ADAPT Phase	Operationalisation for the Encompass Study
Formation of the adaptation team	The adaptation team was formed at the beginning of the project including the core research group, caregivers with lived experience, health professionals and academic researchers who were involved in the original development of the “Baby Ubuntu” programme and subsequent implementation and adaptations in LMICs, and professionals with expertise in relation to the clinical population, the development and evaluation of complex interventions, and the NHS/UK context. The adaptation team met every 6 months to explore key uncertainties, share local perspectives, develop the programme theory, and make decisions about the programme manual and delivery plan.
Assessing the rationale for intervention and considering intervention-context fit	We conducted a qualitative interview study to explore local perspectives about the rationale for the intervention, the intervention’s fit for the context, and local recommendations for the new programme manual and delivery plan. In this qualitative study, healthcare professionals and caregivers working with children with complex neurodisability were interviewed about their needs and priorities, which provided much of the rationale for the intervention. Participants from the qualitative study were also shown a presentation about the “Ubuntu” programme and asked general questions about the content, format, and ways to reach diverse groups. Subsequently, questions were asked about each module. The similarities and differences between the two contexts were explored in site visits by the lead researcher and in discussions with caregivers and healthcare professionals in each context. Intellectual property rights were considered throughout the process.
Planning for and undertaking adaptations	The manual and delivery plan were co-created through several iterative cycles. Based on feedback from the qualitative interviews and meetings with the adaptation team, the ten modules were decided upon. The parents with lived experience contributed heavily to the manual adaptation to ensure that pictures and examples were relevant to the local context. Having the initial developers of the programme on the adaptation team allowed for the core values of the programme to remain the same. The costs and resources required to test the intervention were managed by the lead researcher. Further information on the plan for evaluation, may be found in the pilot and feasibility study protocol [41].
Implementing and maintaining the intervention at scale	This will be the next step after evaluating the intervention for feasibility and acceptability. A larger implementation study will be conducted with the view of exploring sustainability and cost-effectiveness.