Adaptation Defined
What is Adaptation?
Adaptations are the modifications and changes made to a program. This can include the decision to add videos or activities, omit modules, or change the delivery method or dosage.
Some adaptations may seem like minor alterations, but they often hold more weight than expected. Even small changes can lead to ineffective program outcomes when not considered with care and caution.
Keep reading to learn more about best practices in program adaptation and how to find the balance between fidelity and adaptation.
When Should I Consider Adaptations?
A program may not require any adaptations when it is a good match for your community. However, the need to make adaptations is very common.
Adaptations should be considered when there is a need to increase participant responsiveness. This typically includes the need for more culturally or developmentally appropriate materials and updated health statistics or materials.
Remember that even when adaptations are made with the best intentions, they should still be made using a model of best practices.
Here is an article discussing the benefits of program adaptation when made with care and caution.
PRC’s Adaptation Guidance
Consider using the following research to practice tools and Prevention Extension Cast to guide your adaptation decisions.
Adaptations: A Deeper Dive
How do I Make Adaptations?
Adaptations can be tricky. On one hand, they can improve the effectiveness when made according to best practices. On the other hand, they take a lot of time, care, and caution, and they can potentially decrease program effects when made haphazardly.
Consider using our PRC Adaptation Guidance section to make these decisions with your team.
Considering Culture & Identity When Adapting
When considering adaptation, there are two main points of debate. On one hand there are those who consider adaptations to be necessary due to the natural conditions of implementing programs in real-world settings, stating that many EBPs have not been tested among diverse populations. On the other hand, there are those who consider adaptations to be a lack of fidelity, representing poor implementation quality. Well-funded effectiveness studies that use a systematic approach to testing adaptations can provide insights about adaptations’ effects on program benefits, but otherwise it is best practice to stick with the green light adaptations. When in doubt, check with the program developer.
Toolkit for modifying evidence-based practices to increase cultural competence.
Guide Overview: Adapting Evidence-Based Practices for Under-Resources Populations by SAMHSA
*Note: SAMHSA uses “EBP” to abbreviate evidence-based practices, but the PRC uses “EBP” to abbreviate evidence-based programs. The two are not interchangeable but share similarities.
The Complete Guide: Adapting Evidence-Based Practices for Under-Resourced Population by SAMHSA
*Note: SAMHSA uses “EBP” to abbreviate evidence-based practices, but the PRC uses “EBP” to abbreviate evidence-based programs. The two are not interchangeable but share similarities.
Fidelity vs Adaptation Tension
Referring to EBP’s logic model or theory of change is important for understanding the program and why it works. Balancing fidelity and adaptations often comes down to adhering to the program’s theory of change when making any modifications.
Here are some Logic Models for Select Evidence-Based Programs.
Balancing Fidelity & Adaptation by Washington State University.