{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:59:28Z","timestamp":1781614768349,"version":"3.54.5"},"reference-count":69,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100006356","name":"University of Southern Denmark","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006356","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Addict Sci Clin Pract"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Unhealthy alcohol use is a major global public health problem, yet alcohol problems often remain unaddressed in primary care. The 15-method, developed in Sweden, offers a flexible, patient-centered approach to alcohol-related issues using opportunistic screening and stepped-care treatment in the same setting. The present study describes adaptations and modifications made to the 15-method by Danish healthcare professionals during a randomized controlled trial testing the 15-method\u2019s effectiveness in Danish general practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data for the present qualitative study were individual and group interviews with 28 healthcare professionals from 12 Danish general practices enrolled in the Identification and Treatment of Alcohol Problems in Primary Care (iTAPP) study, a stepped-wedge cluster randomized controlled trial. Interviews focused on innovation and implementation process determinants from the Consolidated Framework for Implementation Science (CFIR). By means of the Framework for Reporting Adaptations and Modifications to Evidence-based interventions (FRAME), data were analyzed to identify modifications to the 15-method when implemented in daily use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Four distinct modifications were identified: a loosening of the method\u2019s structure, condensed use of the method\u2019s materials, modification of screening procedures, and integration into existing clinical procedures. Half of the changes were unplanned, and half were fidelity-consistent. Three of four changes occurred on practice level and were made by general practitioners. The most common goal of the changes was to increase patient reach and engagement. More training and structured follow-up were also identified as important to increase healthcare professionals\u2019 confidence in delivering the 15-method.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>General practitioners and nurses generally find the 15-method suitable for their work in Danish general practice, and the method can be readily implemented with minor adaptations. More training and implementation planning may promote higher utilization and more consistent use, ultimately increasing the method\u2019s sustainability and effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s13722-025-00613-7","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T11:25:29Z","timestamp":1761564329000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adaptations and modifications to the 15-method in Danish general practice classified using the framework for reporting adaptations and modifications to evidence-based interventions (FRAME)"],"prefix":"10.1186","volume":"20","author":[{"given":"Peter N\u00e6sborg","family":"Sch\u00f8ler","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per","family":"Nilsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanne","family":"Rasmussen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jens","family":"S\u00f8ndergaard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anette S\u00f8gaard","family":"Nielsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"issue":"6","key":"613_CR1","doi-asserted-by":"publisher","first-page":"596","DOI":"10.1056\/NEJMcp042262","volume":"352","author":"R Saitz","year":"2005","unstructured":"Saitz R. 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New Dir Evaluation. 2011;2011(132):25\u201342.","journal-title":"New Dir Evaluation"}],"container-title":["Addiction Science &amp; Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13722-025-00613-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s13722-025-00613-7","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s13722-025-00613-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T12:36:12Z","timestamp":1781613372000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s13722-025-00613-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,27]]},"references-count":69,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["613"],"URL":"https:\/\/doi.org\/10.1186\/s13722-025-00613-7","relation":{},"ISSN":["1940-0640"],"issn-type":[{"value":"1940-0640","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,27]]},"assertion":[{"value":"8 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 October 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 October 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The iTAPP study is approved by the Research Ethics Committee at The University of Southern Denmark (REC 21\/66119) and the Danish College of General Practitioners (MPU 18-2021). Data storage and handling is approved by Odense Patient data Explorative Network (OPEN) (license agreement OP1523, case number 21\/61172) and by the Research and Innovation Organization at The University of Southern Denmark (ref. number 11.521). This study was not eligible for application to the Danish National Research Ethics Committee according to national regulations Sect.\u00a014;2 of the Danish Act on Research Ethics Review of Health Research Projects (case no. 20212000144). The study adheres to the Declaration of Helsinki for ethical principles for medical research.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"87"}}