mihalic, S. (2004). Issues in disseminating and replicating effective prevention programs. Prevention Science, 5, 47–53.

    Article  PubMed  Google Scholar 

  • Ennett, S. T., Haws, S., Ringwalt, C. L., Vincus, A. A., Hanley, S., Bowling, J. M., et al. (2011). Evidence-based practice in school substance use prevention: Fidelity of implementation under real-world conditions. Health Education Research, 26, 361–371.

    Article  PubMed  CAS  Google Scholar 

  • Fixsen, D. L., Naoom, S. F., Blase, K. A., Friedman, R. M., & Wallace, F. (2005). Implementation research: A synthesis of the literature. Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute, The National Implementation Research Network (FMHI Publication #231).

    Google Scholar 

  • Gottfredson, D. C., & Gottfredson, G. D. (2002). Quality of school-based prevention programs: Results from a national survey. Journal of Research in Crime & Delinquency, 39, 3–35.

    Article  Google Scholar 

  • Hallfors, D., & Godette, D. (2002). Will the “Principles of Effectiveness” improve prevention practice? Early findings from a diffusion study. Health Education Research, 17, 461–470.

    Article  PubMed  CAS  Google Scholar 

  • Hansen, W. B., Bishop, D. C., & Bryant, K. S. (2009). Using online components to facilitate program implementation: Impact of technological enhancements to All Stars on ease and quality of program delivery. Prevention Science, 10, 66–75.

    Article  PubMed  Google Scholar 

  • Hill, L. G., Maucione, K., & Hood, B. K. (2007). A focused approach to assessing program fidelity. Prevention Science, 8, 25–34.

    Article  PubMed  Google Scholar 

  • Kalichman, S. C., Cherry, C., White, D., Pope, H., Cain, D., & Kalichman, M. (2007). Altering key characteristics of a disseminated effective behavioral intervention for HIV positive adults: The “Healthy Relationships” experience. The Journal of Primary Prevention, 28, 145–153.

    Article  PubMed  Google Scholar 

  • Knoche, L. L., Sheridan, S. M., Edwards, C. P., & Osborn, A. Q. (2010). Implementation of a relationship-based school readiness intervention: A multidimensional approach to fidelity measurement for early childhood. Early Childhood Research Quarterly, 25, 299–313.

    Article  PubMed  Google Scholar 

  • Kumpfer, K. L., Alvarado, R., Smith, P., & Bellamy, N. (2002). Cultural sensitivity and adaptation in family-based prevention interventions. Prevention Science, 3, 241–246.

    Article  PubMed  Google Scholar 

  • Kumpfer, K. L., Pinyuchon, M., Teixeira de Melo, A., & Whiteside, H. O. (2008). Cultural adaptation process for international dissemination of the Strengthening Families Program. Evaluation and the Health Professions, 31, 226–239.

    Article  Google Scholar 

  • Lee, S. J., Altschul, I., & Mowbray, C. T. (2008). Using planned adaptation to implement evidence-based programs with new populations. American Journal of Community Psychology, 41, 290–303.

    Article  PubMed  Google Scholar 

  • Lightfoot, M. A., Kasirye, R., Comulada, W. S., & Rotheram-Borus, M. J. (2007). Efficacy of a culturally adapted intervention for youth living with HIV in Uganda. Prevention Science, 8, 271–273.

    Article  PubMed  Google Scholar 

  • Marek, L. I., Brock, D. P., & Sullivan, R. (2006). Cultural adaptations to a family life skills program: Implementation in rural Appalachia. The Journal of Primary Prevention, 27, 113–133.

    Article  PubMed  Google Scholar 

  • Odom, S. L., Fleming, K., Diamond, K., Lieber, J., Hanson, M., Butera, G., et al. (2010). Examining different forms of implementation and in early childhood curriculum research. Early Childhood Research Quarterly, 25, 314–328.

    Article  PubMed  Google Scholar 

  • Ozer, E. J., Wanis, M. G., & Bazell, N. (2010). Diffusion of school-based prevention programs in two urban districts: Adaptations, rationales, and suggestions for change. Prevention Science, 11, 42–55.

    Article  PubMed  Google Scholar 

  • Perez, D., Lefèvre, P., Castro, M., Sánchez, L., Toledo, M. E., Vanlerberghe, V., et al. (2011). Process-oriented fidelity research assists in evaluation, adjustment and scaling-up of community-based interventions. Health Policy and Planning, 26(5), 413–422.

    Google Scholar 

  • Resnicow, K., Soler, R., Braithwaite, R. L., Ahluwalia, J. S., & Butler, J. (2000). Cultural sensitivity in substance use prevention. Journal of Community Psychology, 28, 271–290.

    Article  Google Scholar 

  • Rhoades, B. L., Bumbarger, B. K., & Moore, J. E. (2012). The role of a state-level prevention support system in promoting high-quality implementation and sustainability of evidence-based programs. American Journal of Community Psychology, 50, 386–401.

    Article  PubMed  Google Scholar 

  • Ringwalt, C. L., Pankratz, M. M., Hansen, W. B., Dusenbury, L., Jackson-Newsom, J., Giles, S. M., et al. (2009). The potential of coaching as a strategy to improve the effectiveness of school-based substance use prevention curricula. Health Education & Behavior, 36, 696–710.

    Article  Google Scholar 

  • Ringwalt, C. L., Vincus, A., Ennett, S., Johnson, R., & Rohrbach, L. A. (2004). Reasons for teachers’ adaptation of substance use prevention curricula in schools with non-white student populations. Prevention Science, 5, 61–67.

    Article  PubMed  Google Scholar 

  • Rohrbach, L. A., Grana, R., Sussman, S., & Valente, T. W. (2006). Type II translation: Transporting prevention interventions from research to real-world settings. Evaluation and the Health Professions, 29, 302–333.

    Article  Google Scholar 

  • Spoth, R., Guyll, M., Lillehoj, C. J., Redmond, C., & Greenberg, M. T. (2007). PROSPER study of evidence-based intervention implementation quality by community–university partnerships. Journal of Community Psychology, 35, 981–999.

    Article  PubMed  Google Scholar 

  • Wandersman, A., Imm, P., Chinman, M., & Kaftarian, S. (2000). Getting to outcomes: A results-based approach to accountability. Evaluation and Program Planning, 23, 389–395.

    Article  Google Scholar 

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Correspondence to Julia E. Moore.

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Moore, J.E., Bumbarger, B.K. & Cooper, B.R. Examining Adaptations of Evidence-Based Programs in Natural Contexts. J Primary Prevent 34, 147–161 (2013). https://doi.org/10.1007/s10935-013-0303-6

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