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Identify any adaptations needed to the knowledge
Keep the following questions in mind when you are identifying any adaptations needed to the knowledge:
- How does your context differ from the one in which the knowledge was originally created and evaluated?
- How will you, your stakeholders and end-users identify any adaptations needed so that the knowledge is appropriate to the local context while upholding the consistency of the evidence?
- How will you document the adaptations to the knowledge?
- What process will be put in place to update the knowledge, if necessary?
SOURCE: Health Canada, 2017.
How to decide which components of the knowledge to adapt
In most cases, it is possible to adapt knowledge to some degree, while still maintaining the integrity of the knowledge. The following points can help when planning and choosing which components of the knowledge can and cannot be adapted (Centre for Effective Services, 2021; Chambers et al., 2013; RNAO, 2012):
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Define the intervention - Define and document the different components of the intervention, and distinguish between the components which are essential for the intervention to be effective (the core components) and those which can/should be adapted to the local context.
Identify the core components – These are essential and indispensable elements of an intervention. They cannot change without undermining it. You will need to work with those who designed or developed the intervention to identify core components and deliver them with fidelity (implementing the intervention as originally intended by the developers). For some interventions, it is possible that all components will be core components.
Plan the adaptable components – These elements may be tailored to local settings. When these elements are not adapted, the knowledge you are trying to get into routine practice can be a poor fit for the local setting, generate resistance from those involved, and may result in poor outcomes. You and your team will need to determine, to what extent the knowledge needs to be adapted to your local context. This can be done in formal or informal ways, depending on the extent of adaptation (Graham et al., 2013; RNAO, 2012). Examples of approaches include: pilot testing recommendations, sharing plans with stakeholders and advisory teams, and hosting a workshop to review the evidence (Field et al., 2014).
