1. Describe two frameworks for guiding and tracking adaptations
2. Discuss how to apply MADI to understand adaptation impacts
3. Explain strategies to apply the FRAME to track adaptations

Pragmatic research answers the question, “Does it work in typical clinical care settings?” Ultimately, the goal of pragmatic research is to inform the implementation, spread, and scale of evidence in clinical settings to improve patient outcomes. There has been an increasing recognition that adaptations are the reality when implementing interventions in clinical settings. This change has been accompanied by a rapidly growing body of research on adaptations, which has accelerated in response to environmental demands from COVID-19. Unfortunately, this growing evidence base is not yet ready for use by the people responsible for leading change in organizations. In an effort to bridge this gap between the research on adaptations and the practice of adaptations in clinical settings, we developed a practical roadmap, Map2Adapt, to guide decision-making and planning for adaptations. Map2Adapt is a practical tool that highlights key concepts of adaptations and identifies strategies to systematically approach adaptations by applying existing literature that have exemplified ways to categorize and document adaptations in interventions, programs, or policies. Map2Adapt can be used collaboratively by pragmatic researchers and implementers to understand, plan for, track, and evaluate the impact of adaptations. This workshop will illustrate how pragmatic researchers, implementation scientists, and implementers can work collaboratively to better plan for adaptations.

LEARNING OBJECTIVES

1. Provide concrete and practical guidance to bridge the gap between adaptations in research and adaptations in practice
2. Describe key concepts related to adaptations
3. Use strategies to systematically approach adaptations
4. Classify different types of adaptations and the reasons for making those adaptations

Complex systems approaches to intervention science are increasingly advocated. However, despite a growing abundance of conceptual publications, there have to date been few attempts to consider in practical terms what a complex systems lens means for intervention researchers. This talk discusses the influence of complex systems thinking within historical and ongoing guidance development for intervention researchers. It will argue that whole systems evaluations may be neither attainable, nor necessary and that acknowledgment of complexity does not mean that real-world evaluations must investigate all facets of complexity. However, a systems lens may add value to intervention science through framing issues such as how fidelity is conceived, aspects of context which matter for intervention effects to transfer across contexts, and how intervention effects may build or diminish over time in real world settings. The talk will introduce new MRC-NIHR funded ADAPT guidance, which draws upon complex systems perspectives to provide guidance in thinking through and undertaking the adaptation of interventions for new contexts.

LEARNING OBJECTIVES

1. Definitions of a complex systems perspective, including i) what is meant by the terms ‘complex intervention’, ii) a ‘complex system” iii) intervention as an ‘event within a complex system’
2. The influence of complex systems perspectives in guidance development for health intervention research;
3. Practical implications of complexity for development, evaluation and implementation of interventions, with an emphasis on adaptation of interventions across contexts