Adaptation as Innovation: Making Content Meaningful

Me in front of my laptop and monitor — always with multiple windows open :-)

I’ve worked remotely for almost seven years now. This means that I can be in front of my computer during calls without being viewed as inattentive or rude. I simultaneously amaze and annoy my coworkers with my responsiveness to email requests, because I am able to quickly search for information as we discuss things. My work style has unearthed my talents as a sleuth — always looking to see what others already know or have published on a particular topic of interest. As a result, when we begin new projects, I’m often quick to discover similar projects that have already been completed in our field and to suggest that we build on these efforts instead of recreating them.

I used to fear that this meant that I was lazy or not all that creative. But my colleague, Simone Parrish helped me understand that what I am doing is actually innovating by adapting what already exists for one particular audience or setting to another. This is an important skill, especially in public health, where so many great resources and tools are developed for the public good and are available free of charge.

Adaptation takes content proven in one context and applies it in another. This is both evidence-based and innovative.

Educators, trainers, content providers, and even technologists must be able to identify knowledge needs and adapt evidence-based content to address these needs.

For the past few years, I’ve been working on developing, managing, and monitoring online learning programs for the Knowledge for Health (K4Health) Project. I can tell you firsthand that a lot of work goes into adapting and synthesizing information so that it can be easily digested online.

For example, it often takes at least nine months (often more than a year) to develop a course on the Global Health eLearning Center (GHeL). The rigorous review process of GHeL courses ensures that they are reputable resources for the latest technical and programmatic guidance on a wide range of health and development topics. However, as a global resource, courses are developed for a broad audience of stakeholders — mostly health program managers, service providers, and policy makers.

When we asked learners if course content should be adapted to fit local contexts, we received mixed responses. Those who work for the government (U.S. or other countries) often prefer the global perspective. In contrast, people who work at non-governmental organizations (NGOs) at the country or regional level tell us that it would be helpful if the content could be adapted to fit their contexts. This might include translation into local languages and the addition of country-specific case studies.

One GHeL user wondered:

“…if it is possible to use the local dialect (Filipino) so that it can be used and be easily understood by health care providers who do not have a good command of the English language or competency to cascade the learning into the local dialect. [Rural health care providers] will be able to impart the correct information to their target clients who may belong to the marginalized and uneducated. The essence of the information and knowledge might be lost if they translate information by themselves” — Tuberculosis Basics course learner, the Philippines.

Champions of adaptation believe that it is key to implementation, community development, program improvement and performance, and knowledge enhancement. Target audiences for localized course content include individuals who may not have a good grasp of the English language and who work directly with the community, such as rural health workers, community health workers, social workers, counselors, community government officials, volunteers, health surveillance assistants, and nurses.

K4Health responded to calls to adapt our global content for local contexts by working with partners in the field and documenting adaptation processes that are efficient, effective, and result in content that is easy to understand and simple to use. Based on our experiences, we recently published an adaptation guide, Making Content Meaningful (also available in French).

In the guide, we identify three types of adaptation and acknowledge that content adaptation often involves a combination of these approaches:

  • Making content appropriate to a specific local and cultural context
  • Translating content into a local language
  • Making it available through a different delivery method or technology appropriate for a specific local context

We outline a framework with key steps and questions, accompanied by activity sheets and illustrative examples to guide users in making informed decisions throughout the content adaptation process. The framework is divided into three phases:

  • Before adaptation is the formative stage when you understand and scan the audience, their needs, and the content that is available.
  • During adaptation — the implementation stage — is when you design and deliver adapted content.
  • After adaptation is the evaluation stage when you evaluate and learn from the experience and develop ideas for next steps.

This piece is the first in a series on content adaptation. The stories that follow will provide an in-depth and personal look at the case studies featured in the guide and how each relates to the adaptation framework.

We hope that this series encourages others to share their own experiences adapting educational content for the field — especially key lessons learned and best practices.

We all develop training tools and resources that we hope get used. It is our hope that by sharing our experiences and the framework that we’ve outlined in the Making Content Meaningful guide, more people will take the plunge and adapt existing evidence-based content to reach new and different audiences effectively.


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Also, follow the The Exchange for more useful information on how to better curate, synthesize, and share knowledge.

The Exchange is a K4Health publication. The Knowledge for Health (K4Health) Project is supported by the United States Agency for International Development (USAID) Office of Population and Reproductive Health, Bureau for Global Health, under Cooperative Agreement #AID-OAA-A-13–00068 with the Johns Hopkins University.

The contents are the responsibility of the authors and do not necessarily reflect the views of USAID or the U.S. Government.

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