Adapting complex health population health interventions for new contexts

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Some population health interventions are effective in a wide range of settings – public smoking bans are a good example. Others that work well in some settings may turn out to be less effective, ineffective or even harmful in others. Such failures to replicate effects may reflect difficulties of implementation in a new setting, but also arise even when the intervention is closely based on the original and implemented well. Deciding whether and how an ‘evidence-informed’ intervention needs to be adapted to a new context is not straightforward. Changes may need to be made to the core components of the intervention, to the way it is delivered, to both or to neither.

Many suggestions have been put forward about how to adapt population health interventions to new contexts, but comprehensive guidance is lacking, and decisions are made in ad hoc way. Researchers at the Unit are working with colleagues at DECIPHeR, the NMAHP Research Unit, ScHaRR and Ludwig Maximilians University Munich to review existing guidance and case studies of adaptation, speak to research, policy and practice stakeholders, and conduct a consensus exercise to identify areas of agreement and remaining uncertainty.

The aim of this project is to develop guidance based on existing good practice that researchers, policy-makers and practitioners can use to make decisions about adapting interventions for use in new context, and to set out a methodological agenda for further research on intervention adaptation. The project will begin in June 2018 and run for two years. It is funded by the MRC Methodology Research Panel.

Information sheet for Adapt Study Delphi participants.


Rhiannon Evans, DECIPHer, Cardiff University

Hannah Littlecott, DECIPHer, Cardiff University

Simon Murphy, DECIPHer, Cardiff University

Jeremy Segrott, DECIPHer, Cardiff University

Graham Moore, DECIPHer, Cardiff University

Patt Hoddinott, Nursing Midwifery and Allied Health Professions (NMAHP) Research Unit, University of Stirling

Alicia O’Caithain, School of Health and Related Research (ScHARR), University of Sheffield

Lisa Pfadenhauer, Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University Munich

Eva Rehfuess, Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University Munich

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