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A focused approach to assessing program fidelity.

Laura Griner Hill¹, Katherine Maucione, Brianne K Hood

¹Department of Human Development, Washington State University, Pullman, WA 99164-4852, USA. laurahill@wsu.edu

Prevention Science : the Official Journal of the Society for Prevention Research

|September 13, 2006

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Program facilitators often adapt prevention programs, primarily due to time constraints. An efficient approach using the Pareto principle identifies key adaptations for quality improvement.

Area of Science:

Implementation Science
Program Evaluation
Public Health Interventions

Background:

Fidelity to prevention program curricula is crucial for effective dissemination.
Facilitators frequently adapt programs during implementation, despite recognizing the importance of fidelity.

Purpose of the Study:

To identify types and frequencies of adaptations made by program facilitators.
To document facilitators' reasons for program adaptation.
To propose an efficient method for studying prevention program fidelity.

Main Methods:

Qualitative interviews with 42 program facilitators regarding their implementation experiences.
Application of the Pareto principle (80/20 rule) to analyze adaptation types and reasons.
Focus on high-frequency adaptations for targeted assessment.

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Main Results:

Nearly all facilitators deemed program fidelity important, yet most reported adaptations.
The most common reason for adaptation was time constraints leading to material deletion or changes.
The Pareto principle identified a small percentage of adaptation types and reasons accounting for the majority of reported changes.

Conclusions:

An efficient approach to studying fidelity involves focusing on high-frequency adaptations.
Identifying and analyzing frequent adaptations can guide training and quality improvement efforts.
Targeting key adaptations allows for assessment of their impact on program outcomes.