Research project Understanding the value of adhering to or adapting evidence-based interventions
The project will offer unique insights into decision-making processes influencing how EBIs are used in practice. Such knowledge is needed for a more granular understanding of how practitioners manage the fidelity to and adaptation of EBIs and thus, ultimately, how the value of implementating EBIs can be optimized.
Whereas the value of an evidence-based intervention (EBI) is often determined by its effect on clinical outcomes, the societal impact – and thus value – of implementing and using EBIs is broader, reflecting qualities such as appropriateness, equity and costs-effectiveness.
This implies a complicated decision process that has received very limited scholarly attention. Inspired by studies on decision making, the objective of this project is to explore and test how practitioners appraise the value of achieving a certain outcome and how this influences decisions related to the so-called “fidelity and adaptation dilemma.” The dilemma is concerned with ensuring that an EBI is used as it was designed to ensure its effectiveness while purposefully making appropriate adaptations in accordance with constraints and possibilities in the local context.
Project description
The project starts with an explorative phase (RQ1–4) using focus group and individual interviews to uncover the parameters that influence fidelity and adaptation decisions—the dilemmas, available options, how outcomes are valued, and value trade-offs.
This is followed by a survey experiment, where how value appraisals influence decision making (RQ5) is tested.
Last, the explorative and experimental findings are contrasted to investigate how the outcome of value conflicts differs between optimal decision situations (experiment) and constraint/real-world decision situations (RQ6).
In this, we aim to mirror and contrast the structured, rational adaptation decision process that is recommended in the implementation literature with the unsystematic approach typically taken in practice.
The project will offer unique insights into decision-making processes influencing how EBIs are used in practice. Such knowledge is needed for a more granular understanding of how practitioners manage the fidelity to and adaptation of EBIs and thus, ultimately, how the value of implementating EBIs can be optimized.
Project members
Project managers
Ulrica von Thiele Schwarz
Professor
Members
Fabrizia Giannotta
Guest Researcher
Henna Hasson
Adjunct professor
Aaron Lyon
Professor