4.6 Article

Adapting population health interventions for new contexts: qualitative interviews understanding the experiences, practices and challenges of researchers, funders and journal editors

Journal

BMJ OPEN
Volume 12, Issue 10, Pages -

Publisher

BMJ PUBLISHING GROUP
DOI: 10.1136/bmjopen-2022-066451

Keywords

public health; public health; qualitative research

Funding

  1. MRC-NIHR Methodology Research Programme [MR/R013357/1]
  2. Centre for the Development and Evaluation of Complex Interventions for Public Health Improvement (DECIPHer)
  3. UKCRC Public Health Research Centre of Excellence
  4. British Heart Foundation [MR/KO232331/1]
  5. Cancer Research UK
  6. Economic and Social Research Council, Medical Research Council
  7. Welsh Government
  8. Wellcome Trust
  9. UK Clinical Research Collaboration
  10. Scottish Government Chief Scientist Office [SPHSU13]
  11. Health and Care Research Wales
  12. UK Medical Research Council [MC_UU_12017-13]

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This qualitative study examines the experiences of researchers and stakeholders in funding, conducting, and reporting adaptation research. The study identifies the complexities and challenges involved in intervention adaptation, such as stakeholder involvement, selecting interventions, and decision-making in the re-evaluation process. The study also highlights the importance of using adaptation frameworks and provides recommendations for future guidance development and refinement.
Objectives Research on the adaptation of population health interventions for implementation in new contexts is rapidly expanding. This has been accompanied by a recent increase in the number of frameworks and guidance to support adaptation processes. Nevertheless, there remains limited exploration of the real-world experiences of undertaking intervention adaptation, notably the challenges encountered by different groups of stakeholders, and how these are managed. Understanding experiences is imperative in ensuring that guidance to support adaptation has practical utility. This qualitative study examines researcher and stakeholder experiences of funding, conducting and reporting adaptation research. Setting Adaptation studies. Participants Participants/cases were purposefully sampled to represent a range of adapted interventions, types of evaluations, expertise and countries. Semistructured interviews were conducted with a sample of researchers (n=23), representatives from research funding panels (n=6), journal editors (n=5) and practitioners (n=3). Measures A case study research design was used. Data were analysed using the framework approach. Overarching themes were discussed within the study team, with further iterative refinement of subthemes. Results The results generated four central themes. The first three relate to the experience of intervention adaptation (1) involving stakeholders throughout the adaptation process and how to integrate the evidence base with experience; (2) selecting the intervention and negotiating the mismatch between the original and the new context; and (3) the complexity and uncertainty when deciding the re-evaluation process. The final theme (4) reflects on participants' experiences of using adaptation frameworks in practice, considering recommendations for future guidance development and refinement. Conclusion This study highlights the range of complexities and challenges experienced in funding, conducting and reporting research on intervention adaptation. Moving forward, guidance can be helpful in systematising processes, provided that it remains responsive to local contexts and encourage innovative practice.

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