Oncology mental health providers' adaptation of an evidence‐based intervention: A mixed‐methods study

• Published in: Psycho-oncology (Chichester, England) Vol. 33; no. 1; pp. e6272 - n/a
• Main Authors: Conley, Claire C., Ryba, Marlena M., Brothers, Brittany M., Lo, Stephen B., Andersen, Barbara L.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01-01-2024
• Subjects: Adaptation; Alternative approaches; biobehavioral; cancer; Change agents; Content analysis; dissemination; evidence‐based intervention; Frame analysis; framework for reporting adaptations and modifications‐enhanced (FRAME); implementation; Intervention; Mental health; Mixed methods research; Oncology; Psychosocial factors; Social workers; Training; evidence-based intervention; framework for reporting adaptations and modifications-enhanced (FRAME); dissemination; implementation; adaptation; cancer; oncology; biobehavioral
• ISSN: 1057-9249; 1099-1611
• DOI: 10.1002/pon.6272

Background
Adaptations are intentional modifications maximizing the fit of an evidence‐based intervention (EBI) in new context. Little is known about EBI adaptation within psychosocial oncology. Guided by the Framework for Reporting Adaptations and Modifications‐Enhanced (FRAME), this mixed‐methods study describes oncology mental health providers' planned adaptations to a psychosocial oncology EBI and examines the relationship between planned adaptations and longitudinal EBI usage.
Methods
Providers (N = 128) were social workers (47%) and psychologists (40%) practicing in community settings (44%) or academic medical centers (41%). They attended a 3‐day training on a multicomponent psychosocial oncology EBI, the Biobehavioral Intervention (BBI). During training, providers prepared an “adaptation plan” describing necessary adaptations to BBI and rationales for change. Qualitative data from adaptation plans were analyzed using directed content analysis. Linear mixed models examined the relationship between adaptation characteristics (number, similarity to the manualized BBI) and EBI usage across 12 months post‐training.
Results
Three sets of qualitative themes reflecting FRAME elements emerged: (1) content modifications (e.g., shortening/condensing, selecting elements, adding/removing elements); (2) contextual changes (e.g., alternative group formats); and (3) reasons for adaptations (e.g., organization/setting, provider, and recipient factors). Neither number of adaptations nor adaptation similarity were associated with BBI usage across 12 months post‐training.
Conclusions
To our knowledge, this study is the first to characterize oncology mental health providers' planned adaptations to a psychosocial oncology EBI. Planned adaptations did not increase usage, but importantly they did not decrease usage. The adaptation process enabled providers to make thoughtful adaptation choices, with implementation successful irrespective of setting constraints.