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Table 2 Description of how BFBW was modified according to Stirman model

From: Development of a scalable weight loss intervention for low-income workers through adaptation of interactive obesity treatment approach (iOTA)

Modification BFBW WFY
Who made decision to modify?
 Individual practitioner  
 Administrator or supervisor  
 Researcher   Surveys, interviews, and focus groups with the target population and supervisors
 Intervention Developer   A member of the BFBW development team included on the WFY workgroup
 Coalition of Stakeholders  
What was Modified
 Content modification   Y (described below)
 Context modification   Y (described below)
 Training and Evaluation Community health worker training Health coach training
Context modifications
 Population Low-income and racially diverse clinic patients with obesity and hypertension Low-income and racially diverse healthcare workers with obesity
 Setting Community health centers Worksite
 Format Interactive Voice Recognition or website with community health worker phone calls SMS with health coach meetings
 Personnel Physician and community health worker Health coach
Level of delivery for Content modifications
 Individual participant Participant selects behavioral goals Participant selects behavioral goals
 Individual practitioner  
 Clinic/unit Community health center
 Organization Community health center Work group within an academic hospital system
Nature of the Content modification
 1-Tailoring/tweaking/refining   Goals were tailored to the new setting, population, and mode of delivery
 2-Integrating the intervention into another framework  
 3-Integrating another treatment into the intervention  
 4-Removing/skipping elements   Hypertension medication adherence component was removed
 5-Lengthening/extending (pacing/timing) 24 months 24 months
 6-Shortening/condensing (pacing/timing) 24 months 24 months
 7-Adjusting the order of intervention components  
 8-Adding elements  
 9-Departing from the intervention (“drift”)  
 10-Loosening structure  
 11-Repeating components  
 12- Substituting 15 goals, 7 removed– based on updated scientific evidence and target population perspectives 11 goals added – based on updated scientific evidence and target population perspectives
MyHealthRisk Baseline survey to inform plan
Group support sessions Workgroup level intervention