Table 2 Description of how BFBW was modified according to Stirman model
Modification | BFBW | WFY |
|---|---|---|
Who made decision to modify? | ||
Individual practitioner | – | |
Team | – | |
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 |
Group | – | |
Individual practitioner | – | |
Clinic/unit | Community health center | – |
Organization | Community health center | Work group within an academic hospital system |
Network | – | |
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 | |