TitleThe dynamics of de-adoption: a case study of policy change, de-adoption, and replacement of an evidence-based HIV intervention.
Publication TypeJournal Article
Year of Publication2017
AuthorsMcKay, VR, Dolcini, MM, Hoffer, LD
JournalTransl Behav Med
Date Published2017 Dec

Evidence-based intervention (EBI) de-adoption and its influence on public health organizations are largely unexplored within public health implementation research. However, a recent shift in support for HIV prevention EBIs by the Centers for Disease Control and Prevention provides an opportunity to explore EBI de-adoption. The current mixed-method study examines EBI de-adoption and the subsequent impact on a community-based organization (CBO) dedicated to HIV prevention. We conducted a case study with a CBO implementing RESPECT, an HIV prevention EBI, over 5 years (2010-2014), but then de-adopted the intervention. We collected archival data documenting RESPECT implementation and conducted two semi-structured interviews with RESPECT staff (N = 5). Using Fixsen and colleagues' implementation framework, we developed a narrative of RESPECT implementation, delivery, and de-adoption and a thematic analysis to understand additional consequences of RESPECT de-adoption. Discontinuation of RESPECT activities unfolded in a process over time, requiring effort by RESPECT staff. RESPECT de-adoption had wide-reaching influences on individual staff, interactions between the staff and the community, the agency overall, and for implementation of future EBIs. We propose a revision of the implementation framework, incorporating EBI de-adoption as a phase of the implementation cycle. Furthermore, EBI de-adoption may have important, unintended consequences and can inform future HIV prevention strategies and guide research focusing on EBI de-adoption.

Alternate JournalTransl Behav Med
PubMed ID28397157
Grant ListR01 MH085502-01 / / National Institute of Mental Health / United States
T32 MH019960 / / National Institute of Mental Health / United States
Ruth E Warnke Graduate Fellowship / / Oregon State University / United States
Provost's Distinguished Fellowship / / Oregon State University / United States