Iterative Decision‐making for Evaluation of Adaptations (IDEA): A decision tree for balancing adaptation, fidelity, and intervention impact

• Published in: Journal of community psychology Vol. 48; no. 4; pp. 1163 - 1177
• Main Authors: Miller, Christopher J., Wiltsey‐Stirman, Shannon, Baumann, Ana A.
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.05.2020
• Subjects: Adaptation; culture; Decision Making; Decision Trees; Evidence-Based Practice - organization & administration; evidence‐based healthcare; evidence‐based practice; fidelity; Humans; implementation; modification; Qualitative Research; Stakeholder Participation; evidence-based practice; culture; evidence-based healthcare; implementation; adaptation; fidelity; modification
• ISSN: 0090-4392; 1520-6629; 1520-6629
• DOI: 10.1002/jcop.22279

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.