Table 1 Adaptation coding and scoring categories for Play Active

Description of the adaptation

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Reason for the adaptation (16)

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What is adapted? (16)

□ Content (of the strategy itself, or how aspects are delivered)

□ Training

□ Context – Format

□ Context – Setting

□ Context – Personnel

□ Context – Population

What is the type of content or training adaptation? (16)

□ Tailoring/tweaking/refining

□ Changes in packaging or materials

□ Adding elements

□ Removing/skipping elements

□ Shortening/condensing (pacing/timing)

□ Lengthening/ extending (pacing/timing)

□ Substituting

□ Reordering of implementation modules or segments

□ Spreading (breaking up implementation content over multiple sessions)

□ Integrating parts of the implementation strategy into another strategy (e.g., selecting elements)

□ Integrating another strategy into the implementation strategy in primary use (e.g., adding an audit/feedback component to an implementation facilitation strategy that did not originally include audit/feedback)

□ Repeating elements or modules of the implementation strategy

□ Loosening structure

□ Departing from the implementation strategy (“drift”) followed by a return to strategy within the implementation encounter

□ Drift from the implementation strategy without returning (e.g., stopped providing consultation, stopped sending feedback reports)

What is the relationship to the core elements (fidelity)? (16)

□ Fidelity Consistent/Core elements or functions preserved

□ Fidelity Inconsistent/Core elements or functions changed

What is the goal? (16)

□ Increase reach of the EBP (i.e., the number of patients receiving the EBP)

□ Increase the clinical effectiveness of the EBP (i.e., the clinical outcomes of the patients or others receiving the EBP)

□ Increase adoption of the EBP (i.e., the number of clinicians or teachers using the EBP)

□ Increase the acceptability, appropriateness, or feasibility of the implementation effort (i.e., improve the fit between the implementation effort and the needs of those delivering the EBP)

□ Decrease costs of the implementation effort

□ Improve fidelity to the EBP (i.e., improve the extent to which the EBP is delivered as intended)

□ Improve sustainability of the EBP (i.e., increase the chances that the EBP remains in practice after the implementation effort ends)

□ Increase health equity or decrease disparities in EBP delivery

At what level is the adaptation made? (16)

□ Organizational level (i.e., available staffing or materials)

When is the adaptation initiated (16)

□ Scale-up (i.e., when the EBP is being spread to additional clinics/settings within your system)

Is modification planned? (16)

□ Planned/Proactive (proactive adaptation)

Who participates in the decision to modify? (16)

□ Program Manager

□ Implementer or implementation strategy expert (Researcher)

□ Practitioners (Childcare service providers, directors and educators)

□ Community members (Parents)

Indicate who makes the ultimate decision (16)

□ Program Manager

How widespread is the modification? (16)

□ Organization

Proposed impact of the adaptation on intervention effectiveness (43)

9-point scale from most negative possible (0) to neutral (5) to most positive possible (9).

Size of the adaptation (42)

9-point scale from smallest change possible (0), to small (3) to medium (5) to large (7) to largest change possible (9).

Scope of the adaptation across the entire implementation support strategy (42)

9-point scale from smallest change possible (0), to small (3) to medium (5) to large (7) to largest change possible (9).