a conceptual framework for implementation fidelity

Int J Clin Pharm. Measuring fidelity is one way of evaluating implementation, a key process which is just as important as the evaluation of the programme (Fixsen et al., 2005). Implementation fidelity is an important source of variation affecting the credibility and utility of research. Context and implementation in the effectiveness literature on domestic smoke detectors. 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. Evidence & Policy. It can give primary researchers confidence in attributing outcomes to the intervention; evidence-based practitioners can be confident they are implementing the chosen intervention properly; and secondary researchers can be more confident when synthesising studies. Summary . The relevant studies identified by this search were also then scanned for additional literature. Emotional & Behavioral Disorders in Youth. Experiences with tailoring of primary diabetes care in well-organised general practices: a mixed-methods study. prescribed by the program" [4], or applying a benchmark from outside the programme, i.e., "the extent to which a provider approaches a theoretical ideal in terms of delivering program content" [1]. Implementation fidelity is the degree to which an intervention is implemented as intended. This chapter describes a conceptual framework of implementation fidelity. The author(s) declare that they have no competing interests. Found inside – Page 47A conceptual framework for implementation fidelity. Implementation Science, 2, 40.. Casey, P. M., Elek, J. K., Warren, R. K., Cheesman, F., Kleiman, M., & Ostrom, B. (2014). Offender risk & needs assessment instruments: A primer for ... For example, an intervention could be delivered but delivered badly; in turn, the degree of fidelity achieved by the implemented intervention could be adversely affected. However, much more research is needed on this topic. One moderator might therefore predict another. 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. Figure. Implementation fidelity of the Falls Management Exercise Programme: a mixed methods analysis using a conceptual framework for implementation fidelity Author links open overlay panel E. Orton a N. Lafond a D.A. The implication of our framework is that any evaluation must measure all the factors listed above that influence the degree of implementation fidelity, such as intervention complexity and the adequacy of facilitation strategies. Found inside – Page 325In response to the need to better understand factors that combine to promote implementation fidelity, Domitrovich et al. (2008) developed a conceptual framework that addresses three spheres of influence on implementation fidelity: macro ... Carroll et al. A conceptual framework: Background and Rationale Evaluation and Program Planning. However, it may potentially also be viewed as a moderator of the relationship between an intervention and the fidelity with which it is implemented. Below are the links to the authors’ original submitted files for images. However, no study has yet measured the moderating effect of these strategies on the degree of implementation fidelity. Public policy scholars have long argued that favourable changes in government, such as turnover of key governmental actors as a result of elections . The modified version of the Conceptual Framework of Implementation Fidelity (CFIF) was used in this study . However, these studies did not analyse quality of delivery as a moderator of implementation fidelity, but rather as a discrete aspect of fidelity. Health Educ Res. CAS  There is therefore an issue of adequacy, and this may be determined by the relationship between facilitation strategies and the complexity of an intervention's description. The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention implementation. For instance, two studies examining programmes to help people with mental health issues obtain employment found that employment outcomes among their study groups were weakest for those in poorly implemented programmes [6, 7]. However, it is perhaps a more ambiguous element than this suggests. Drawing upon and advancing a conceptual framework for implementation fidelity proposed by Carroll and colleagues we discuss the iterative process designed to investigate the individual, school and system level factors within the wider political and ideological setting(s) of the program that impact on its implementation. It is only by making an appropriate evaluation of the fidelity with which an intervention has been implemented that a viable assessment can be made of its contribution to outcomes, i.e ., its effect on performance. The measurement of adherence to an intervention's predefined components can therefore be quantifiable: An evaluation to gauge how much of the intervention's prescribed content has been delivered, how frequently, and for how long. In addition, there is a conceptual framework to measure five indexes of implementation fidelity (Carroll et al., 2007). Maidment R, Livingston G, Katona C: "Just keep taking the tablets": Adherence to antidepressant treatment in older people in primary care. Data collection methods included: key informant interviews, focus groups, questionnaire studies and project documents. . 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. This paper offers a more complete conceptual framework for implementation fidelity than proposed hitherto, and explains why and how implementation fidelity should be evaluated. Implementation science : IS Indeed, the pro-adaptation perspective implies that successful interventions are those that adapt to local needs [ 22 ]. Found insideTable 3.2 Percentage of Teacher Observations with Effective Implementation of the Intervention Component Study Grade Level Comprehension Canopy Essential Words Warm- up Critical ... A conceptual framework for implementation fidelity. Cookies policy. . 2005, A-76. Mihalic S: The importance of implementation fidelity. It is therefore possible that these strategies, like the nature of an intervention's description, may potentially moderate the degree of fidelity achieved: the more that is done to help implementation, through monitoring, feedback, and training, the higher the potential level of implementation fidelity achieved. The relationship between these potential moderators is discussed more fully below. Measuring implementation fidelity means evaluating whether the result of the implementation process is an effective realisation of the intervention as planned by its designers. The fidelity with which this intervention was implemented, i.e., the level of adherence to its model, was evaluated by trained coders using videotapes of sessions to score how far the implemented intervention actually adhered to the prescribed model in terms of content [8]. How closely does the actual implementation Qual Saf Health Care. 10.1300/J147v27n03_05. Article  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. 2005, 11: 148-151. The potential effect of intervention complexity on implementation fidelity was suggested to the authors by literature on implementation more broadly – especially a systematic review that focused on identifying facilitators and barriers to the diffusion of innovations in organisations that found that the complexity of an idea presented a substantial barrier to its adoption [ 18 ]. 10.1080/00952990500328646. Found inside – Page 397A conceptual framework for implementation fidelity. Implementation Science 2007, 2, 40. doi:10.1186/1748-5908-2-40 Century, J., Rudnick, M., & Freeman, C. (2010). A framework for measuring fidelity of implementation: A foundation for ... The organisation more broadly may also influence the response of those delivering a new intervention. 22-24 Stetler's model 25 is one of the first models applied to the implementation of evidence-based research, despite its failure to examine wider organizational issues and the organization's impact on the implementation process. Careers. Adherence includes the subcategories of content, frequency, duration and coverage (i.e., dose). Am J Com Psychol. Overview of attention for article published in Implementation Science, November 2007. Search Conference abstracts and presentations provided another source of literature in this field. Complex interventions have greater scope for variation in their delivery, and so are more vulnerable to one or more components not being implemented as they should. On the one hand, it is argued that each of these five elements represents an alternative way to measure fidelity, i.e., implementation fidelity can be measured using either adherence or dosage or quality of delivery etc [4, 5]. Please enable it to take advantage of the complete set of features! Found inside – Page 138... S. A conceptual framework for implementation fidelity. Implementation Science 2007; 2:40. Carvajal A, Ortega PG, Sainz M, Velasco V, Salado I, Arias LHM, Eiros JM, Rubio AP, Castrodeza J. Adverse events associated with pandemic ... implementation fidelity and developed a new conceptual framework for understanding and. Evidence-based practice assumes that an intervention is being implemented in full accordance with its published details. : Applied Social Sciences Index and Abstracts, Cumulative Index of Nursing and Allied Health Literature (CINAHL), International Bibliography of the Social Sciences, MEDLINE, and the Social Science Citation Index. Gladman a c d e S. Iliffe f P.A. The scale stipulated that an "Over-reliance on verbal teaching can result in lower scores". The conceptual framework presented here offers a means for measuring this variable and understanding its place in the process of intervention . There are certain overlaps here with the concept of process evaluation [15]. This National Science Foundation (NSF) supported effort is developing a suite of instruments for measuring FOI of The scale stipulated that an "Over-reliance on verbal teaching can result in lower scores". CC drafted the paper; CC, MP, and SW are responsible for the intellectual content of the paper. Fidelity monitoring/support EBP Role clarity Fidelity support system Supportive coaching Staffing Staff selection criteria Validated selection procedures Aarons, G.A., Hurlburt, M. & Horwitz, S.M. A search was performed to identify literature on implementation fidelity, i.e., empirical research, reviews, or theoretical pieces. as intended by the program developers" [ 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. This evaluation in turn may inform the content of the intervention by determining the minimum requirements for high implementation fidelity, i.e ., the implementation of the essential components of the intervention. 10.1023/B:PREV.0000013981.28071.52. For example, studies examining factors associated with substance abuse prevention and health promotion programmes in schools found that teachers' beliefs concerning the intervention itself, for example whether they liked it or not, and the training and support they themselves had received, were all associated with their level of adherence to the intervention [34, 35]. Despite being viewed as an element of implementation fidelity by the literature, programme differentiation actually measures something distinct from fidelity. Monitoring the fidelity of implementing interventions is challenging. The level achieved may be influenced or affected, (i.e., moderated) by certain other variables: intervention complexity, facilitation strategies, quality of delivery, and participant responsiveness. The aim of this implementation fidelity study was to evaluate to what extent a dialogue-based psychosocial intervention was delivered according to protocol. Google Scholar, Thomas RE, Baker P, Lorenzetti D: Family-based programmes for preventing smoking by children and adolescents. Admin Soc Work. 2005, 54: 139-143. PubMed Central  For example, it has been found that implementation fidelity of prescribed drug interventions for elderly people in the community can be low because these patients deliberately fail to comply with their prescribed regimens [ 31 - 33 ]. The Facilitation strategies may also influence participant responsiveness: The provision of incentives could make both providers and participants more amenable or responsive to a new intervention. Implementation fidelity is "the degree to which . Clin Psychol Rev. In summary, evaluation of implementation fidelity is important because this variable may not only moderate the relationship between an intervention and its outcomes, but its assessment may also prevent potentially false conclusions from being drawn about an intervention's effectiveness. -. However, as noted above, these relationships are more complex than may be captured in the simple correlation of large numbers of facilitation strategies producing high quality of delivery, or by stating that small incentives produce limited participant responsiveness.

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a conceptual framework for implementation fidelity