Table 2.

Overview of the Original PREMIER EBI and Documentation of Adaptations for Heart Matters Using the Wiltsey-Stirman et al. Coding System

Description of Original PREMIER Content	Description of Heart Matters Content	Level of Adaptation	Type of Adaptation	Source/s of Adaptation (community partner input, focus groups,	Relevant Intervention Mapping Step Coinciding with Adaptations
Content modifications: changes made to the intervention procedures, materials or delivery
Curricula behavioral goals
Reduce weight by 4.5 kg (10 lb) or more if overweight Limit daily sodium intake to 100 mmol or less Limit fat intake to 30% or less of total kcal No more than 1.0 ounce of alcohol per day for men, and no more than 0.5 ounces of alcohol per day for women Engage in 180 minutes per week or equivalent of moderate physical activity	If recommended, lose 15 lbs, or your individualized goal Eat 2,400 mg or less of sodium every day Eat 30% or less of total calories from fat No more than two alcoholic drink per day for men, and no more than one alcoholic drinks per day for women Be physically active for 30 minutes per day, three days per week, or accumulate 180 minutes of moderate-intensity each week	Population	Tailoring/tweaking/refining	Community partner input  PREMIER had challenging behavior change and health outcome goals  Participants may be discouraged if goals are unrealistic	Step 2: performance objective matrices
Intervention dose/duration
Fourteen 120-minute group sessions and four individual sessions in first 6 months of intervention Twelve group sessions and three individual sessions for 12 months following first 6 months	Fourteen 90-minute group sessions and four individual sessions in first 6 months 12 group sessions and three individual sessions for 6 months after the first 6 months	Cohort	Shortening/condensing	Focus group  Participants preferred sessions be no longer than 90 minutes  Participants preferred a 6- to 12-month intervention	Step 4: program plan
Curricula components and materials
No content/curricula components specifically for adults with mobility limitations Social support emphasized during the maintenance phase only.	Added special curricula that gives adults with mobility issues strategies for physical activity Family and friends from same household allowed to attend all group session with participant	Individual population	Adding elements	Focus group  Participants expressed the need for modifications for physical activity for those with limited mobility  Participants expressed an interest in having family and friends also participate in the intervention for social support	Step 4: program plan
Time for group to taste, compare, and discuss different foods discussed during the group session Handouts and participant materials relevant to urban population	Modified sample food to make it more culturally appropriate and ensure availability in community Handouts and materials amended to reflect relevancy and applicability to rural population	Population	Tailoring/tweaking/refining	Community partner input  Community partners expressed that foods should be types that participants would be most likely to incorporate into their daily diets and materials provided would need to be relevant to a rural community	Step 4: program plan
Check-in activity rigid with strict time constraint	Check-in structure and time constraints were loosened	Population	Loosening structure	Community partner input  Community partners suggested a shortened check-in to accommodate other session needs	Step 4: program plan
Context: changes made to delivery of the same program content, but with modifications to the format or channel, the setting or location in which the overall intervention is delivered, the personnel who deliver the intervention, or the population to which an intervention is delivered.
Inclusion/exclusion criteria
Excluded prediabetics Excluded individuals with hypertension	Included prediabetics Included those with hypertension	Population	Loosening structure	Academic and community partner input  Results of pre-eligibility screening found majority of eligible participants were prediabetic and diabetic  In order to have a large enough pool of participants and reach adequate numbers of the community, we revised eligibility criteria	Step 4: program plan
Intervention delivery
Primarily delivered to AA and White populations living in urban areas	Delivered exclusively to AAs living in a rural and semiurban area	Population	N/A	N/A; by nature of our objective the population was different	Step 5: implementation of intervention
Group sessions delivered at specialized clinical treatment centers Individual one-on-one counseling sessions designed to be delivered in person	Delivered at communityand faith-based organization facilities Individual sessions amended to be conducted over the phone by facilitators	Setting	Integrating the intervention into another setting	Community partner input, community assets survey  Mistrust in and discomfort of community members with health care institutions  Implementation via communityand faith-based organizations would provide improve reach and acceptability  Community partners suggested in-person would be difficult owing to time and travel constraints; phone sessions would be convenient for both facilitators and community members	Step 5: implementation of intervention
Delivered by staff at specialized centers	Delivered by lay community members	Personnel	Tailoring/tweaking/refining	Community partner input  Community partners indicated that the facilitator should be someone relatable in order to ensure retention of participants	Step 5: implementation of intervention
Training and evaluation: changes made to the procedures for training personnel or evaluating the program
Study design and procedures
Intervention evaluated using a RCT design with three arms	Intervention evaluated using a delayed intervention control RCT design with two arms	Evaluation		Academic and community partners  Academic partners expressed budgetary and recruitment constraints  Community partners expressed concerns with equitable resources provided to the participants	Step 6: evaluation
Multiple recruitment screening sessions; participants had to meet certain cut-offs to continue through eligibility	One recruitment screening session	Evaluation		Community partner input  Community partners expressed concern about participant burden with multiple screening sessions	Step 6: evaluation
Evaluation measures
Systolic Blood Pressure Data collected at 7 timepoints; prescreening visit, screening visit, baseline, 3, 6, 12, and 18 months	Weight is primary outcome Four data collection timepoints; baseline, 6, 12 and 18 months	Evaluation		Academic and community partner input  Owing to changes in the inclusion criteria (i.e., inclusion of individuals on blood pressure medications), blood pressure was no longer appropriate Academic partners  Resource limitation and participant burden	Step 6: evaluation