Intervention Mapping to Adapt Evidence-Based Interventions for Use in Practice: Increasing Mammography among African American Women

Table 1

Adaptation “to do list” for telephone counseling program.

Breast Cancer Screening Among Nonadherent Women
Fit category	Adaptation ideas
Behaviors from logic model of change; Adherence to mammography	Change behavior to “appointment keeping” rather than general mammogram
Environmental conditions from logic model of change	No change
Change methods (with determinants) for at risk group: Information dissemination (barriers); Staging (but does not seem closely related to change methods beyond information)	Role modeling: quotations from women in the community regarding barriers; Problem solving: regarding logistical barriers; Information dissemination: correcting misinformation; Persuasion: by culturally congruent navigator; Message matching to stage of change: initial message to either preparation/action or precontemplation/contemplation
Change methods (with determinants) for environmental agents	Not applicable
Delivery for components, at risk group: Telephone counseling call. Note: does not have conversational structure comfortable for navigators to implement	Change staging question and scripts to be less research oriented and more “real-world” navigator approach; Develop an active listening framework for barrier scripts; Retain staging but with only two classifications (precontemplation/contemplation; preparation/action); Editing for local idiom (ways of speaking of breast cancer and barriers)
List delivery for components, environmental agents	Not applicable
List design features and cultural relevance; Barriers are general and information-based	Add barriers described by local women: perceived likelihood of no cancer; expectation that God will protect against cancer; no money for treatment; becoming less than a woman with the loss of a breast; fear of losing partner; cancer being a death sentence; time only for caring for others; Logistics: no time off work; no transportation; responsibilities caring for a child or others; money/lack of awareness of programs that can pay for breast cancer treatment
Describe implementation plan; Research-based; elaborate staging; unclear how script changes based on staging; unclear transition between one barrier and the next	Add script with conversational transitions; Add local barriers; Simplify stages; Match script to stage