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Adapt

D&I researchers often utilize theory-based approaches that evolve over time based on empirical testing. As you “shop” for an appropriate model, you should review the core concepts, proposed relationships, and outcomes to be sure you are fully informed beyond what is depicted on the graphic. It is helpful to gather associated literature to define concepts and identify any issues or recommended adaptations based on prior studies. There is likely no comprehensive model that will perfectly fit every study, so it may be necessary to either adapt a model and/or to combine multiple models for your study. The focus of this section is on considerations that should be addressed to adapt an existing model to improve the fit (there are other resources for adapting evidence-based interventions and implementation strategies); please refer to the combine section for more information on using models together.

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+/-What is adaptation of D&I models about?

Adapting an existing model for a study has many important considerations, which are explored in greater depth in this section. Along the way, documenting adaptations and the reasons for those adaptations is important. However, it is difficult to provide detailed guidance on how much/little adaptation is appropriate or how much on an original model must be maintained (e.g. How many constructs can I change? What are the core elements of a model?). Like the other sections of this website, there is not a single “cookbook” approach to model adaptation, every situation is different and every study is different. It helps to have someone on your team with experience in implementing and using models.

+/-What are the benefits of adapting or an existing D&I model?

  • There are many benefits for using an existing model.
    • It encourages researchers to build on previous findings.
    • It allows you to demonstrate generalizability of the model thereby enhancing the field’s understanding of a model and its constructs.
  • Well thought out adaptation often improves the appropriateness of the selected model to the intervention being disseminated or implemented, the population, and the setting.
  • Adaptation contributes to the field by testing modifications to existing models, such as disregarding pieces shown to be ineffective or adding constructs with additional evidence
  • Models should be living documents, or works in progress, not static entities (and these ongoing adaptations should be documented).

+/-What should be considered before adapting an existing D&I model?

  • Initial identification of a D&I model to adapt should consider factors that influence the fit of a model such as
    • The intervention itself (e.g., technology and resources needed for intervention delivery: high-speed Internet connection, media skills)
    • The organization and practitioners/providers delivering the intervention
    • The target population and/or setting for the intervention (sociodemographics, geography, language, and culture)
    • The construct flexibility and level of specificity
    • The focus of the study and selected model on dissemination and/or implementation
  • As long as model adaptations do not become a weakness of the proposed study, when drastic changes are made to a model, it provides an excellent opportunity for model testing. This could add innovation to a study.
  • In studies that adapt a model, adaptations should be documented and monitored so that the impact of changes on model applicability can be reported and incorporated into the literature.

+/-What type of modifications can be made to D&I models?

  • Modifications that can be made to the model without much hesitation include: wording to suit the audience and language or cultural preferences based on the population or setting.
  • Adaptations that may be possible, but should be made with caution. For example, adaptations might include substituting key constructs within a model or changing the hypothesized relationships between or organization of key constructs in the model, shifting the focus between dissemination and implementation.
  • Adaptations that compromise the core (or evidence based) elements of the model should not be attempted without substantial evidence and/or pilot data to support adaptation unless the study will explicitly evaluate the adapted model.
    • This includes changing the theoretical underpinning; deleting core constructs; or putting in strategies that detract from the core elements.
    • The level of evidence for different models may vary, so this determination may differ between models with more or less evidence. Looking for examples where a model has been applied could help address these points.
 

You can view an example here.

Adapt Case example
 

You can use the fillable PDF on this page that will walk you through this process.

Adapt Worksheet.