Supporting quality adaptations of evidence-based interventions: A review of adaptation guidance and a decision-making process for violence prevention practitioners

Background: CDC's Division of Violence Prevention (DVP) supports efforts to enhance the implementation and adaptation of evidence-based interventions (EBIs) in violence prevention. Since practice and research settings differ, practitioners may adapt EBIs to align with their local context. However, some changes may reduce an EBI's effect on intended outcomes. To support these efforts, DVP conducted an environmental scan of adaptation guidance and, in collaboration with RTI, developed an Implementation and Adaptation Package (the Package) for practitioners. We will discuss a systematic process and strategies that practitioners can use to determine whether adaptations are needed and what should be adapted; to make the adaptations; to pilot test the adaptations; and to modify the adapted materials. Methods: We identified adaptation guidance through expert contacts and a web-based search that included 17 EBI registries. We then conducted six interviews with practitioners about the usefulness of the guidance. To inform Package development, we conducted interviews with practitioners, convened an expert panel, and piloted the Package with four sites implementing violence prevention EBIs. Results: We identified 25 adaptation guidance documents and will present consistencies and variations in approaches. We also developed an adaptation decision-making process that includes a hybrid of approaches identified in the environmental scan. Conclusions: Practitioners report wanting guidance on how to successfully implement EBIs within their local context. The Package is the first document designed to inform quality adaptations to EBIs in violence prevention. It reflects a number of approaches to adaptation and was informed by practitioner feedback on usability and usefulness.