Dissemination & Implementation Models
in Health Research & Practice

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Construct Details

ConstructAdaptation and evolution
DefinitionFor the success of D&I, interventions often need to be adapted to fit the local context (i.e., needs and realities). Adaptation is defined as the degree to which an evidence-based intervention is changed or modified by a user during adoption and implementation to suit the needs of the setting or to improve the fit to local conditions. The need for adaptation and understanding of context has been called Type 3 evidence (i.e., the information needed to adapt and implement an evidence-based intervention in a particular setting or population). Ideally, adaptation will lead to at least equal intervention effects as is shown in the original efficacy or effectiveness trial. To reconcile the tension between fidelity and adaptation, the core components (or essential features) of an intervention (i.e., those responsible for its efficacy/effectiveness) must be identified and preserved during the adaptation process.
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Elements
Adapt

Adaptability

Adaptable protocols and procedures

Adaptations

Adaption or reformulation

Adaptor

By whom was the decision to modify made?

Consider need for appropriate, reasoned variation

Content modifications

Contextual modifications

Determine predictors of adherence/non-adherence

Engagement and Adaptation

evolving

Evolution of intervention

Levels at which content modifications occur

Maintenance and Evolution

Maintenance and Evolution

Maintenance and Evolution

Modifications to training and evaluation processes

Ongoing change

Rapid Learning Systems

Re-Customize delivery as need arises

Refinement

Reflect and Adapt

Revision

Theory Regeneration or refinement

Types of content modifications

Usability and adaptability
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ModelsStetler Model of Research Utilization

Community Based Participatory Research (CBPR)

Technology Transfer Model

Conceptual Framework for Research Knowledge Tranfer and Utilization

Marketing and Distribution System for Public Heatlh

Knowledge Exchange Framework

Health Promotion Technology Transfer Process

Interacting Elements of Integrating Science, Policy, and Practice

Pathways to Evidence Informed Policy

CDC DHAP's Research-to-Practice Framework

Practical, Robust Implementation and Sustainability Model (PRISM)

Consolidated Framework for Implementation Research

Replicating Effective Programs Plus Framework

Stirman framework and coding system for modifications and adaptations of evidence-based interventions

General theory of implementation

Dynamic Sustainability Framework

Intervention Mapping

Framework for Enhancing the Value of Research for Dissemination and Implementation

Adaptation in dissemination and implementation science

EQ-DI Framework

Adherence Optimization Framework

RE-AIM 2.0/Contextually Expanded RE-AIM

Number of Models22
MeasureGEM D&I link: Adaptation and Evolution