Table 3.

Applying the ADAPT-ITT framework to adapt ESTEEM: Phases and Corresponding Actions.

Phase	Corresponding Actions	Intervention Manual Version
1. Assessment	● Conducted 3 focus groups and a needs assessment with Chinese YMSM with anxiety or depressive symptoms and one focus group with CBO staff	N/A
	● Analyzed the interview results
2. Decision	● Decided to adapt the ESTEEM intervention	Original
3. Training	● Trained the potential counselors, research assessors, and data staff on the original ESTEEM protocol
	● Analyzed the trainees’ feedback to form potential adaptations
4. Administration/Adaptation	● Created a stakeholder Community Advisory Board (CAB) and a YMSM Advisory Board	Original
	● Administered theater demonstration with Chinese YMSM and CBO staff
	● Analyzed the results of theater demonstration
5. Producing	● Produced the first draft of the adapted ESTEEM protocol	Draft 1
	● Developed the process evaluation sheets for supervisors to supervise the intervention delivery and identified the measurement tools to assess session-to-session progress in the pilot trial
6. Topic Experts	● Involved five experts knowledgeable about HIV prevention and psychological counseling with Chinese YMSM	Draft 1
7. Integration	● Integrated content from topic experts workshop, CAB, and theater demonstration and created the second draft of the adapted ESTEEM	Draft 2
	● Conducted readability testing to create the third draft	Draft 3
8. Training &Testing	● Trained the counselors and research assistant to implement the third draft of the adapted ESTEEM
	● Conducted an open trial
	● Analyzed the results and feedback of the open trial	Final