Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial

Weber, Mary Beth; Rhodes, Elizabeth C.; Ranjani, Harish; Jeemon, Panniyammakal; Ali, Mohammed K.; Hennink, Monique M.; Anjana, Ranjit M.; Mohan, Viswanathan; Venkat Narayan, K. M.; Prabhakaran, Dorairaj

doi:10.1186/s43058-023-00516-1

Implementation Science Communications

Table 2 Content-level adaptations to the INDIA-WORKS program

From: Adapting and scaling a proven diabetes prevention program across 11 worksites in India: the INDIA-WORKS trial

Description	Examples	Nature^a/additional detail	Goal Reason^b	Timing^c		Planned^d			Players^e
Description	Examples	Nature^a/additional detail	Goal Reason^b	Pre-implementation	Implementation	Planned/proactive	Planned/reactive	Unplanned/reactive	INDIA-WORKS staff	Worksite managers	Peer educators
Curriculum adaptations: format changes to class scripts and handouts	- Translation to local language	Tailoring/make materials more understandable and approachable for users	Address cultural factors Recipient level: first/spoken language	X		X			X	X
	- Use less technical language - Less formal presentation style	Tailoring/make materials more understandable and approachable for users	Improve fit with recipients Recipient level: literacy and education level		X	X	X		X		X
	- Focus on local foods in lessons	Tailoring/make materials more approachable for users; in some cases based on views of peer educators	To address cultural factors Sociopolitical/outer context: societal/cultural norms		X	X		X			X
Curriculum adaptations: additions to curriculum	- Addition of more hands-on/interactive elements in class - Added training on physical activity skills	Adding elements/make materials more understandable and approachable for users	Improve fit with recipients Recipient level: motivation and readiness		X	X			X		X
	- Adding different and more advanced exercise classes	Adding elements/make program more appealing to users	Increase retention Recipient level: motivation and readiness		X	X		X		X	X
	- Encouraging participants to use existing exercise spaces (trails, gyms) - Encouraging participants to use factory/office spaces and grounds for walking - Encourage use of health food canteens	Tailoring: guiding participants to leverage worksite resources	Improve effectiveness/outcomes Organizational level: available resources Recipient level: motivation and readiness		X	X	X		X	X	X
Study testing protocol adaptations	- Doing all study testing at a single visit minimized drop-out - Adding additional testing of interest to the worksite	Tailoring: conducting study testing to reduce drop-outs and acceptability	Improve retention Recipient level: motivation and readiness		X			X	X	X
Class logistics	- Holding classes at times convenient to workers at site - Selecting class venues to maximize participation - Allowing classes to be held during working hours	Tailoring/planning classes to balance needs of workers and the worksite	Improve feasibility Recipient level: access to resources Organizational level: location/accessibility and competing demands or mandates		X	X		X		X
Recruitment logistics	- Focus on health improvement in recruitment instead of cardiovascular disease prevention - Using trusted individuals to recruit workers - Making eligibility criteria less restrictive for classes or exercise programming	Tailoring/tailoring the recruitment tools or plans to improve acceptability among workers	Increase reach or engagement Recipient level: motivation and readiness	X		X				X
Retention plans	- Use of appropriate channels to communicate with participants - Provide short-form make-up classes - Be flexible with make-up classes - Provide additional incentives	Tailoring, adding elements, and shortening/improve and support participant engagement	Increase retention Recipient level: motivation and readiness and access to resources Organizational level: competing demands or mandates and available resources		X			X	X	X	X

Headers correspond to the following FRAME domains: ^aWhat is the nature of the adaptation and why was it done?; ^bWhat is the goal of and reason for the adaptation?; ^cWhen did the adaptations occur?; ^dWhere modifications planned?; ^eWho participated in the decision to make the adaptation? Here, reported as specific players; in FRAME, these groups are included in the following categories: INDIA-WORKS staff includes treatment/intervention team, program developers and purveyors, and individual practitioners/facilitators; peer educators are individual practitioners/facilitators; and worksite managers are administration

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ISSN: 2662-2211

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