Designing for Accelerated Translation-Intervention (DART-I): adaptation, theoretical grounding, and formative evaluation in community care for evaluating implementation potential.

backgroundImplementation science requires pragmatic tools that can assess implementation potential before large-scale testing, yet most existing measures focus on provider perspectives and are applied after implementation begins. The Designing for Accelerated Translation–Intervention (DART-I) tool was adapted from a clinician-focused measure into a plain-language, patient-centered version to support early-stage, multigroup-informed refinement of behavioral interventions. This study examined the feasibility, factor structure, and convergent validity of the adapted DART-I when deployed within a behavioral intervention.

methodsA mixed-methods design was used to support initial adaptation and evaluation of a rapid implementation potential assessment. The original clinician-facing DART survey was first adapted into a patient-centered version through a community advisory board (CAB) focus group and revised to a sixth-grade reading level. The adapted DART tool (DART-I) was then used in a pilot intervention to evaluate feasibility and measurement performance across different groups. Participants included adult intervention participants (n = 93), providers (n = 13), and community partners (n = 6). Quantitative data included DART-I and the Acceptability/Appropriateness/Feasibility Implementation Measures (AIM/IAM/FIM) and RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) survey measures. Descriptive statistics, confirmatory factor analysis (CFA), Kruskal–Wallis tests with Holm-x-adjusted post-hoc comparisons, and correlational analyses were used to examine construct validity and group differences.

resultsCAB-guided adaptation improved readability from a graduate-level to sixth-grade (FK ≈ 6.7) and was appropriate for patient use. The DART-I was successfully deployed to address a novel intervention. CFA supported a single-factor model encompassing cost, safety, effectiveness, clinical demand, patient values, clinical utility, and relative advantage. Overall implementation potential ratings were high (M = 4.41–4.81 on a 5-point scale). Providers reported significantly lower scores for cost (χ² (2) = 30.17) for intervention participants (p < 0.001) and partners (p = 0.003, p < 0.001), while intervention participants rated clinical demand lower than partners (χ² (2) = 8.79, p = 0.012). DART-I was correlated, but distinct, from AIM/IAM/FIM (r=0.3). DART-I scores correlated strongly with RE-AIM effectiveness (r=0.50) and maintenance (r=0.64), supporting convergent validity with established implementation outcomes.

conclusionsThe DART-I demonstrates feasibility, conceptual coherence, and preliminary validity as patient-centered implementation potential assessment. Incorporating end-user perspectives into implementation assessments offers a pragmatic approach for identifying barriers, guiding participatory refinement, and accelerating translation of interventions.