Adaptation is a critical implementation process that represents the intersection between evidence-based practice (EBP) design by intervention developers and EBP use in practice. Adaptation encompasses not only changes made to EBPs, but also changes made within organizations and service systems to accommodate new practices. Clients, direct service providers, and other organizational and administrative actors influence adaptation over the course of EBP implementation. Current literature acknowledges that adaptation can positively or negatively influence EBP implementation. Because adaptation can bridge?or thwart?translation of a practice into mental health service settings, it is integral to the public health impact of an EBP. Improved understanding of the adaptation process, including how it affects EBP sustainment, will aid in the management of adaptation during EBP implementation. The proposed study systematically explores the process of adaptation and builds upon a series of NIMH-funded research projects that examine SafeCare implementation (two projects under R01MH072961 and R01CE001556). SafeCare is a well-established and behaviorally prescriptive EBP designed to prevent child neglect and improve outcomes for at-risk children. A mixed methods approach will be used to conduct an analysis of the adaptation process among 18 community-based organizations that are implementing SafeCare in California and Oklahoma. A variety of data sources will be used including qualitative interview data from agency administrators and providers, annual survey responses from providers, and fidelity ratings from SafeCare coaches.
The aims of the proposed project are to: (1) characterize engagement in adaptation across diverse organizational contexts, (2) examine organizational level predictors of adaptation patterns, and (3) assess the relationship between adaptation and SafeCare sustainment. The applicant will be completing these aims in a rich learning environment comprised of targeted training activities and structured mentorship from an exceptional, well-rounded team of experts. This proposed research and training plan will significantly surpass what the applicant would normally have access to during the dissertation process, enhance her EBP adaptation and sustainment research trajectory, and allow her to meaningfully contribute as an early career implementation science scholar.
Adaptation is a critical implementation process that represents the intersection between the design of evidence-based practices (EBPs) by researchers and the use of EBPs by mental health practitioners. Because adaptation can bridge?or thwart?translation of an EBP into real world service settings, this process directly affects the ability of an EBP to achieve its desired client benefits. Understanding the adaptation process and how to maintain and enhance the public health impact of EBPs aligns with NIMH Strategic Objective 4.1 and is the focus of this study.
