Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA.
Department of Psychology, University of South Carolina, Columbia, SC, USA.
Transl Behav Med. 2023 Sep 12;13(9):700-709. doi: 10.1093/tbm/ibad022.
Interventions for adolescent weight management that are ready to use in clinical settings are needed to address the obesity epidemic and improve the health and wellbeing of affected adolescents. This report describes the systematic process our team followed to adapt an evidence-based intervention (EBI) for adolescent weight management from its randomized control trial protocol to a package for delivery in a group-based telehealth format within a medical center. The EBI adaptation was clinician initiated, prompted by identified practice needs, and involved collaboration of the clinical team with the EBI developer. The process was guided by the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and followed key steps for adapting EBIs to new contexts. RE-AIM-aligned adaptations included telehealth delivery and broader inclusion criteria, separate clinical and research evaluation batteries, adaptations to fit the clinical practice, practical fidelity checklists to guide and record session delivery, and continuous quality improvement processes aimed to facilitate program longevity and family engagement. The process culminated in a package of adapted intervention materials deemed by stakeholders as appropriate to the practice and congruent with the EBI model. This report provides a much-needed practical demonstration of the translation of an EBI for adolescent weight management from research protocol to group telehealth delivery in a medical center. Key lessons include the value of clinician-researcher collaboration, the breadth of resources needed to adapt EBIs for real-world delivery, and the importance of considering delivery context in implementation and evaluation decisions, including defining inclusion criteria, staffing, and outcomes assessments.
需要在临床环境中使用的针对青少年体重管理的干预措施,以应对肥胖症的流行并改善受影响青少年的健康和福利。本报告描述了我们团队遵循的系统过程,以便将基于证据的青少年体重管理干预措施(EBI)从其随机对照试验方案改编为在医疗中心的基于小组的远程医疗格式中提供的一揽子计划。EBI 的改编是由临床医生发起的,是根据已确定的实践需求提出的,涉及临床团队与 EBI 开发人员的合作。该过程以 RE-AIM(可及性、有效性、适用性、实施性和维持性)框架为指导,并遵循了将 EBI 改编为新环境的关键步骤。与 RE-AIM 一致的改编包括远程医疗交付和更广泛的纳入标准、单独的临床和研究评估电池、适应临床实践、指导和记录课程交付的实用保真度检查表,以及旨在促进项目长期和家庭参与的持续质量改进过程。该过程最终形成了一套经过利益相关者认为适合实践并与 EBI 模型一致的改编干预材料包。本报告为将青少年体重管理的 EBI 从研究方案转化为医疗中心的小组远程医疗提供了急需的实际演示。关键经验包括临床医生-研究人员合作的价值、为 EBI 进行真实世界交付所需的广泛资源,以及在实施和评估决策中考虑交付环境的重要性,包括定义纳入标准、人员配备和结果评估。