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Classifying Changes to Preventive Interventions: Applying Adaptation Taxonomies

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Abstract

High-quality implementation is important for preventive intervention effectiveness. Although this implies fidelity to a practice model, some adaptation may be inevitable or even advantageous in routine practice settings. In order to organize the study of adaptation and its effect on intervention outcomes, scholars have proposed various adaptation taxonomies. This paper examines how four published taxonomies retrospectively classify adaptations: the Ecological Validity Framework (EVF; Bernal et al. in J Abnorm Child Psychol 23(1):67–82, 1995), the Hybrid Prevention Program Model (HPPM; Castro et al. in Prev Sci 5(1):41–45, 2004. https://doi.org/10.1023/B:PREV.0000013980.12412.cd), the Moore et al. (J Prim Prev 34(3):147–161, 2013. https://doi.org/10.1007/s10935-013-0303-6) taxonomy, and the Stirman et al. (Implement Sci 8:65, 2013. https://doi.org/10.1186/1748-5908-8-65) taxonomy. We used these taxonomies to classify teacher-reported adaptations made during the implementation of TOOLBOX™, a social emotional learning program implemented in 11 elementary schools during the 2014–2015 academic year. Post-implementation, 271 teachers and staff responded to an online survey that included questions about adaptation, yielding 98 adaptation descriptions provided by 42 respondents. Four raters used each taxonomy to try to classify these descriptions. We assessed the extent to which raters agreed they could classify the descriptions using each taxonomy (coverage), as well as the extent to which raters agreed on the subcategory they assigned (clarity). Results indicated variance among taxonomies, and tensions between the ideals of coverage and clarity emerged. Further studies of adaptation taxonomies as coding instruments may improve their performance, helping scholars more consistently assess adaptations and their effects on preventive intervention outcomes.

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Acknowledgements

This research was funded by the Stuart Foundation and a Hellman Foundation Graduate Fellow Award. We thank Mark Collin, Dr. Chuck Fisher, Pamela McVeagh-Lally, and our colleagues at the UC Berkeley Center for Prevention Research in Social Welfare (especially Dr. Sarah Accomazzo and Kimberly Knodel) for their contributions to this work. We also thank Dr. Stacey Alexeeff for statistical consultation. Finally, we thank the administrators, teachers, and staff who participated in this research, and Catherine Rodecker and Dr. Kathryn Mapps for their implementation and evaluation leadership. Aspects of this paper were previously presented at the 2016 Society for Prevention Research conference in San Francisco and the 2017 Society for Social Work and Research conference in New Orleans. All research protocols were approved by the Committee for the Protection of Human Subjects (CPHS) at the University of California, Berkeley.

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Correspondence to Joseph N. Roscoe.

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The authors declare they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Appendices

Appendix 1

Taxonomy coverage by adaptation question

Taxonomy

Overall

Favorite lesson

Least favorite lesson

Outside lesson

%

κ

%

κ

%

κ

%

κ

EVF

57

0.06

63

− 0.07

48

0.08

57

0.21

HPPM—Form

19

0.12

16

0.10

8

0.05

33

0.18

HPPM—Dimension

16

0.26

16

0.17

8

0.16

23

0.35

Moore—Fit

36

0.26

33

0.26

28

0.10

47

0.39

Moore—Timing

5

− 0.07

7

− 0.01

0

− 0.15

7

− 0.09

Moore—Valence

66

0.02

77

− 0.10

56

− 0.01

60

0.18

Stirman—Decision

90

0.10

95

0.22

84

− 0.04

87

0.11

Stirman—Adaptation Type

82

0.13

84

0.21

84

0.03

77

0.13

Stirman—Context

0

1.00

0

0.00

0

0.00

0

0.00

Stirman—Level

81

− 0.12

81

− 0.13

78

− 0.17

86

− 0.09

Stirman—Nature

87

0.33

92

0.02

78

0.13

86

0.46

  1. EVF ecological validity framework, HPPM hybrid prevention program model

Appendix 2

Taxonomy clarity by adaptation question

Taxonomy

Overall

Favorite lesson

Least favorite lesson

Outside lesson

%

κ

%

κ

%

κ

%

κ

EVF

32

0.31

22

0.23

58

0.46

29

0.24

 Language

2

 

0

 

8

 

0

 

 Persons

4

 

0

 

8

 

6

 

 Metaphors

0

 

0

 

0

 

0

 

 Content

4

 

7

 

0

 

0

 

 Concepts

0

 

0

 

0

 

0

 

 Goals

0

 

0

 

0

 

0

 

 Methods

14

 

11

 

42

 

0

 

 Context

9

 

4

 

0

 

24

 

HPPM—Form

47

0.11

29

0.08

50

− 0.13

60

0.19

 Content

37

 

29

 

0

 

50

 

 Delivery

11

 

0

 

50

 

10

 

HPPM—Dimension

94

0.45

86

0.32

100

1.00

100

0.24

 Cognitive-informational

69

 

43

 

50

 

100

 

 Affective-motivational

25

 

43

 

50

 

0

 

 Environmental

0

 

0

 

0

 

0

 

Moore—Fit

77

0.03

79

0.33

86

− 0.12

71

− 0.43

 Logistical

20

 

43

 

14

 

0

 

 Philosophical

57

 

36

 

71

 

71

 

Moore—Timing

100

0.25

100

0.26

0

0.00

100

− 0.15

 Proactive

60

 

100

 

0

 

0

 

 Reactive

40

 

0

 

0

 

100

 

Moore—Valence

43

0.13

42

0.01

57

0.32

33

0.08

 Positive

28

 

33

 

21

 

22

 

 Neutral

14

 

9

 

36

 

6

 

 Negative

2

 

0

 

0

 

6

 

Stirman—Decision Maker

98

0.17

100

− 0.04

95

0.26

96

0.29

 Individual practitioner

98

 

100

 

95

 

96

 

 Team or group of practitioners

0

 

0

 

0

 

0

 

 Administrator

0

 

0

 

0

 

0

 

 Researcher

0

 

0

 

0

 

0

 

 Intervention developer or purveyor

0

 

0

 

0

 

0

 

 Coalition of stakeholders

0

 

0

 

0

 

0

 

Stirman—Adaptation Type

94

− 0.01

100

− 0.09

86

0.13

91

0.06

 Training and evaluation processes

0

 

0

 

0

 

0

 

 Context

0

 

0

 

0

 

0

 

 Content

94

 

100

 

86

 

91

 

Stirman—Context

0

0

0

0

 Format

0

 

0

 

0

 

0

 

 Setting

0

 

0

 

0

 

0

 

 Personnel

0

 

0

 

0

 

0

 

 Population

0

 

0

 

0

 

0

 

Stirman—Level

25

− 0.15

21

− 0.17

14

− 0.10

39

− 0.21

 Individual recipient

0

 

0

 

0

 

0

 

 Cohort

23

 

21

 

7

 

39

 

 Population

2

 

0

 

7

 

0

 

 Provider/facilitator

0

 

0

 

0

 

0

 

 Unit

0

 

0

 

0

 

0

 

 Hospital/organization

0

 

0

 

0

 

0

 

 Network/community

0

 

0

 

0

 

0

 

Stirman—Nature

78

0.62

79

0.59

71

0.74

83

0.45

 Tailoring/tweaking/refining

42

 

33

 

36

 

61

 

 Adding elements

25

 

33

 

21

 

11

 

 Removing elements

9

 

9

 

7

 

11

 

 Shortening/condensing

6

 

3

 

7

 

0

 

 Lengthening/extending

0

 

0

 

0

 

0

 

 Substituting elements

0

 

0

 

0

 

0

 

 Re-ordering elements

0

 

0

 

0

 

0

 

 Integrating another approach into the intervention

0

 

0

 

0

 

0

 

 Integrating the intervention into another approach

0

 

0

 

0

 

0

 

 Repeating elements

0

 

0

 

0

 

0

 

 Loosening structure

0

 

0

 

0

 

0

 

 Departing from the intervention (“drift”)

0

 

0

 

0

 

0

 
  1. Percent agreement and kappa statistics are based on occasions when ≥ 3 raters agreed on coverage. Subcategory percent agreements may not sum to category percent agreement due to rounding
  2. EVF ecological validity framework, HPPM hybrid prevention program model

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Roscoe, J.N., Shapiro, V.B., Whitaker, K. et al. Classifying Changes to Preventive Interventions: Applying Adaptation Taxonomies. J Primary Prevent 40, 89–109 (2019). https://doi.org/10.1007/s10935-018-00531-2

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