Commentary on one of the key themes of the 9th Annual Conference on the Science of Dissemination and Implementation In Health

Jan 13,2017 | Alexis Kirk Commentary

Commentary: In December of 2016, the National Institutes of Health and AcademyHealth hosted the 9th Annual Conference on the Science of Dissemination and Implementation in Health. The conference was designed to “focus our thinking and discussion on the highest priorities for dissemination and implementation science…to optimize health and health care in the United States and elsewhere”.

One of the key themes of the meeting was balancing adaptation and fidelity. The opening plenary explored the adaptation-fidelity continuum, and several concurrent sessions at the conference focused on the topic. Speakers discussed the challenges in balancing adaptation and fidelity, as well as strategies for studying and making adaptations without sacrificing fidelity and intervention effectiveness.

A key message emerging from the conversation was that meaningful adaptations are possible. Adaptations can boost implementation and intervention effectiveness in instances where 1) they improve fit between the intervention and local context and 2) where adaptations are still aligned with the core components of an intervention and are not the result of ‘drift’. Overall, there was a call for additional study of adaptation and fidelity, as well as development and refinement of methods, frameworks, and measures for this area.

One presentation that highlights a first step in developing consensus in the field on one aspect of adaptation-fidelity was a scoping review presented by Escoffery et al. The authors conducted the review to determine 1) what adaptation frameworks were used in research and practice and 2) what the common steps were across frameworks. The review was the first of its kind to identify common adaptation frameworks and consolidate key steps in the adaptation process. The authors found 12 frameworks and identified 11 common steps across the frameworks.

This review presents a first step towards building consensus in the area of adaptation frameworks and the authors discuss areas for future research common across many of the frameworks, including a need for development of specific methods and tools to help the community better understand how to perform adaptations.

Copies of presentation materials are now available on the conference website for public viewing and download.