Christopher J Miller1, Shannon Wiltsey-Stirman2, Ana A Baumann3. 1. Department of Psychiatry, VA Boston Healthcare System, Center for Healthcare Organization and Implementation Research (CHOIR), Harvard Medical School, Boston, Massachusetts. 2. Department of Psychiatry and Behavioral Sciences, VA Palo Alto Healthcare System, National Center for PTSD Dissemination and Training Division, Stanford University, Stanford, California. 3. Brown School, Washington University in St. Louis, St. Louis, Missouri.
Abstract
BACKGROUND: Evidence-based practices (EBPs) are frequently adapted to maximize outcomes while maintaining fidelity to core EBP elements. Many step-by-step frameworks for adapting EBPs have been developed, but these models may not account for common complexities in the adaptation process. In this paper, we introduce the Iterative Decision-making for Evaluation of Adaptations (IDEA), a tool to guide adaptations that addresses these issues. FRAMEWORK DESIGN AND USE: Adapting EBPs requires attending to key contingencies incorporated into the IDEA, including: the need for adaptations; fidelity to core EBP elements; the timeframe in which to make adaptations; the potential to collect pilot data; key clinical and implementation outcomes; and stakeholder viewpoints. We use two examples to illustrate application of the IDEA. CONCLUSIONS: The IDEA is a practical tool to guide EBP adaptation that incorporates important decision points and the dynamism of ongoing adaptation. Its use may help implementation scientists, clinicians, and administrators maximize EBP impact. Published 2020. This article is a U.S. Goverment work and is in the public domain in the USA.
BACKGROUND: Evidence-based practices (EBPs) are frequently adapted to maximize outcomes while maintaining fidelity to core EBP elements. Many step-by-step frameworks for adapting EBPs have been developed, but these models may not account for common complexities in the adaptation process. In this paper, we introduce the Iterative Decision-making for Evaluation of Adaptations (IDEA), a tool to guide adaptations that addresses these issues. FRAMEWORK DESIGN AND USE: Adapting EBPs requires attending to key contingencies incorporated into the IDEA, including: the need for adaptations; fidelity to core EBP elements; the timeframe in which to make adaptations; the potential to collect pilot data; key clinical and implementation outcomes; and stakeholder viewpoints. We use two examples to illustrate application of the IDEA. CONCLUSIONS: The IDEA is a practical tool to guide EBP adaptation that incorporates important decision points and the dynamism of ongoing adaptation. Its use may help implementation scientists, clinicians, and administrators maximize EBP impact. Published 2020. This article is a U.S. Goverment work and is in the public domain in the USA.
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