How does adapting an intervention protocol impact fidelity and outcomes?
Not just an interesting question but one that I'm looking at myself.
I've had interesting conversations with the developers of a couple of interventions that I am looking to adapt for specialized populations. Making language changes to improve understanding and self-identification with the intervention (is this for people like me?) and using additional aids and prompts to support intervention activities do these adaptations in and of themselves so change the intervention that we can't rely on the original outcomes evidence and fidelity expectations?
I feel in my own work there is a feasibly issue to be addressed first. Will the changes I'm attempting improve the likelihood that a group who does not currently participate in the intervention will be able to and will chose to do so; and will they have a level of attendance/participation that they should experience the benefits of the intervention?
Then if they participate how do those changes influence (for better or worse) adherence to content and approaches which have been previously identified as core to the intervention (the fidelity issue)?
Only then do I feel I will be ready to look at outcomes - are the types and rates of outcomes the same as previously reported?..... and then another question for me at least,.... if the group is particularly at risk and there are not other interventions demonstrated to be effective, what lesser but measurable rate of either fidelity or effectiveness is enough to continue to justify the continued use of the intervention?
So I feel like I answered your question with more questions,.... and I did,.... I'm hoping others will join in and build this discussion.
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