Table 2.
FRAME framework (13) modification codes for adaptations from efficacy to scale-up trial.
| Modification categories | Code |
Physical activity practices n (%) |
Implementation support strategies n (%) |
Evaluation methods n (%) |
Total (practices, strategies and evaluation) n (%)** |
|---|---|---|---|---|---|
| Program component? | Physical activity practices implementation support strategies evaluation |
8 (100) N/A N/A |
N/A 6 (100) N/A |
N/A N/A 6 (100) |
8 (40) 6 (30) 6 (30) |
| Proposed impact on the project? | Positive Negative Null Not applicable |
8 (100) 0 (0) 0 (0) 0 (0) |
4 (66) 1 (17) 1 (17) 0 (0) |
N/A N/A N/A 6 (100) |
12 (86) 1 (7) 1 (7) 6* |
| Relationship to fidelity/core elements? | Fidelity consistent Fidelity inconsistent Not applicable |
7 (88) 1 (13) 0 (0) |
5 (83) 1 (17) 0 (0) |
N/A N/A 6 (100) |
12 (86) 2 (14) 6 |
| Were adaptations systematic or unsystematic? | Systematic Unsystematic |
7 (88) 1 (13) |
6 (100) 0 (0) |
6 (100) 0 (0) |
19 (95) 1 (5) |
| Were adaptations proactive or reactive? | Proactive Reactive |
8 (100) 0 (0) |
6 (100) 0 (0) |
6 (100) 0 (0) |
20 (100) 0 (0) |
| Who participated in the decision to modify?* | Program manager Treatment/Intervention team Other codes |
8 (100) 8 (100) 0 (0) |
6 (100) 6 (100) 0 (0) |
6 (100) 6 (100) 0 (0) |
20 (100) 20 (100) 0 (0) |
| What was the goal?* | Improve fit with recipients Improve feasibility Improve effectiveness/outcomes Reduce cost Increase reach or engagement Increase satisfaction Other codes Not applicable |
4 (50) 0 (0) 3 (38) 0 (0) 1 (13) 1 (13) 0 (0) 0 (0) |
4 (67) 5 (83) 1 (17) 3 (50) 0 (0) 0 (0) 0 (0) 0 (0) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 6 (100) |
8 (57) 5 (36) 4 (29) 3 (21) 1 (7) 1 (7) 0 (0) 6 |
| What is adapted?* | Content Implementation and scale-up activities Training and evaluation Contextual |
7 (88) 0 (0) 0 (0) 1 (13) |
6 (100) 6 (100) 0 (0) 0 (0) |
0 (0) 6 (100) 6 (100) 0 (0) |
13 (65) 12 (60) 6 (30) 1 (5) |
| Contextual modifications are made to what? | Format Setting Personnel Population Not applicable |
1 (13) 0 (0) 0 (0) 0 (0) 7 (88) |
0 (0) 0 (0) 0 (0) 0 (0) 6 (100) |
N/A N/A N/A N/A 6 (100) |
1 (100) 0 (0) 0 (0) 0 (0) 19 |
| At what level of delivery were adaptations made? | Target intervention group (all schools) Cohort (group of schools sharing a characteristic) Clinic unit/level (individual schools) |
8 (100) 0 (0) 0 (0) |
6 (100) 0 (0) 0 (0) |
6 (100) 0 (0) 0 (0) |
20 (100) 0 (0) 0 (0) |
| What is the nature of the content adaptation?* | Substituting Tailoring/tweaking/refining Lengthening/extending elements Adding elements Shortening/condensing Not applicable |
3 (38) 0 (0) 2 (25) 1 (13) 1 (13) 1 (13) |
4 (67) 0 (0) 0 (0) 1 (17) 2 (33) 0 (0) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 6 (100) |
8 (62) 3 (23) 2 (15) 2 (15) 3 (23) 7 |
| Reasons–socio-political (i.e., broad context)* | None (no reason) Funding or resource availability/allocation Existing policies Societal/cultural norms Other codes Not applicable |
4 (50) 2 (25) 2 (25) 0 (0) 0 (0) 0 (0) |
5 (83) 1 (17) 0 (0) 0 (0) 0 (0) 0 (0) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 6 (100) |
9 (64) 3 (21) 1 (7) 1 (7) 0 (0) 6 |
| Reasons –organization/setting (i.e., PA4E1 Implementation Team)* | None (no reason) Available resources (funds, staff, tech, space) Other codes Not applicable |
8 (100) 0 (0) 0 (0) 0 (0) |
0 (0) 6 (100) 0 (0) 0 (0) |
0 (0) 0 (0) 0 (0) 6 (100) |
8 (57) 6 (43) 0 (0) 6 |
| Reasons – provider (i.e., Local Health District)* | None (no reason) Not applicable |
8 (100) 0 (0) |
6 (100) 0 (0) |
0 (0) 6 (100) |
14 (100) 6 |
| Reasons – recipient (i.e., schools and in-School Champions)* | None (no reason) Cultural or religious norms Physical capacity Motivation and readiness Access to resources Other codes Not applicable |
4 (50) 0 (0) 2 (25) 1 (13) 2 (25) 0 (0) 0 (0) |
2 (33) 4 (66) 0 (0) 1 (17) 0 (0) 0 (0) 0 (0) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 6 (100) |
6 (43) 4 (29) 2 (14) 2 (14) 2 (14) 0 (0) 6 |
*
Percentages may not sum to 100%, and n values may not add up to the number of adaptations (N = 20) because multiple codes within this category may be applied to each adaptation.
**
“Not applicable (N/A)” category not included in denominator to calculate percentages.
Not applicable, (N/A).
Additional file 3 outlines each individual adaptation in detail and includes the full set of codes as outlined in the methods.