A new model for making informed adaptations to evidence-based prevention programs

Evidence-based curricula are effective group-based interventions to prevent risky health behaviors. Prevention practitioners are often challenged in adapting (or choosing) the most appropriate evidence-based intervention to meet the needs of the youth they serve and/or their organization's capacity. The lack of information about evidence-based interventions, lack of time to implement the intervention, mismatches between the intervention's intended audience and the audiences served by the practitioner, discordance in community values and intervention values, and lack of skill to implement intervention teaching methods are just some of the factors affecting appropriate selection and adaptation of evidence-based curricula. Education, Training and Research Associates, in close collaboration with the Centers for Disease Control and Prevention, Division of Reproductive Health initiated a project in 2006 to develop a theory-based and practical model to guide the development of intervention-specific adaptation guidance. Through this project, a model was created which includes five steps, including development of: 1) an activity/determinant matrix; 2) BDI logic model (to link curriculum activities with the curriculum's health goals, youth behaviors directly related to those goals, and the psychosocial determinants related to those behaviors); 3) core intervention components; 4) specific green/yellow/red adaptation guidance; 5) fidelity and monitoring logs. The model was used to create “Adaptation Kits” for several teen pregnancy and HIV prevention evidence-based curricula. The model is unique in that it allows for the creation of very specific and practical adaptation guidance. The model can be used across a variety of content areas and audiences.