A conceptual framework for implementation fidelity

Christopher Carroll, Malcolm Patterson, Stephen Wood, Andrew Booth, Jo Rick, Shashi Balain, Christopher Carroll, Malcolm Patterson, Stephen Wood, Andrew Booth, Jo Rick, Shashi Balain

Abstract

Background: Implementation fidelity refers to the degree to which an intervention or programme is delivered as intended. Only by understanding and measuring whether an intervention has been implemented with fidelity can researchers and practitioners gain a better understanding of how and why an intervention works, and the extent to which outcomes can be improved.

Discussion: The authors undertook a critical review of existing conceptualisations of implementation fidelity and developed a new conceptual framework for understanding and measuring the process. The resulting theoretical framework requires testing by empirical research.

Summary: Implementation fidelity is an important source of variation affecting the credibility and utility of research. The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention implementation.

Figures

Figure 1
Figure 1
Conceptual framework for implementation fidelity.

References

    1. Dusenbury L, Brannigan R, Falco M, Hansen W. A review of research on fidelity of implementation: Implications for drug abuse prevention in school settings. Health Educ Res. 2003;18:237–256. doi: 10.1093/her/18.2.237.
    1. Dane A, Schneider B. Program integrity in primary and early secondary prevention: Are implementation effects out of control. Clin Psychol Rev. 1998;18:23–45. doi: 10.1016/S0272-7358(97)00043-3.
    1. Elliot D, Mihalic S. Issues in disseminating and replicating effective prevention programs. Prev Sci. 2004;5:47–53. doi: 10.1023/B:PREV.0000013981.28071.52.
    1. Mihalic S. The importance of implementation fidelity. Emotional & Behavioral Disorders in Youth. 2004;4:83–86. and 99–105.
    1. Mihalic S. Blueprints Violence Prevention Initiative. Boulder, Colorado; 2002. The importance of implementation fidelity.
    1. McGrew J, Griss M. Concurrent and predictive validity of two scales to assess the fidelity of implementation of supported employment. Psychiatr Rehab J. 2005;29:41–47. doi: 10.2975/29.2005.41.47.
    1. Resnick B, Neale M, Rosenheck R. Impact of public support payments, intensive psychiatric community care, and program fidelity on employment outcomes for people with severe mental illness. J Nerv Ment Dis. 2003;191:139–144. doi: 10.1097/00005053-200303000-00001.
    1. Forgatch M, Patterson G, DeGarmo D. Evaluating Fidelity: Predictive Validity for a Measure of Competent Adherence to the Oregon Model of Parent Management Training. Behav Ther. 2005;36:3–13. doi: 10.1016/S0005-7894(05)80049-8.
    1. Thomas RE, Baker P, Lorenzetti D. Family-based programmes for preventing smoking by children and adolescents. Cochrane Database Syst Rev. 2007:CD004493.
    1. Noel P. The impact of therapeutic case management on participation in adolescent substance abuse treatment. Am J Drug Alcohol Abuse. 2006;32:311–327. doi: 10.1080/00952990500328646.
    1. Dobson L, Cook T. Avoiding Type III error in program evaluation: results from a field experiment. Evaluation and Program Planning. 1980;3:269–276. doi: 10.1016/0149-7189(80)90042-7.
    1. Godard J. Beyond the High-Performance Paradigm? An analysis of variation in Canadian Managerial Perceptions of Reform Programme effectiveness. Brit J Ind Rel. 2001;39:25–52. doi: 10.1111/1467-8543.00188.
    1. Roen K, Arai L, Roberts H, Popay J. Extending systematic reviews to include evidence on implementation: Methodological work on a review of community-based initiatives to prevent injuries. Soc Sci Med. 2006;63:1060–1071. doi: 10.1016/j.socscimed.2006.02.013.
    1. Arai L, Roen K, Roberts H, Popay J. It might work in Oklahoma but will it work in Southampton? Context and implementation in the effectiveness literature on domestic smoke detectors. Inj Prev. 2005;11:148–151. doi: 10.1136/ip.2004.007336.
    1. Hulscher M, Laurant M, Grol R. Process evaluation on quality improvement interventions. Qual Saf Health Care. 2003;12:40–46. doi: 10.1136/qhc.12.1.40.
    1. Kirkpatrick D. Evaluation of training. In: Craig R, Bittel L, editor. Training Evaluation Handbook. New York: McGraw-Hill; 1967.
    1. Hermens R, Hak E, Hulscher M, Braspenning J, Grol R. Adherence to guidelines on cervical cancer screening in general practice: programme elements of successful implementation. Brit J Gen Prac. 2001;51:897–903.
    1. Greenhalgh T, Robert G, Bate P, Kyriakidou O, Macfarlane F, Peacock R. A systematic review of the literature on diffusion, dissemination and sustainability of innovations in health service delivery and organisation. London: NHS Service Delivery Organisation; 2004. How to spread good ideas.
    1. Hahn E, Noland M, Rayens M, Christie D. Efficacy of training and fidelity of implementation of the life skills training program. J School Health. 2002;72:282–287.
    1. Naylor P-J, MacDonald H, Zebedee J, Reed K, McKay H. Lessons learned from Action Schools! BC – an 'active school' model to promote physical activity in elementary schools. J Sci Med in Sport. 2006;9:413–423. doi: 10.1016/j.jsams.2006.06.013.
    1. Faw L, Hogue A, Liddle H. Multidimensional implementation evaluation of a residential treatment program for adolescent substance use. Am J Eval. 2005;26:77–93. doi: 10.1177/1098214004273183.
    1. Blakely C, Mayer J, Gottschalk R, Schmitt N, Davidson W, Riotman D, Emshoff J. The fidelity-adaptation debate: implications for the implementation of public sector social programs. Am J Com Psychol. 1987;15:253–268. doi: 10.1007/BF00922697.
    1. Grol R, Dalhuijsen J, Thomas S, Veld C, Rutten G, Mokkink H. Attributes of clinical guidelines that influence use of guidelines in general practice: observational study. Brit Med J. 1998;317:858–861.
    1. Medical Research Council . A framework for the development and evaluation of RCTs for complex interventions to improve health. London: Medical Research Council; 2000.
    1. Bellg A, Borrelli B, Resnick B, Hecht J, Minicucci D, Ory M, Ogedegbe G, Orwig D, Ernst D, Czajkowski S. Enhancing treatment fidelity in health behaviour change studies: Best practices and recommendations from the NIH Behavior Change Consortium. Health Psychol. 2004;23:443–451. doi: 10.1037/0278-6133.23.5.443.
    1. Hitt J, Robbins A, Galbraith J, Todd J, Patel-Larson A, McFarlane J, Spikes P, Carey J. Adaptation and implementation of a evidence-based prevention counselling intervention in Texas. AIDS Educ Prev. 2006;18:108–118. doi: 10.1521/aeap.2006.18.supp.108.
    1. Penuel W, Means B. Implementation variation and fidelity in an Inquiry Science Program: analysis of GLOBE data reporting patterns. J Res Sci Teaching. 2004;41:294–315. doi: 10.1002/tea.20002.
    1. O'Brien R. Translating a research intervention into community practice: The nurse-family partnership. J Primary Prev. 2005;26:241–257. doi: 10.1007/s10935-005-3599-z.
    1. Resnick B, Inguito P, Orwig D, Yahiro J, Hawkes W, Werner M, Zimmerman S, Magaziner J. Treatment fidelity in behavior change research: A case example. Nurs Res. 2005;54:139–143. doi: 10.1097/00006199-200503000-00010.
    1. Rogers EM. Diffusion of Innovation. Fifth. New York, NY: Free Press; 2003.
    1. Maidment R, Livingston G, Katona C. "Just keep taking the tablets": Adherence to antidepressant treatment in older people in primary care. Int J Geriatr Psychiatry. 2003;17:752–757. doi: 10.1002/gps.688.
    1. Barat I, Andreasen F, Damsgaard EMS. Drug therapy in the elderly: what doctors believe and patients actually do. Brit J Clin Pharm. 2001;51:615–622. doi: 10.1046/j.0306-5251.2001.01401.x.
    1. Allen H. Adult/elderly care nursing. Promoting compliance with antihypertensive medication. Brit J Nurs. 1998;7:1252–1258.
    1. Martens M, van Assema P, Paulussen T, Schaalma H, Brug J. Krachtvoer: process evaluation of a Dutch programme for lower vocational schools to promote healthful diet. Health Educ Res. 2006;21:695–704. doi: 10.1093/her/cyl082.
    1. Ringwalt C, Ennett S, Johnson R, Rohrbach L, Simons-Rudolph A, Vincus A, Thorne J. Factors associated with fidelity to substance use prevention curriculum guides in the nation's middle schools. Health Educ Behav. 2003;30:375–391. doi: 10.1177/1090198103030003010.
    1. Bullock R, Batten D. Its just a phase we are going through: A review and synthesis of OD phase analysis. Group and Organization Studies. 1985;10:383–412. doi: 10.1177/105960118501000403.
    1. McBride N, Farringdon F, Midford R. Implementing a school drug education programme: reflections on fidelity. Int J Health Promotion Educ. 2002;40:40–50.
    1. Herzog S, Wright P. Addressing the fidelity of personal and social responsibility model implementation. Res Q Exerc Sport. 2005. pp. A–76.
    1. Cash S, Berry M. Measuring service delivery in a placement prevention program: An application to an ecological model. Admin Soc Work. 2003;27:65–85. doi: 10.1300/J147v27n03_05.
    1. Rinaldi M, McNeil K, Firn M, Koletsi M, Perkins R, Singh S. What are the benefits of evidence-based supported employment for patients with first-episode psychosis? Psychiatr Bull. 2004;28:281–284. doi: 10.1192/pb.28.8.281.
    1. Nutley S, Homel P. Delivering evidence-based policy and practice: Lessons from the implementation of the UK Crime Reduction Programme. Evidence & Policy. 2006;2:5–26.

Source: PubMed

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