A Focused Approach to Assessing Program Fidelity

A Focused Approach to Assessing Program Fidelity The primary goals of the present study were 1) to explore the types and frequencies of adaptation reported by facilitators; 2) to document their reasons for making those adaptations; and 3) to propose an efficient approach to the study of prevention program fidelity based on interview data. We interviewed 42 program facilitators involved in a large-scale dissemination about their implementation of a community-based prevention program. Interview questions addressed facilitators’ attitudes about program fidelity and the various types of changes, deletions, and additions they made. Although nearly all facilitators reported that fidelity to program curriculum was important, most also reported adapting the program. The most frequent reason facilitators gave for adaptation was deleting or changing material because they ran out of time. We employed a method used in business and health care settings (the Pareto principle, or the “law of the vital few”) to identify the minority (30%) of types of adaptation that accounted for a majority (70%) of all adaptations reported. Similarly, we identified the minority of reasons (25%) for adaptation that accounted for a majority (75%) of reasons reported. This approach helps to focus the assessment of fidelity on those adaptations that occur with high frequency, since low-frequency events are unlikely to have a significant impact on large-scale outcomes. High-frequency adaptations can then be targeted to determine their effect on outcomes; to address in training; and to assess on an ongoing basis for continuous quality improvement. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Prevention Science Springer Journals

A Focused Approach to Assessing Program Fidelity

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Publisher
Kluwer Academic Publishers-Plenum Publishers
Copyright
Copyright © 2006 by Society of Prevention Research
Subject
Medicine & Public Health; Public Health; Health Psychology; Child and School Psychology
ISSN
1389-4986
eISSN
1573-6695
D.O.I.
10.1007/s11121-006-0051-4
Publisher site
See Article on Publisher Site

Abstract

The primary goals of the present study were 1) to explore the types and frequencies of adaptation reported by facilitators; 2) to document their reasons for making those adaptations; and 3) to propose an efficient approach to the study of prevention program fidelity based on interview data. We interviewed 42 program facilitators involved in a large-scale dissemination about their implementation of a community-based prevention program. Interview questions addressed facilitators’ attitudes about program fidelity and the various types of changes, deletions, and additions they made. Although nearly all facilitators reported that fidelity to program curriculum was important, most also reported adapting the program. The most frequent reason facilitators gave for adaptation was deleting or changing material because they ran out of time. We employed a method used in business and health care settings (the Pareto principle, or the “law of the vital few”) to identify the minority (30%) of types of adaptation that accounted for a majority (70%) of all adaptations reported. Similarly, we identified the minority of reasons (25%) for adaptation that accounted for a majority (75%) of reasons reported. This approach helps to focus the assessment of fidelity on those adaptations that occur with high frequency, since low-frequency events are unlikely to have a significant impact on large-scale outcomes. High-frequency adaptations can then be targeted to determine their effect on outcomes; to address in training; and to assess on an ongoing basis for continuous quality improvement.

Journal

Prevention ScienceSpringer Journals

Published: Sep 13, 2006

References

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