Background Tailoring implementation strategies and adapting treatments to better fit the local context may improve their effectiveness. However, there is a dearth of valid, reliable, pragmatic measures that allow for the prospective tracking of strategies and adaptations according to reporting recommendations. This study describes the development and pilot testing of three tools to designed to serve this purpose.
Methods Measure development was informed by two systematic reviews of the literature (implementation strategies, treatment adaptation). The three resulting tools vary with respect to the degree of structure (Brainstorming Log = low, Activity Log = moderate, Detailed Tracking Log = high). To prospectively track treatment adaptations and implementation strategies, three stakeholder groups (treatment developer, implementation practitioners, mental health providers) were randomly assigned one tool per week via an anonymous web-based survey for nine weeks and incentivized to participate. Three established implementation outcome measures, the Acceptability of Intervention Measure, Intervention Appropriateness Measure, and Feasibility of Intervention Measure were used to assess the tools. Semi-structured interviews were conducted to gather more nuanced information from stakeholders regarding their perceptions of the tools and the tracking process.
Results The three tracking tools demonstrated moderate to good acceptability, appropriateness, and feasibility; the Activity Log was deemed the most feasible of the three tools. Implementation practitioners rated the tools the highest of the three stakeholder groups. The tools took an average of 15 minutes or less to complete.
Conclusion This study sought to fill methodological gaps that prevent stakeholders and researchers from discerning which strategies are most important to deploy for promoting implementation and sustainment of evidence-based practices. These tools would allow researchers and practitioners to track whether activities were treatment adaptations or implementation strategies and what barrier(s) each target. These tools could inform prospective tailoring of implementation strategies and treatment adaptations, which would promote scale out and spread.