Giles Luke, Pearson Nicole, Lamont Hannah, Grady Alice, Yoong Sze Lin
Hunter New England Population Health, Wallsend, New South Wales, Australia.
School of Medicine and Public Health, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, New South Wales, Australia.
Health Promot J Austr. 2025 Apr;36(2):e920. doi: 10.1002/hpja.920. Epub 2024 Aug 26.
The Get Outside, Get Active (GOGA) program is a randomised controlled trial which tested the impact of a multi-component implementation strategy to support early childhood education and care (ECEC) services to replace indoor-only free play with indoor-outdoor-free play. This cross-sectional study aims to describe the extent and nature of modifications made to implementation strategies and Behaviour Change Techniques (BCTs) using the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies (FRAME-IS) and to describe the fidelity of BCT delivery throughout GOGA.
An audit of records was undertaken throughout the intervention delivery period in the intervention arm. GOGA included 14 standard BCTs within six implementation strategies. Modifications and BCT delivery were recorded by Health Promotion Officers via project records. Modifications were categorised according to the FRAME-IS. BCT delivery was recorded using a checklist.
Forty-four ECEC services received the GOGA program. Overall, 60 modifications were recorded. According to FRAME-IS categories, most modifications related to: content; format; pragmatic or practical considerations; tailoring/tweaking/refining in nature; fidelity was inconsistent; the goal was to increase the acceptability, appropriateness, or feasibility of the implementation effort; the rationale was at the practitioner level; and were unplanned/reactive. Overall, 96.4% of standard BCTs were delivered as intended.
GOGA was delivered with high fidelity to protocol as indicated by the level of BCT delivery. This article details a thorough approach to documenting modifications and provides guidance for future studies. SO WHAT?: This article contributes to the emerging evidence regarding documentation of adaptations and modifications to public health implementation interventions.
“走出去，动起来”（GOGA）项目是一项随机对照试验，该试验测试了一种多成分实施策略的影响，以支持幼儿教育与保育（ECEC）服务，用室内外自由玩耍取代仅在室内的自由玩耍。这项横断面研究旨在使用《基于证据的实施策略的适应与修改报告框架》（FRAME-IS）来描述对实施策略和行为改变技术（BCTs）所做修改的程度和性质，并描述在整个GOGA项目中BCTs的实施保真度。
在干预组的整个干预实施期间进行了记录审核。GOGA在六种实施策略中包括14种标准BCTs。健康促进官员通过项目记录记录修改情况和BCTs的实施情况。根据FRAME-IS对修改进行分类。使用清单记录BCTs的实施情况。
44个ECEC服务机构接受了GOGA项目。总体而言，记录了60项修改。根据FRAME-IS类别，大多数修改涉及：内容；形式；务实或实际考虑；本质上的调整/微调/完善；保真度不一致；目标是提高实施工作的可接受性、适当性或可行性；理由是在从业者层面；并且是无计划的/被动的。总体而言，96.4%的标准BCTs按计划实施。
如BCTs的实施水平所示，GOGA项目按照方案以高保真度实施。本文详细介绍了记录修改的全面方法，并为未来研究提供了指导。那又如何？：本文为有关公共卫生实施干预措施的适应与修改记录的新证据做出了贡献。
