ArticleBMC health services research2021
Adaptations and modifications to a co-designed intervention and its clinical implementation: a qualitative study in Denmark.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
9 citing papers in PubMed.
- Trial
- Adoption of an Electronic Decision Support Tool for Capacity Building of Community Health Workers: Mixed Methods Study.JMIR formative research · 2026Article
- Review
- Continuity Is Essential: The Experiences of Co-Design Participants During the Implementation of a New Health Service.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Article
- Adapting Public Health and Health Services Interventions in Diverse, Real-World Settings: Documentation and Iterative Guidance of Adaptations.Annual review of public health · 2025Review
- Exploring the adaptability ofPEC innovation · 2024Article
- Can an evidence-based mental health intervention be implemented into preexisting home visiting programs using implementation facilitation? Study protocol for a three variable implementation effectiveness context hybrid trial.Implementation science : IS · 2024Article
- Between acute medicine and municipal alcohol treatment: Cross-sectoral collaborations regarding patients with alcohol problems.Nordisk alkohol- & narkotikatidskrift : NAT · 2024Article
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Authors and funding
10 authors.
Funding
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Abstract
backgroundThere is a long-standing debate in implementation research on whether adaptations to evidence-based interventions (EBIs) are desirable in health care. If an intervention is adapted and not delivered as conceived and planned, it is said to have low fidelity. The WALK-Cph project was developed based on the assumption that involving stakeholders in co-design processes would facilitate the fidelity of an intervention to increase the mobility of acutely admitted older medical patients and its implementation in two hospitals in Denmark. The purpose of this study is to describe and analyse adaptations and modifications that were made to the co-designed WALK-Cph intervention and its implementation.
methodsThis study used a qualitative design. An ethnographic field study was performed using participant observations, workshops and semi-structured interviews. Data were analysed twice using the Framework Method. The first analysis was based on the frameworks from Stirman, Moore and Proctor. The second analysis, a retrospective modifications analysis, was based on the Adaptation-Impact Framework.
resultsMany different types of adaptations and modifications were made to the WALK-Cph intervention and its implementation plan. Most of the modifications were made on the contents of the intervention. In total, 44 adaptations and modifications were made, of which 21 were planned (adaptations) and 23 were made haphazardly (modifications). Most of the content and context adaptations and modifications made on the intervention had a mixed result regarding enhanced fidelity. The retrospective modifications analysis showed that modifications were ongoing and both situationally and contextually shaped.
conclusionsAlthough an extensive co-design process was carried out to facilitate the fidelity of the WALK-Cph intervention, this study showed that many adaptations and modifications were still made to both the intervention and its implementation plan. It could indicate that the co-design process had a small effect or that adaptations and modifications are ongoing and both situationally and contextually shaped, which challenge the assumption and the desire to be able to plan and control changes.
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