Adapting Dance to Complex Clinical Contexts: A Methodology Model

Abstract

Background: While the content of health-related dance interventions is still relatively undocumented in the literature, the processes of adapting dance to specific situations are even less so, and rarely seem to be based on theoretical or practical guidelines. Yet the description of these processes could guide the adaptation of other interventions. Purpose: This study aimed to document the process of adapting a dance intervention in a complex clinical setting, in order to propose a methodology that could inspire the development of other interventions in specific clinical contexts. Methods: The adaptation methodology described in this article is part of an embedded single-case study, where the case unit was the adaptation process of a dance group intervention and the subunits of analysis were the intervention’s clinical and theoretical premises, content, and pedagogy. Participants were rehabilitation therapists (n=21), patients (n=6), relatives (n=4), and rehabilitation assistants (n=4). Data were collected through various techniques (focus groups, situational observation, pilot dance sessions, interviews, critical incidents, research journals, template for intervention description and replication/TIDieR checklist, and video recordings) to allow an iterative adaptation process. Data were analyzed using inductive qualitative analysis. Results: Adaptations were made prior to and throughout the intervention, taking into account relevant scientific and disciplinary knowledge, as well as the different actors’ implicit and explicit experiences. The intervention pedagogy focused on adapting the dance content to meet the participants’ needs while inviting them to self-adapt this content. The resulting methodology model includes four stages: preliminary design, validation with rehabilitation therapists, specific tailoring, and ongoing tailoring. Conclusion: Optimizing the adaptation of dance and ensuring its complementarity within a complex clinical context requires collaboration with the different disciplinary clinicians in order to offer synergistic coherence and ensure dance’s contribution to therapeutic objectives.