June 2022 Journal Club Feedback


The latest meeting of the UK-IS Journal Club took place on 28th June 2022. Hosted by UK-IS Honorary Trustee Dr. Alex Ziemann, the group reviewed Adapting interventions to new contexts—the ADAPT guidance Moore G, Campbell M, Copeland L, Craig P, Movsisyan A, Hoddinott P et al. BMJ 2021;374:n1679



 

Summary Points

  • Use of interventions with a previous evidence base in new contexts might be more efficient than developing new interventions

  • Many population health problems and interventions are highly sensitive to context, so implementing an intervention in a new context without adaptation might be less likely to lead to positive outcomes

  • A new consensus informed guidance for adapting interventions to achieve a good fit between the intervention and context (ADAPT) proposes systematic processes for adapting interventions to new contexts, and transparent reporting to facilitate synthesis on what does or does not work

  • The ADAPT guidance was developed using systematic review methods, qualitative interviews, extensive consultation, and formal consensus methods. It provides a framework and step-by-step guidance for working with stakeholders, selecting suitable interventions, undertaking adaptations, making decisions on evaluation and implementation, and reporting adapted interventions

https://www.bmj.com/content/374/bmj.n1679

 

Participants generally welcomed the ADAPT guidance filling an important gap in our knowledge and having the potential to improve the success of replicating interventions in different contexts.


The group liked the emphasis on replicating underlying mechanisms or functions of an intervention next to only its visible form, however, and that is not a critique of the paper, there is little guidance available on how to actually identify, replicate or adapt mechanisms let alone core mechanisms or form in practice. We further discussed the feasibility of applying the guidelines in practice and found that it might be difficult to follow each step of the guide and particularly running pilots of adapted interventions might not be feasible or affordable in practice.

Participants missed a discussion of adapting implementation strategies and activities in the paper and how implementation strategies might be tailored to support adaptation. Further, we discussed that in reality the implementation context can and will change as well when replicating an intervention which could have been highlighted more. Context might be another part of the implementation picture to actively adapt next to the intervention and implementation strategies.

It is important to point out that there is a longer ADAPT guidance document which provides more detail than what could be incorporated in the scientific article.


Interested users of the ADAPT guidance are encouraged to look at the documents on the DECIPHER website: https://decipher.uk.net/portfolio/the-adapt-study/


Hosted/summarised by Dr. Alex Ziemann.


© UK Implementation Society, 2022

All views expressed are the author's own and not those of the UK Implementation Society.




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