BRIEF RESEARCH REPORT article
Front. Health Serv.
Sec. Implementation Science
Using End User Feedback to Specify an Adaptive Implementation Strategy
Provisionally accepted
- 1University of Arkansas for Medical Sciences, Little Rock, United States
- 2Louisiana Tech University, Ruston, United States
- 3University of Colorado Anschutz Medical Campus, Aurora, United States
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Background: Adaptive implementation strategies tailor support to setting needs rather than applying a uniform approach. These strategies improve efficiency and fit, yet practical guidance on identifying decision points and tailoring variables is limited. This study collected end-user and partner input to specify decision points and tailoring variables for an adaptive implementation strategy. Methods: This study focused on the evidence-based nutrition program, Together, We Inspire Smart Eating (WISE). End users and implementation partners with prior experience in WISE were recruited in two states to participate in semi-structured interviews or focus groups designed to elicit feedback to specify an adaptive implementation strategy for WISE. Results: Qualitative input supported 3 crucial decisions for an adaptive implementation strategy: 1) low-intensity support, the starting point for all sites, will include leadership commitments, local champions, an implementation blueprint, classroom reminders, and task-focused facilitation at the site level; 2) assessment of response to low-intensity support will occur in October (Month 3) of the school year; and 3) sites not responding by Month 3 will receive holistic facilitation and tailored educational materials at the teacher level. Participants emphasized the universal need for facilitation at all sites, with struggling sites requiring more. They also identified tailoring variables: sites with fewer than 60% of classrooms achieving fidelity would require high-intensity support. Conclusions: This study illustrates a process for using feedback from end users and partners to define key elements of an adaptive implementation strategy. Our approach holds significant potential to specify strategies for scaling health-related evidence.
Keywords: Adaptive implementation, end user feedback, community engaged dissemination andimplementation, early care and education, implementation science
Received: 09 Sep 2025; Accepted: 14 Nov 2025.
Copyright: © 2025 Massey-Swindle, Rutledge, Johnson and Curran. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Taren Massey-Swindle, tswindle@uams.edu
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.