Assessing Fidelity of a Community-Based Opioid Overdose Prevention Program: Modification of the Fidelity Checklist

The evaluation and maintenance of treatment fidelity is an important methodological consideration in intervention research. Treatment fidelity is the degree to which interventions are delivered as outlined by the program developers. A lack of fidelity to the intervention model has the potential to be a large source of error, including type I and type II error. Monitoring and assuring fidelity is critical to assuring the validity of the interventions. The Fidelity Checklist is a reliable and valid tool designed to measure fidelity in a group-based parenting program. The Fidelity Checklist assesses group leaders' maintenance of the intervention protocol (adherence) and their group facilitation and process skills (competence).

The purpose of this article is to describe the systematic process of modifying the Fidelity Checklist for use in a community-based opioid overdose prevention group educational intervention.

A biphasic approach was used to modify the Fidelity Checklist. Phase 1 included engaging key stakeholders during a full-day meeting to determine adherence subscale components. Phase 2 included: (a) the modification of the competence subscale of the Fidelity Checklist, (b) adaptation of the coding manual defining the components of the Fidelity Checklist, and (c) creating a fidelity checklist to guide interventionists.

The biphasic systematic modification approach resulted in a revised Fidelity Checklist that was successfully used to measure treatment fidelity in a community-based opioid overdose prevention program.

The findings of this study provide information for nurse researchers and nurse educators for modifying a fidelity checklist that can be used to enhance community-based educational interventions.