Adding Adaptation/Modification Size and Scope to Frameworks for Classifying Changes to an Intervention.

Frameworks for classifying adaptations and modifications to an intervention have been developed and continue to evolve. These frameworks capture a range of attributes of adaptations and modifications. However, the size and the scope of a change, relative to the intervention's overall size and structure, are not currently included. This omission can have negative consequences, especially for conclusions about how different kinds of changes to an intervention may influence implementation quality and intervention outcomes. Coding the relative size and scope of an adaptation or modification should be simple when the original intervention is described in detail. For interventions that are not manualized, coding may alternatively be based on rater judgments. Attending to the size and the scope of adaptations and modifications could have an ancillary benefit, generating increased conceptual and empirical work on procedures for identifying the distinct components and sub-elements of an intervention.