By Caroline Kuo, DPhil, MPhil
Associate Professor,
Brown University School of Public Health
Honorary Associate Professor, University of Cape Town

As we work to close disparities in substance use prevention and treatment, we need to turn to the evidence-base and choose interventions that not only work, but are likely to have the largest impact upon the health behaviors we are trying to address. However, interventions are designed and tested in a particular population and context. The transportability of evidence-based models is not always appropriate or guaranteed. Culture, language, poverty, health systems differences, and other social and structural determinants of health may adversely affect engagement in, and response to evidence-based intervention models that are applied to new populations and settings unless the interventions are adapted. Such adaptations to existing evidence-based programs should not alter the core components of the intervention in order to maintain the intervention’s efficacy and effectiveness. Ideally, adaptation procedures strike a delicate balance between the idea of interventions being “universally applicable” to all contexts with the notion that “custom tailoring” is necessary to address inevitable differences in populations, settings, and cultures.

The following six sequential steps can guide the process of assessing, and if necessary, adapting existing interventions to new populations and settings. Click on View Resource to read more.