• Christa Harstall, Paul Taenzer, Nancy Zuck, Donna K Angus, Carmen Moga, and N Ann Scott.
• Director Research Associate, Health Technology Assessment Unit, Institute of Health Economics, Edmonton, Alberta, Canada Specialist/Clinical Psychologist, Calgary Pain Program, Alberta Health Services, Calgary, Alberta, Canada Director, Knowledge Transfer Initiatives, Alberta Innovates - Health Solutions, Edmonton, Alberta, Canada Director and Principal, Sumera Management Consulting, Edmonton, Alberta, Canada.
• J Eval Clin Pract. 2013 Oct 1; 19 (5): 773-81.

Rationale, Aims And ObjectivesThe Alberta Ambassador Program (AAP) adapted seven clinical practice guidelines on low back pain (LBP) into a single guideline spanning the continuum of care from prevention and diagnosis through to treatment. The Ambassador adaptation process was evaluated to 1 Identify the major challenges encountered and successful strategies utilized; 2 Assess strengths and weaknesses by benchmarking it with the ADAPTE framework; and 3 Identify opportunities for improvement.MethodExternal consultants reviewed the Ambassador and ADAPTE materials and conducted semi-structured telephone interviews with 29 participants from the AAP committees. All participants were asked about the major challenges encountered and potential areas for improvement.ResultsThe response rate was 83% (29/35). There was strong consensus that the Ambassador guideline adaptation process was sound and rigorous all respondents indicated willingness to participate in further iterations of the Program. Key elements of success were identified. The main steps and sequence of the process were closely aligned with the ADAPTE framework, although the AAP incorporated additional enhancements which augmented the process. The main divergences between the two frameworks centred on the organizational structure and the methods used to overcome methodological difficulties.ConclusionThe AAP successfully utilized existing stakeholder interest to create an overarching guideline for managing LBP across multiple primary care disciplines. The study highlighted the strengths and weaknesses of the Program, and identified practical strategies for improvement. Evaluating guideline adaptation processes is pivotal to ensuring that they continue to be an efficient, rigorous and practicable option for producing contextualized, clinically relevant guidelines.© 2012 John Wiley & Sons Ltd.

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