Table 2.

Examples of proposed adaptations, the rationale of need, and the potential pros and cons associated with each

Adaptation	No. of sites	Essential element	Part. value	Org. value	Can sustain?	Pros	Cons
Active choices
Group orientation rather than individual and include logistic components	1	Yes	High	High	Yes	Face to face with health educators shortened (90 to 60 min). More participants	None noted
Modify data collection and questionnaires	2	No	Low	Low	Yes	Saves time. Allows more calls in a given period of time	Lack of comparable data
Reduce number of incentives provided at graduation	2	No	Med	Med	Yes	Reduces the cost of celebration activities	Participants receive fewer incentives at graduation
Change initial face-to-face meeting to a telephone call	1	Yes	High	High	Yes	Reduce cost and reach more participants. More convenient for participant	Potential weakening of rapport building
Modify the number of calls	2	Yes	High	High	Yes	Increase capacity for participants while decreasing program cost	May reduce effectiveness of program
Active living everyday
Change group size and/or duration	3	Yes	High	High	Yes	Improve participant satisfaction. Easier to sustain shorter groups	May influence effectiveness
Convert participant manual to an audio format	1	Yes	High	Med	Yes	Audio version would not scare lower literacy participants off like current manual	None noted
Lower cost of manual by dropping internet component and share manuals	4	No	Med	Med	Yes	Lower cost for participants. Participants “not interested” in internet component.	Lose opportunity to provide seniors with computer experience
Use a train the trainer model or internet training for instructors	1	Yes	Med	Med	Yes	Improve the affordability of the program	Facilitators do not get face to face contact with potential instructors

Part. value value to the participants, Org. value value to the organization