ArticleTranslational behavioral medicine2026
Multi-method, longitudinal documentation of adaptations and their impact in the Accelerating Colorectal Cancer Screening and Follow-up through Implementation Science San Diego colorectal cancer screening implementation study.
Article in Translational behavioral medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04941300 (CRC-HUB-SPOKE), which is not on this map. Not yet cited in PubMed.
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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.
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.
CRC-HUB-SPOKE: A ColoRectal Cancer Screening Hub for Southern California Community Health Centers
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Authors and funding
11 authors.
Funding
Abstract
backgroundAdaptations are common in implementation studies, yet they are rarely documented systematically. Understanding when, why, and how adaptations occur can improve implementation processes, support interpretation of study outcomes, and inform scaling in diverse settings. Using comprehensive frameworks such as reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) and expanded framework for reporting adaptations and modifications-enhanced can guide systematic documentation, but practical, standardized approaches remain underdeveloped. PURPOSE: This study describes a multi-method, framework-guided approach to documenting adaptations across all phases of the accelerating colorectal cancer screening and follow-up through implementation science San Diego study, which implemented multilevel, evidence-based interventions to reduce colorectal cancer in community health center (CHC) systems.
resultsWe documented 44 adaptations over the pre-implementation (n = 22), implementation (n = 19), and sustainment (n = 3) phases. Most were verified through emails/meetings, with research staff/CHC staff as primary informants. Adaptations most frequently involved intervention materials, content, and format, and were primarily driven by pragmatic considerations to align with CHC workflows, patient needs, and contextual factors. While most adaptations had no major impact on RE-AIM outcomes, several improved implementations (e.g. centralizing FIT kit procurement to address COVID-19-related supply chain issues). Negative impacts were rare.
conclusionsA multi-method, framework-based approach to adaptation documentation is feasible and valuable in complex, real-world implementation studies. Early and ongoing tracking supports proactive problem-solving, enhances contextual fit, and informs sustainability planning. This methodology can serve as a model for systematic adaptation tracking in safety-net and community-based healthcare settings, strengthening the evidence base for how adaptations influence implementation and effectiveness outcomes. CLINICAL TRIALS REGISTRATION: The Clinical Trials Registration #NCT04941300.
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