Assessment and classification of modification of evidence-based interventions in implementation research

Shannon Wiltsey-Stirman, Ph.D.
Stanford University

ABSTRACT:
Implementation theory suggests that adaptation of evidence-based interventions is necessary for implementation and sustainment, and that appropriate adaptation may improve the interventions’ outcomes as well (Chambers, Stange, & Glasgow, 2012). Research indicates that providers routinely modify interventions in routine care settings (Cook et al., 2014; Stirman et al., 2013a). However, little is known about the impact of the changes that are made. The focus of this presentation will be to differentiate between modifications and adaptations to evidence-based interventions, to describe challenges to examining the impact of modifications and adaptations on implementation and intervention-level outcomes, to introduce a framework for classifying modifications and adaptations (Stirman et al., 2013b), and to demonstrate methods for making these classifications. Additionally, we will review findings related to the use of the framework, and present recommendations from the literature on how to make and assess the impact of adaptations in routine care settings.