BACKGROUND Adapting interventions that have worked elsewhere can save resources associated with developing new interventions for each specific context. While a developing body of evidence shows benefits of adapted interventions compared with interventions transported without adaptation, there are also examples of interventions which have been extensively adapted, yet have not worked in the new context. Decisions on when, to what extent, and how to adapt interventions therefore are not straightforward, particularly when conceptualising intervention effects as contingent upon contextual interactions in complex systems. No guidance currently addresses these questions comprehensively. To inform development of an overarching guidance on adaptation of complex population health interventions, this systematic review synthesises the content of the existing guidance papers. METHODS We searched for papers published between January 2000 and October 2018 in 7 bibliographic databases. We used citation tracking and contacted authors and experts to locate further papers. We double screened all the identified records. We extracted data into the following categories: descriptive information, key concepts and definitions, rationale for adaptation, aspects of adaptation, process of adaptation, evaluating and reporting adapted interventions. Data extraction was conducted independently by two reviewers, and retrieved data were synthesised thematically within pre-specified and emergent categories. RESULTS We retrieved 6694 unique records. Thirty-eight papers were included in the review representing 35 sources of guidance. Most papers were developed in the USA in the context of implementing evidence-informed interventions among different population groups within the country, such as minority populations. We found much agreement on how the papers defined key concepts, aims, and procedures of adaptation, including involvement of key stakeholders, but also identified gaps in scope, conceptualisation, and operationalisation in several categories. CONCLUSIONS Our review found limitations that should be addressed in future guidance on adaptation. Specifically, future guidance needs to be reflective of adaptations in the context of transferring interventions across countries, including macro- (e.g. national-) level interventions, better theorise the role of intervention mechanisms and contextual interactions in the replicability of effects and accordingly conceptualise key concepts, such as fidelity to intervention functions, and finally, suggest evidence-informed strategies for adaptation re-evaluation and reporting. TRIAL REGISTRATION PROSPERO 2018, CRD42018112714.

中文翻译：

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针对新情况调整循证复杂的人口健康干预措施：指南的系统审查。

背景 调整在别处奏效的干预措施可以节省与针对每个特定环境开发新干预措施相关的资源。虽然越来越多的证据表明，与未经调整的干预措施相比，调整后的干预措施有好处，但也有一些干预措施已经广泛调整，但在新环境中没有奏效的例子。因此，关于何时、在多大程度上以及如何调整干预的决定并不简单，尤其是在将干预效果概念化为取决于复杂系统中的上下文交互时。目前没有任何指南全面解决这些问题。为制定关于适应复杂人口健康干预措施的总体指南提供信息，本系统综述综合了现有指导文件的内容。方法 我们在 7 个书目数据库中检索了 2000 年 1 月至 2018 年 10 月期间发表的论文。我们使用引文跟踪并联系作者和专家以查找更多论文。我们对所有已识别的记录进行了双重筛选。我们将数据提取到以下类别中：描述性信息、关键概念和定义、适应的基本原理、适应的方面、适应的过程、评估和报告适应的干预措施。数据提取由两名评审员独立进行，检索到的数据在预先指定的和紧急的类别中按主题进行合成。结果 我们检索了 6694 条唯一记录。审查中纳入了 38 篇论文，代表了 35 个指南来源。大多数论文是在美国在国内不同人群（例如少数民族）中实施循证干预措施的背景下编写的。我们对这些论文如何定义关键概念、目标和适应程序（包括关键利益相关者的参与）达成了很多共识，但也确定了几个类别在范围、概念化和操作化方面的差距。结论 我们的审查发现了应在未来的适应指南中解决的局限性。具体而言，未来的指导需要反映在跨国家转移干预措施的背景下的调整，包括宏观（例如国家）层面的干预措施，更好地理论化干预机制和背景相互作用在影响可复制性中的作用，并相应地将关键概念概念化，例如对干预功能的忠诚度，最后，提出适应重新评估和报告的循证策略。试用注册 PROSPERO 2018，CRD42018112714。