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QUERI – Quality Enhancement Research Initiative

2019 Adaptation, Fidelity, and Tailoring (AFT) Implementation Workgroup Activity Summary

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Group leaders: Borsika Rabin, MPH, PhD, PharmD and Russell E. Glasgow, PhD

Group Facilitator: Christine Kowalski, MPH




January 14, 2019

James O. E. Pittman

Scaling up the VA eScreening Program Tailoring and Adaptation

eScreening is an evidence-based screening tool that provides customized and automated self-report health screening via iPad for Veterans receiving healthcare at the VA. The data integrates in to the medical record and is used to support patient-centered care and early identification efforts. This presentation will include a broad description of the process we used to develop and implement eScreening, our scale up plans, and some interesting adaptations that occurred along the way.

February 11, 2019

Shannon Stirman

Ana Baumann

Chris Miller

The FRAME Framework for Reporting Adaptations and Modifications Expanded

‘The FRAME: Framework for Reporting Adaptations and Modifications-Expanded.’ Drs. Stirman, Baumann, and Miller discussed their work to expand the 2013 Stirman et al framework and presented a working version of the updated framework. They also discussed the adaptation process and the relationship between fidelity, adaptations, and outcomes.

March 11, 2019

Maria Fernandez

Pat Mullen

Cam Escoffrey

IM Adapt March Adaptation, Fidelity, and Tailoring AFT seminar

Description of IM Adapt, an online tool that helps users find, select and adapt evidence-based cancer control interventions. It is based on the Intervention Mapping protocol for adaptation and serves as a decision support tool to help users: understand their needs, find EBIs that may fit, understand the EBI they have chosen, compare it to the needs of their population and setting, make adaptation decisions, and then make actual changes to the EBI and plan implementation of the adapted EBI.

April 8, 2019

Ana Baumann

April Adaptation, Fidelity, and Tailoring group AFT call

Dr. Baumann led a discussion of the following recent article: Alvidrez, J., A. M. Napoles, G. Bernal, J. Lloyd, V. Cargill, D. Godette, L. Cooper, M. Y. Horse Brave Heart, R. Das and T. Farhat (2019). "Building the Evidence Base to Inform Planned Intervention Adaptations by Practitioners Serving Health Disparity Populations." Am J Public Health 109(S1): S94-S101.

Access article here:

May 13, 2019

Karen L. Drummond

Consultation conference for analyzing model adaptations in qualitative data May AFT call

Dr. Drummond gave an overview of the parent study in which they are implementing primary care-mental health integration (PCMHI) in rural clinics via telehealth and then described A) the methods they are using to document implementation facilitation activities; B) the nature of the qualitative data produced through these methods; and C) the analytical approach they are using to analyze the data. Finally, she presented the group with a few questions to orient a discussion regarding how best to analyze adaptations to our Tele-PCMHI model in that data.

June 10, 2019

Russ and Borsika

June Adaptation, Fidelity, and Tailoring group AFT call

Borsika led a continued conversation from Dr. Drummond’s presentation last month regarding methods to document implementation facilitation activities and approaches to analyze adaptation data.

Russ led a group discussion of the following article:

Nilsen, P. and S. Bernhardsson (2019). "Context matters in implementation science: a scoping review of determinant frameworks that describe contextual determinants for implementation outcomes." BMC Health Serv Res 19(1): 189.

July 8, 2019


July Adaptation, Fidelity, and Tailoring Group seminar

Borsika led a group discussion of the following article:

Aarons, G. A., Sklar, M., Mustanski, B., Benbow, N., & Brown, C. H. (2017). "Scaling-out" evidence-based interventions to new populations or new health care delivery systems. Implement Sci, 12(1), 111.

September 9, 2019

Christine Kowalski

The argument for adaptations to maximize sustainability and adoption of an evidence based

It is a common belief that evidence and evidence-based practices are static and that change to the intervention can be expected to have negative consequences. Christine presented on a process of bringing an evidence-based intervention (diabetes Shares Medical appointments) into 5 different clinical settings through a dynamic model of adaptation that acknowledged inherent variability across settings. Details were shared about how we retained core elements deemed necessary to maintain effectiveness, while adapting the intervention sufficiently to increase relevance, and feasibility for implementation in a new setting and population.

October 21, 2019

Christine Kowalski

Adaptation, Fidelity, and Tailoring group seminar cont discussion of “The argument

A brief overview/recap was presented by Christine (following the session last month), “The argument for adaptations to maximize sustainability and adoption of an evidence-based clinical program.”  The remaining 45 mins was devoted to a group discussion and continued questions for Christine.

November 18, 2019

Lisa Lederer

Adaptation, Fidelity, and Tailoring group AFT call

Lisa presented, “Core Components: What they are and who defines them.” A group discussion continued related to better defining and understanding core components.

December 9, 2019


Adaptation, Fidelity, and Tailoring group AFT call Discuss D&I 2019

Russ and Borsika led a group discussion regarding learning and next steps from the 2019 Dissemination and Implementation (D&I) conference pertaining to adaptations, fidelity, and tailoring.