Table 4.
FRAME framework modification codes for modifications during the scale-up trial.
| Modification categories | Codes |
Physical activity practices n (%) |
Implementation support strategies n (%) |
Evaluation methods N (%) |
Total (practices, strategies, whole program and evaluation) n (%)** |
|---|---|---|---|---|---|
| Program component?* | Implementation support strategies physical activity practices evaluation |
N/A 3 (100) N/A |
16 (100) N/A N/A |
N/A N/A 1 (100) |
16 (80) 3 (15) 1 (5) |
| Proposed impact on the project? | Positive Negative Null Not applicable |
2 (67) 1 (33) 0 (0) 0 (0) |
13 (81) 3 (19) 0 (0) 0 (0) |
0 (0) 0 (0) 0 (0) 1 (100) |
15 (79) 4 (21) 0 (0) 1 |
| Relationship to fidelity/core elements? | Fidelity consistent Fidelity inconsistent Not applicable |
3 (100) 0 (0) 0 (0) |
16 (100) 0 (0) 0 (0) |
N/A N/A 1 (100) |
19 (100) 0 (0) 1 |
| Were modifications systematic or unsystematic? | Systematic Unsystematic |
0 (0) 3 (100) |
2 (13) 14 (88) |
0 (0) 1 (100) |
2 (10) 18 (90) |
| Were modifications proactive or reactive? | Proactive Reactive |
3 (100) 0 (0) |
9 (56) 7 (44) |
0 (0) 1 (100) |
12 (60) 8 (40) |
| Who participated in the decision to modify?* | Program Manager Individual practitioners Treatment/Intervention Team Administrator Recipients None |
3 (100) 2 (67) 1 (33) 0 (0) 0 (0) 0 (0) |
13 (81) 8 (50) 2 (13) 2 (13) 1 (6) 1 (6) |
1 (100) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) |
17 (85) 10 (50) 3 (15) 2 (10) 1 (5) 1 (5) |
| What was the goal?* | Improve fit with recipients Increase satisfaction Improve effectiveness/outcomes Increase reach or engagement Increase retention Improve feasibility None Not applicable |
2 (67) 0 (0) 0 (0) 0 (0) 0 (0) 1 (33) 0 (0) 0 (0) |
5 (31) 6 (38) 5 (31) 4 (25) 4 (25) 0 (0) 1 (6) 0 (0) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 1 (100) |
7 (37) 6 (32) 5 (26) 4 (21) 4 (21) 1 (5) 1 (5) 1 |
| What is modified? | Content Training and evaluation Contextual Implementation and scale-up activities |
2 (67) 1 (33) 0 (0) 0 (0) |
12 (75) 4 (25) 0 (0) 0 (0) |
0 (0) 1 (100) 0 (0) 0 (0) |
14 (70) 6 (30) 0 (0) 0 (0) |
| Context modifications are made to what? | Not applicable | 3 (100) | 16 (100) | 1 (100) | 20 |
| At what level of delivery were modifications made? | Target intervention group (all schools) Cohort (group of schools sharing a characteristic) Clinic unit/level (individual schools) |
3 (100) 0 (0) 0 (0) |
11 (69) 3 (19) 2 (13) |
1 (100) 0 (0) 0 (0) |
15 (75) 3 (15) 2 (10) |
| What is the nature of the content modification?* | Adding elements Tailoring/tweaking/refining Removing/skipping elements Lengthening/extending elements Substituting Reordering of intervention modules or segments Loosening structure Not applicable |
0 (0) 1 (33) 1 (33) 0 (0) 0 (0) 0 (0) 0 (0) 1 (33) |
5 (31) 2 (13) 1 (6) 1 (6) 1 (6) 1 (6) 1 (6) 4 (25) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 1 (100) |
5 (36) 3 (21) 2 (14) 1 (7) 1 (7) 1 (7) 1 (7) 6 |
| Reasons – socio-political (i.e., broad context)* | None (no reason) Societal/cultural norms Historical context Not applicable |
3 (100) 0 (0) 0 (0) 0 (0) |
14 (88) 1 (6) 1 (6) 0 (0) |
0 (0) 0 (0) 0 (0) 1 (100) |
17 (89) 1 (5) 1 (5) 1 |
| Reasons – organization/setting (i.e., PA4E1 implementation team)* | Available resources (funds, staff, tech, space) None (no reason) Social context Not applicable |
1 (33) 2 (67) 0 (0) 0 (0) |
13 (81) 3 (19) 1 (6) 0 (0) |
0 (0) 0 (0) 0 (0) 1 (100) |
14 (74) 5 (26) 1 (5) 1 |
| Reasons – provider (i.e., Local health district)* | None (no reason) Not applicable |
3 (100) 0 (0) |
16 (100) 0 (0) |
0 (0) 1 (100) |
19 (100) 1 |
| Reasons – recipient (i.e., Schools and in-school champions)* | None (no reason) Motivation and readiness Physical capacity Access to resources Cultural or religious norms Not applicable |
1 (33) 2 (67) 0 (0) 0 (0) 0 (0) 0 (0) |
8 (50) 5 (31) 3 (19) 2 (13) 1 (6) 0 (0) |
0 (0) 0 (0) 0 (0) 0 (0) 0 (0) 1 (100) |
9 (47) 7 (37) 3 (16) 2 (11) 1 (5) 1 |
Percentages are rounded, so may not sum to 100%.
Additional File 4 outlines each individual modification in detail and includes the full set of codes as outlined in the methods.
*
Percentages may not sum to 100%, and n values may not add up to the number of modifications (N = 20) because multiple codes within this category may be applied to each modification.
**
“Not applicable (N/A)” category not included in denominator to calculate percentages.