A is for Adaptation

by Jon Scaccia September 21, 2021

A brief introduction. Implementation science is the study of how to get good ideas into practice. Over the past twenty or so years, there has been a huge amount of academic effort spent studying the factors and variables that impact how different evidence-based practices get out into the community. There have been millions of dollars, millions of hours, and tens of thousands of papers devoted to this topic. And there’s been a lot of progress!

But the reality is that implementation science needs an implementation science. Just because you get a great list of topics back from PubTrawlr doesn’t mean you know exactly what to do with that information. The topics and concepts don’t always lend themselves to actionable insights. It can be challenging, if not impossible, to pick up a paper and use the information in it to improve a program

So that’s where this slightly silly series of blogs comes in. I want to provide an accessible, gentle, and FUN, introduction to many concepts in implementation science. This is by no means exhaustive. Like any research topic, you can get really into the weeds.

Our world does not lack good ideas. There are many neat solutions and strategies out there. All over, scientists, activists, and concerned citizens are pushing the envelope about what is possible and what will make a difference in our world.

And a lot of these strategies have good evidence behind them. Science can tell us that this method works for the following reasons and works for the following conditions.

It’s these conditions that often trip innovators up. In day-to-day practice, we can’t always replicate those conditions that a change was first tested and validated under. We may work with different types of people. We may have a different setting. And we may have different resource limitations on what we can do.

Adaptation is making changes to the design characteristics of an innovation so it better fits with the context you are working in. Sometimes we make changes that making content more culturally appropriate. This is often one of the main reasons for adaptation.

Sometimes we also make changes to our location. Maybe our building is only open certain hours out of the day, or we only have space available for a certain number of weeks? Or, maybe we have to convert to delivering an innovation over video conferences instead of in-person?

We can’t be haphazard with adaptation, though. There are certain elements that make up the spirit and the soul of a change effort. These core components can’t be changed without expecting the results to be totally different. We must preserve the attributes of an innovation that are driving the evidence and driving the results.

Adaptation is what happens when we consider the overall scope and the characteristics and the design of an intervention, preserve the core elements, and make alterations so that the change is more easily implementable by our teams.

Other Resources

• The Center for Implementation has developed an extensive tool to help team more effectively plan for adaptation. You can find their Map2Adapt tool here.
• This super (and freely available article) by Lori Rolleri and colleagues talks about different levels of adaption that can be considered. There are lots of figures and tables, especially Table 7, that can be used to guide your efforts.

Upcoming Entries

• B is for Best Practice

Have ideas for topics you want to see? There are a few letters where the posts could go multiple ways. Let us know in the comments!

Getting ideas out there