Implementation fidelity in community‐based interventions

Abstract

Implementation fidelity is the degree to which an intervention is delivered as intended and is critical to successful translation of evidence-based interventions into practice. Diminished fidelity may be why interventions that work well in highly controlled trials may fail to yield the same outcomes when applied in real life contexts. The purpose of this paper is to define implementation fidelity and describe its importance for the larger science of implementation, discuss data collection methods and current efforts in measuring implementation fidelity in community-based prevention interventions, and present future research directions for measuring implementation fidelity that will advance implementation science.

Measures of fidelity of delivery of, and engagement with, complex, face‐to‐face health behaviour change interventions: A systematic review of measure quality

“…A similar percentage of studies used observational and self‐report measures to measure fidelity of delivery, despite observational measures being recommended as the gold‐standard measure and the reported limitations of self‐report measures (Bellg et al ., 2004; Borrelli, 2011; Breitenstein et al ., 2010; Lorencatto et al ., 2014; Schinckus et al ., 2014). Intervention records (e.g., attendance or homework) were also used to measure engagement.…”

“…Perhaps these findings demonstrate that measures need to be easy to use and acceptable to respondents and researchers in order to be selected for use. This explanation is consistent with previous studies which suggest that observational measures are perceived to be more expensive, time‐consuming and difficult to use (Breitenstein et al ., 2010; Schinckus et al ., 2014). Many studies used measures of fidelity of delivery and engagement specific to one intervention, and therefore, generalizability is limited (Breitenstein et al ., 2010).…”

“…This finding demonstrates that the reporting of psychometric qualities in the complex, face‐to‐face health behaviour change interventions included in this review, may not be as infrequent as previously suggested in different populations (Baer et al ., 2007; Breitenstein et al ., 2010; Maynard et al ., 2013; Rixon et al ., 2016). However, not all studies reported psychometric qualities, and fewer reported implementation qualities, despite the importance of psychometric and implementation qualities (Gearing et al ., 2011; Glasgow et al ., 2005; Holmbeck & Devine, 2009; Lohr, 2002; Stufflebeam, 2000).…”

“…In this review, we use the term ‘implementation qualities’ to refer to descriptions of how the measures were implemented in practice. Aspects of ‘implementation qualities’ of measures in the fidelity literature include time constraints, cost, and reactions to measurements (Breitenstein et al ., 2010). …”

“…Furthermore, researchers have previously outlined some strengths and weaknesses of different measures of fidelity of delivery and engagement (e.g., Borrelli, 2011; Breitenstein et al ., 2010; Moncher & Prinz, 1991). To the authors’ knowledge, no systematic reviews have been conducted to identify the measures used to monitor fidelity of delivery and engagement (including intervention receipt and enactment), in complex, face‐to‐face health behaviour change interventions.…”