A systematic review of adaptations of evidence-based public health interventions globally
2018
Adaptationsof evidence-based interventions (EBIs) often occur. However, little is known about the reasons for
adaptation, the
adaptation process, and outcomes of
adaptedEBIs. To address this gap, we conducted a systematic review to answer the following questions: (1) What are the reasons for and common types of
adaptationsbeing made to EBIs in community settings as reported in the published literature? (2) What steps are described in making
adaptationsto EBIs? and (3) What outcomes are assessed in evaluations of
adaptedEBIs? We conducted a systematic review of English language publications that described
adaptationsof public health EBIs. We searched Ovid PubMed, PsycINFO, PsycNET, and CINAHL and citations of included studies for
adaptedpublic health EBIs. We abstracted characteristics of the original and
adaptedpopulations and settings, reasons for
adaptation, types of modifications, use of an
adaptationframework,
adaptationsteps, and evaluation outcomes. Forty-two distinct EBIs were found focusing on HIV/AIDS, mental health, substance abuse, and chronic illnesses. More than half (62%) reported on
adaptationsin the USA. Frequent reasons for
adaptationincluded the need for
cultural appropriateness(64.3%), focusing on a new target population (59.5%), and implementing in a new setting (57.1%). Common
adaptationswere content (100%), context (95.2%), cultural modifications (73.8%), and delivery (61.9%). Most study authors conducted a community assessment, prepared new materials, implemented the
adaptedintervention, evaluated or planned to evaluate the intervention, determined needed changes, trained staff members, and consulted experts/stakeholders. Most studies that reported an evaluation (k = 36) included behavioral outcomes (71.4%), acceptability (66.7%), fidelity (52.4%), and feasibility (52.4%). Fewer measured adoption (47.6%) and changes in practice (21.4%). These findings advance our understanding of the patterns and effects of modifications of EBIs that are reported in published studies and suggest areas of further research to understand and guide the
adaptation process. Furthermore, findings can inform better reporting of
adaptedEBIs and inform capacity building efforts to assist health professionals in
adaptingEBIs.
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