Considerations When Adapting a Program

It is important to balance implementing a program as designed with ensuring program components are relevant to the population of interest. Module 1 discusses the importance of including community members and other intended audiences in program design. Adaptations may be necessary to ensure programs are feasible in rural contexts and acceptable to program participants.

When tailoring program components to specific communities, rural program planners should avoid removing program elements responsible for positive results. To avoid mismatching the program and intervention activities with the needs of the community, researchers have suggested that communities consider the following types of proposed program changes and adaptations:

• Cultural adaptations: Tailoring the intervention to incorporate community preferences and views
• Cognitive adaptation: Tailoring the reading or age level of the intervention
• Affective-motivational adaptation: Adjusting aspects of the program to account for the norms and values of participants
• Environmental adaptation: Acknowledging ecological aspects of the community, for example implementing in homes instead of at a clinic
• Adaptations of program content: Tailoring visuals, examples, scenarios, and activities used during the intervention

These adaptations could be made without threatening program fidelity, which is the extent to which the delivery of the replicated program adheres to the original program. Program implementers should carefully consider whether adaptations will influence effective practices from the original program. For example, altering the program structure, theoretical foundation, key components, and goals could reduce program effectiveness. Changes that could affect a program's potential effectiveness include:

• Reducing number or length of program sessions
• Reducing participant engagement
• Eliminating key messages or skills learned
• Using inadequately trained staff
• Using fewer staff members than recommended

Resources to Learn More

The Community Tool Box: Chapter 19 – Section 4. Adapting Community Interventions for Different Cultures and Communities
Website
Addresses the aspects of adapting programs to different communities through identification and assessment of community concerns and assets to meet the needs of the intended population.
Organization(s): University of Kansas Work Group for Community Health and Development