Evidence map›Paper›PMID 42228560›Full record

ArticleTranslational behavioral medicine2026

Applying the ADAPT-ITT framework to adapt a lifestyle Redesign® occupational therapy intervention for diabetic foot ulcer self-management.

Stacey L Schepens Niemiec, Lauren Styer, Jasmine Chapman, Elliot Myong, Ryan Moshtael, Christopher Lopez, Jocelyn Arteaga, Elaine Wong, Diana Motta Morales, Neel Kumar and 1 more

Erratum issued Registry-linked trialAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Translational behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT06278935 (Adapting a Lifestyle-based Offloading Intervention in Diabetic Foot Ulcers), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06278935 narecruitingnot on this map

Adapting a Lifestyle-based Offloading Intervention in Diabetic Foot Ulcers

TypeinterventionalSponsorUniversity of Southern CaliforniaRan2025 to 2026Enrolled20ConditionsDiabetic Foot Ulcer, Diabetic FootArmsLifestyle-based intervention by an occupational therapist
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Adapting Lifestyle RedesignCanadian journal of occupational therapy. Revue canadienne d'ergotherapie · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Stacey L Schepens NiemiecMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.ORCID 0000-0002-3766-7015
Lauren StyerMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
Jasmine ChapmanMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
Elliot MyongDivision of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America.
Ryan MoshtaelMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
Christopher LopezMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
Jocelyn ArteagaMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
Elaine WongDivision of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America.
Diana Motta MoralesDivision of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America.
Neel KumarMrs. T.H. Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, United States of America.
Tze-Woei TanDivision of Vascular Surgery and Endovascular Therapy, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States of America.ORCID 0000-0002-6658-9482

Funding

Southern California Clinical and Translational Science InstituteUL1TR001855 · NCATS · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Thomas A Buchanan, Michele D. Kipke · 2016 to 2026
$81.3M
National Institutes of Health/National Center for Advancing Translational Sciences (NIH/NCATS) UL1TR001855NCATS NIH HHS UL1 TR001855Southern California Clinical and Translational Science Institute
6 · The paper itself

Abstract

backgroundDiabetic foot ulcers (DFUs) affect approximately 25% of people with diabetes and are associated with decreased quality of life, high healthcare costs, recurrent wounds, and amputation risk. Standard DFU care emphasizes offloading to promote healing; however, adherence is often poor due to behavioral, psychosocial, and everyday life challenges. These gaps highlight the need for person-centered interventions that support DFU self-management within daily routines. PURPOSE: To systematically adapt a Lifestyle Redesign® occupational therapy intervention (LR-OT) for DFU self-management using the ADAPT-ITT framework.

methodsAn iterative, stakeholder-engaged adaptation process was conducted across the first seven ADAPT-ITT phases: Assessment, Decision, Administration, Production, Topical Experts, Integration, and Training. Activities included targeted literature synthesis, theater testing with individuals with DFUs and DFU care providers, iterative material development, and expert consultation. Adaptation efforts focused on refining intervention content, delivery, and training supports to DFU-specific care demands while retaining alignment with LR-OT core elements.

resultsThe ADAPT-ITT process yielded an interventionist-ready, DFU-specific LR-OT package, including patient-facing materials, an interventionist resource guide, and a conceptual mapping linking LR-OT theoretical elements to DFU-targeted management activities. Stakeholder input informed coordinated refinements to content, session structure, and delivery to support feasibility within DFU care contexts.

conclusionApplication of the ADAPT-ITT framework supported a transparent, stakeholder-informed, and reproducible process for adapting an evidence-based occupational therapy intervention for a high-risk and medically complex population. This work illustrates how lifestyle-focused interventions can be systematically adapted for specialty care contexts, with subsequent testing needed to evaluate fidelity and effectiveness. CLINICAL TRIAL INFORMATION: #NCT06278935.

Indexed as

Diabetic FootLife StyleOccupational TherapySelf-ManagementHumansQuality of Lifebehavior changechronic disease managementhealth promotionintervention adaptationrehabilitationstakeholder engagement

Identifiers

PMID42228560
PMCPMC13228136

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.