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Quality Enhancement Research Initiative

2021 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




Feb 8, 2021

Gila Neta




AFT group discussion on learning and next steps from the 2020 NIH Dissemination and Implementation (D&I) conference pertaining to adaptations, fidelity, and tailoring

Dr. Neta, Dr. Glasgow, and Dr. Rabin will facilitate a group discussion of the newest science pertaining to adaptations, fidelity, and tailoring from the 2020 NIH Dissemination and Implementation (D&I) conference. 

Dr. Neta is one of the primary planners of the meeting and will start off our open-ended discussion with her observations.

Please make a note of and come prepared to share your thoughts on adaptation information from the conference as well.

March 8, 2021



Iterative use of RE-AIM to guide implementation for real-world settings in the VA and beyond

This session will describe a pragmatic method using the RE-AIM framework, iterative steps, and action planning to guide purposeful adaptations of interventions during implementation in real-world settings. We will describe the methodology that has been used across multiple studies, provide case examples, and discuss opportunities for application in other studies within and outside of the VA.

April 12, 2021

Prajakta Adsul, MBBS, MPH, PhD

Promoting health equity through implementation science: a focus on adaptations

Summary: Dr. Adsul pursues implementation research utilizing qualitative, quantitative, and mixed methods to incorporate the complexities of real-world practice and produce meaningful and useful products that are relevant to several stakeholders including fellow researchers and clinicians, community members, and most importantly, individuals that are directly affected by improving clinical and community practice. Dr. Adsul has been co-leading a workgroup on Health Equity and Context within the Implementation Science Consortium in Cancer to explore and promote synergies between the fields of health disparities and implementation research. We will discuss the workgroup thoughts on “public goods” that could inform moving research agenda for cancer prevention and control, especially as they related to adaptations. We will also discuss how adaptations are being considered in interventions delivered at the healthcare settings and community health interventions.

May 10, 2021

Christine Kowalski, MPH; Andrea Nevedal, PhD; Linda Kawentel, PhD

Breaking new ground: Enhancing VA Cooperative Studies clinical trials by integrating implementation planning and expertise

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

Summary: The Veterans Health Administration is undergoing a transformation to embed more strategic implementation planning in its Cooperative Studies Program (CSP). CSP is an award-winning and internationally recognized research organization that is uniquely positioned to provide definitive evidence in the prevention, diagnosis, and treatment of serious physical and mental health conditions. We will provide a background about why implementation planning is needed and how we developed an implementation planning checklist to inform VHA CSP clinical trials. The implementation plan encourages researchers to consider implementation issues and inform strategies to help providers adopt effective interventions, notably by ensuring in the pre-implementation phase that there is leadership support for the intervention, input from frontline users on the design and deployment of the intervention, and planning of the interventions' sustainment once the trial ends. The implementation planning checklist is a tool that can be used by other healthcare systems aiming to improve implementation of clinical trials. We will present our newly developed checklist and ask for group feedback.

June 14, 2021

Kelsey S. Dickson, PhD

A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes

Dr. Dickson will lead a group discussion about her recent manuscript, "A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes."

Dickson KS, Lind T, Jobin A, Kinnear M, Lok H, Brookman-Frazee L. A Systematic Review of Mental Health Interventions for ASD: Characterizing Interventions, Intervention Adaptations, and Implementation Outcomes. Adm Policy Ment Health. 2021 Apr 21. doi: 10.1007/s10488-021-01133-7. Epub ahead of print. PMID: 33884535.

July 12, 2021

Christopher Miller, PhD

The Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS)

Presented by: Christopher Miller, PhD is a clinical psychologist and investigator at the VA Boston Healthcare System Center for Healthcare Organization and Implementation Research (CHOIR). He also has an appointment as an Assistant Professor of Psychology in the Harvard Medical School Department of Psychiatry, and he is Co-PI of the VA Behavioral Health Quality Enhancement Research Initiative (BH QUERI) Program. His research focuses primarily on the implementation of team-based outpatient mental health care.

Topic: Implementation strategies are used to enhance the uptake of evidence-based practices (EBPs) into routine clinical care. Like EBPs themselves, implementation strategies are frequently modified to fit the population, clinical setting, and context in which the EBP is being implemented. In this session, Dr. Miller will present the FRAME-IS, a framework for documenting modifications to implementation strategies.

September 13, 2021

Cassie Goedken, MPH

Implementation Tracking: A Case Study from the Field of Antibiotic Stewardship

Presenter/Background: Cassie Goedken, MPH
Iowa City VA Healthcare System, Center for Access & Delivery Research and Evaluation (CADRE)

Cassie Goedken serves as the Implementation Specialist for the CARRIAGE QUERI Program. She is also a member of Ethnographic Methods and Implementation Core (EMIC) within CADRE.

Summary of presentation:  Discussion on implementation tracking, both strategies and adaptations, providing some background on the Antibiotic Self-Stewardship Time Out Program (SSTOP) project, which evaluated the implementation at VAMCs of an “Antibiotic Timeout”, 3 days after initiation of antibiotics to encourage providers to review continued use of antibiotic therapy. Following a description on how to develop a learning collaborative and track implementation of the intervention and contextual factors to improve intervention uptake and to promote sustainment. 

November 15, 2021

Dr. Russell Glasgow

Journal review of "Alignment in implementation of evidence-based interventions: a scoping review"

Description: The group will co-lead a journal club with a discussion and review of the article, "Alignment in implementation of evidence-based interventions: a scoping review".

Prior to the start of the session, we ask that you read the article (, for further conversational engagement and review. Lundmark, R., Hasson, H., Richter, A. et al. Alignment in implementation of evidence-based interventions: a scoping review. Implementation Sci 16, 93 (2021).

Background: Alignment (i.e., the process of creating fit between elements of the inner and outer context of an organization or system) in conjunction with implementation of an evidence-based intervention (EBI) has been identified as important for implementation outcomes. However, research evidence has so far not been systematically summarized. The aim of this scoping review is therefore to create an overview of how the concept of alignment has been applied in the EBI implementation literature to provide a starting point for future implementation efforts in health care.

December 20 , 2021

Dr. Russell Glasgow

Discuss All Things Adaptation and Fidelity from 2021 D&I

Description: We will be using this session to review the Annual Conference on the Science of Dissemination and Implementation in Health (D&I), co-hosted by the National Institutes of Health (NIH) and Academy Health conference content related to all things adaptation and fidelity.