title: The "Retrofitting" Approach to Adapting Evidence-Based Interventions: A Case Study of Pediatric Asthma Care Coordination, United States, 2010-2014.
abstract: Adaptation of evidence-based interventions upon implementation into new practice settings is universal, yet poorly understood. During a cross-site evaluation of the implementation of a proven intervention for pediatric asthma care coordination into 4 resource-challenged settings, we conducted in-depth interviews with site representatives, who reported how and why they modified intervention components. Interview notes were coded for themes. We focused on a single theme from a respondent who described the adaptation process as "backing" the intervention into ongoing services; we found evidence of a similar process at other sites. We labeled this process "retrofitting" to signify adaptation that consists of altering existing services to align with intervention components, rather than modifying the intervention to fit a new setting. Advantages of retrofitting may include allowing organizations to keep what works, capitalizing on existing support for program activities, elevating the role of local knowledge, and potentially promoting the sustainability of effective innovations.
authors: University of Michigan School of Public Health, 1425 Washington Heights, Ann Arbor, MI 48109-2029. Email: mjanevic@umich.edu.
authors: Mary R
authors: MR
authors: Janevic
authors: University of Michigan School of Public Health, Ann Arbor, Michigan.
authors: Shelley C
authors: SC
authors: Stoll
authors: RAND Corporation, Santa Monica, California.
authors: Marielena
authors: M
authors: Lara
authors: University of Puerto Rico School of Public Health, San Juan, Puerto Rico.
authors: Gilberto
authors: G
authors: Ramos-Valencia
authors: Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors: Tyra
authors: T
authors: Bryant-Stephens
authors: University of Illinois at Chicago School of Public Health, Chicago, Illinois.
authors: Victoria
authors: V
authors: Persky
authors: Los Angeles Unified School District, Los Angeles, California.
authors: Kimberly
authors: K
authors: Uyeda
authors: Merck Childhood Asthma Network, Washington, DC.
authors: Julie Kennedy
authors: JK
authors: Lesch
authors: Merck Childhood Asthma Network, Washington, DC.
authors: Floyd J
authors: FJ
authors: Malveaux
mesh_terms: D001249:Asthma / Q000175:diagnosis / Q000628:therapy; D002648:Child; D002662:Child Health Services / Q000458:organization & administration*; D055317:Evidence-Based Practice / Q000193:education*; D006282:Health Personnel; D006801:Humans; D007407:Interviews as Topic; D020380:Needs Assessment; D016730:Program Development; D014481:United States