Adapting evidence to local context

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Anonymous
21/09/2009
If I adapt a program to reflect my local circumstances, which is what is advised on the NCCMT homepage, how confident can I be that I will achieve the same outcome as that found in the research? How much can a program be adapted before it loses the integrity of the original design?
 
dciliska
22/09/2009
Great question - unfortunately, there is no great answer! The best you can do is go by the judgement of what you and your colleagues know about your community. You have to think about how the context of your community is similar and different from that described in the study.

The other key element is to not 'water down" the intervention by giving it at a lower intensity....which will decrease the likelihood of a similar effect.

If the intervention is the same (quality and intensity), then confidence in getting the same result depends on how much you think the intervention is affected by a different community and population. The net step in the cycle is critical - EVALUATION!

The evaluation does not have to be a randomized trial, but some collection of outcome data (preferably before/after) so that you can compare if the changes your participants are similar to those experienced by the study population.

Donna
 
Mongeon, Amanda
20/10/2009
To take this further, and to clarify my own learning around this experience of applying research to local contexts, is that once we've evaluated, it is important to share the evaluation findings. Am I correct in understanding that the best way to accumulate/develop some "best practices" is to find those interventions that in fact are successful across a multitude of contexts and communities, based on the experiences of those who have tried them out?

Amanda.
 
Ciliska, Donna
21/10/2009
Hi Amanda,

You are absolutely right - once you have evaluated, it is important to share that evaluation so that we can build our understanding of the effect of that intervention in different communities and different contexts. That is called "practice-based evidence".

We currently do not have a good way of doing that accumulation and sharing. One project that has just begun, whose purpose is exactly that, is the CAPTURE (CANADIAN PLATFORM TO INCREASE USAGE OF REAL‐WORLD EVIDENCE) project.

Capture Project

We look forward to the progress of the CAPTURE program to help us with common evaluations and sharing the results of those evaluations.

Donna