A process-driven framework for creating equity-focused adaptation guidance for interventions or implementation strategies: the Adaptation with Equity (AwE) Framework

Adaptation has emerged as a critical area within implementation science and practice, reflecting the need to modify interventions and strategies to better fit specific contexts and improve implementation outcomes, while also maintaining fidelity. This methodology paper proposes the Adaptation with Equity (AwE) framework as a principled and process-driven framework for creating equity-focused adaptation guidance for interventions or implementation strategies. It offers implementers, researchers, and organisations a process to co-create adaptation guidance. It is a process framework involving eight sequential but overlapping steps: partner with organisations serving equity-deserving groups, prepare, establish Adaptation Teams, run Adaptation Team workshops, analyse suggested adaptations, and develop adaptation guidance. Once adaptation guidance is produced it can be field tested and revised alongside the intervention or implementation strategy. We present the detailed methods and procedures we developed to operationalise each of these steps in a project to produce an Adaptation Guide for the Walk the Talk toolkit – an implementation strategy for implementing guidelines for recovery-oriented practice. Future research should test AwE for other implementation strategies as well as interventions, guidelines and knowledge mobilisation products, in a range of settings.