Adapting evidence-based HIV prevention interventions:Using the ADAPT-ITT model to guide the systematic adaptation of interventions for diverse populations and venues

The Institute of Medicine (IOM) recommends the use of HIV interventions with proven efficacy to avert new infections. Similarly, the CDC requires health departments and community-based agencies to use evidence-based behavioral interventions (EBIs). Although identification of EBIs is an important public health priority, ultimately, to avert further escalation of the HIV epidemic, EBIs need to be ‘‘scaled up'' for wider dissemination and adoption by diverse HIV prevention providers. Adoption of EBIs requires agencies to modify existing interventions to facilitate implementation, encourage ownership, and enhance acceptability of the intervention for new target populations. There are, however, few theoretic frameworks to guide the adaptation of EBIs. Over the past few years, we have systematically developed a framework for adapting HIV-related EBIs, known as the ‘‘ADAPT-ITT'' model. The ADAPT-ITT model consists of 8 sequential phases that inform HIV prevention providers and researchers of a prescriptive method for adapting EBIs. The ADAPT-ITT model has evolved over repeated applications from adaptations of several CDC-defined EBIs. Through this process, each application has informed the evolution and development of successive iterations of the ADAPT-ITT model. Additionally ADAPT-ITT has been applied with diverse populations of adolescents and adults in domestic and international settings. Moreover, observing implementation and national dissemination of these EBIs was instrumental in developing and refining the ADAPT-ITT model. This iterative and experiential process has resulted in the development of a pragmatic framework for adapting EBIs. This presentation will describe the ADAPT-ITT model and its applicability across diverse populations, venues, and cultures using case studies.