The ADAPT Study

Background

In recent decades, a growing body of evaluations have enhanced our understandings of what does (or doesn’t) work in improving population health. Using interventions which have a prior evidence base in new contexts might be more efficient than developing new interventions for each context. 

However, the implementation of interventions, and their effects, are often somewhat dependent on context. While some transfer well, there are a growing number of examples of effective interventions which have not worked when implemented elsewhere. 

There is growing recognition that adaptation is often needed when using interventions in a new context. However, it is often unclear from published studies why specific interventions were selected for use in a new context, how or why specific adaptations were undertaken and implications of these adaptations for intervention functioning. 

Funded by the MRC/NIHR Methodology Research Programme panel, the ADAPT study has developed new guidance for researchers, funders and policymakers on how to make decisions regarding: 

  1. Involving stakeholders in adaptation; 
  2. Selecting a suitable evidence-informed intervention to adapt; 
  3. Planning and undertaking adaptations; 
  4. Evaluating adapted interventions; 
  5. Implementing adapted interventions in routine practice;
  6. Reporting adaptation processes and outcomes. 

Study design

The development of guidance was underpinned by three key work packages: 

  1. A systematic review of existing guidance and a scoping review of practice in adaptation of interventions for new contexts; 
  2. Qualitative interviews with researchers, funder, journal editors and policy and practice stakeholders about current practice and future directions; 
  3. An expert consensus process, including a 3 round e-DELPHI and a series of online meetings of international experts to discuss a draft of the guidance. 

Further Information and Publications

The ADAPT study was conducted in collaboration between DECIPHer (co-investigators: Dr Hannah Littlecott, Dr Jeremy Segrott and Professor Simon Murphy), Ludwig-Maximilian University Munich (co-investigators Professor Eva Rehfuess and Dr Lisa Pfadenhauer), the MRC/CSO Social and Public Health Sciences Unit in University of Glasgow (co-investigators: Dr Peter Craig & Professor Laurence Moore), University of Sheffield (co-investigator: Professor Alicia O’Cathain) and University of Stirling (co-investigator: Professor Pat Hoddinott). 

Dr Ani Movsisyan and Dr Laura Arnold were appointed to the systematic review work package in LMU Munich, and Doctor Lauren Copeland was appointed to the qualitative interview work package in Cardiff University. Dr Mhairi Campbell was appointed to the DELPHI work in University of Glasgow. 

Our study advisory group included Professor Frank Kee (Queens University, Belfast), Dr Julie Bishop (Public Health Wales), Dr Andrew Booth (University of Sheffield), Professor Frances Gardner (University of Oxford) and Professor Penny Hawe (University of Sydney). 

 We have published the following articles from the ADAPT study:

Evans, R., Craig, P., Hoddinott, P., Littlecott, H., Moore, L., Murphy, S., . . . Moore, G. (2019). When and how do ‘effective’interventions need to be adapted and/or re-evaluated in new contexts? The need for guidance Journal of Epidemiology & Community Health. 

 Movsisyan, A., Arnold, L., Evans, R., Hallingberg, B., Moore, G., O’Cathain, A., . . . Rehfuess, E. (2019). Adapting evidence-informed complex population health interventions for new contexts: a systematic review of guidance. Implementation science, 14(1), 105.  

 Campbell, M., Moore, G., Evans, R. E., Khodyakov, D., & Craig, P. (2020). ADAPT study: adaptation of evidence-informed complex population health interventions for implementation and/or re-evaluation in new contexts: protocol for a Delphi consensus exercise to develop guidance. BMJ open, 10(7), e038965. doi:10.1136/bmjopen-2020-038965 

Evans, R., Moore, G., Movsisyan, A., & Rehfuess, E. (2020). How can we adapt complex population health interventions for new contexts? Progressing debates and research priorities. Journal of Epidemiology & Community Health. 

Version 1.0 of our full guidance is now available to download below. We may update this following peer review of the associated journal article summarising it. Please do get in touch if you have questions or feedback, now or as you begin the use the guidance.

Graham Moore, Mhairi Campbell, Lauren Copeland, Peter Craig, Ani Movsisyan, Pat Hoddinott, Hannah Littlecott, Alicia O’Cathain, Lisa Pfadenhauer, Eva Rehfuess, Jeremy Segrott, Penelope Hawe, Frank Kee, Danielle Couturiaux, Britt Hallingberg, Rhiannon Evans (2020)

Adaptation of interventions for implementation and/or re-evaluation in new contexts: The ADAPT Study guidance (v1.0).
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