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ACT for Youth

Adapting Evidence-Based Programs

Fidelity to program design is vital if an evidence-based program is to deliver its promised outcomes. At the same time, some adaptation may be necessary when implementing these programs in real-world settings. This tension between fidelity and adaptation can be confusing. On this page, we offer resources to help program planners adapt programs in a way that will help, not harm, effectiveness.

What is fidelity?

Fidelity means that the evidence-based program is implemented with adherence to its core components: content (what is being communicated), pedagogy (how the content is taught), and implementation (how the program is delivered).

Developers base their programs in theory. Content, pedagogy, and implementation are not chosen at random or according to the developer's personal preference. The logic underlying each aspect of the program may be disrupted if the core components are changed or skipped.


Adaptations are changes to core components of an evidence-based program. While some adaptations may be helpful -- such as using inclusive language, making activities more interactive, and updating statistics -- others will compromise the integrity and effectiveness of the program.

Start with the right program

All communities are dynamic and unique. Youth groups are very diverse and youth culture changes quickly. To minimize the need for adaptations, it is critically important to select a program that is a match for the community and priority population. Comprehensive Planning for Evidence-Based Programming will assure a good fit.

Plan and prepare for implementation

Many of the adaptations made during implementation can be avoided through planning and communication. All parties should understand and agree to support the requirements of the selected program.

Adaptation Resources

General Adaptation Guidelines

In this presentation, Regina Firpo-Triplett of ETR Associates explains the green-yellow-red light framework for adapting evidence-based programs in the field of adolescent sexual health.

Narrated Presentation (25 minutes)

Slide Set

General Adaptation Guidance: A Guide to Adapting Evidence-Based Sexual Health Curricula

This guidance document from ETR Associates details the green-yellow-red light framework and gives examples of appropriate and inappropriate adaptations.

Guidance Document

Making Adaptations to Evidence-based Pregnancy and STD/HIV Prevention Programs

Adaptation kits for popular evidence-based programs are provided by ETR Associates.

Adaptation Kits