Implementation fidelity of the Promoting First Relationships intervention program in a Native community

Area of Science:

• Child Development
• Public Health
• Community Psychology

Background:

• Implementing evidence-based interventions in diverse settings presents unique challenges.
• Ensuring program fidelity is crucial for accurate efficacy assessment, especially in remote or underserved communities.
• The Promoting First Relationship (PFR) program aims to foster positive caregiver-child relationships.

Purpose of the Study:

• To assess the implementation fidelity of the PFR program delivered by trained tribal members in a remote Native community.
• To evaluate the feasibility and participant satisfaction of PFR in this specific cultural context.
• To identify effective methods and tools for ensuring implementation fidelity in community-based interventions.

Main Methods:

• Tribal members received training and certification from university personnel to deliver PFR.
• Implementation fidelity was measured through adherence to intervention content and quality of delivery.
• Participant satisfaction and session completion rates were recorded.

Main Results:

• High adherence (M=0.99, SD=0.02) and quality of PFR delivery were achieved by tribal members.
• Despite high initial attrition, participants who remained completed all 10 PFR sessions.
• Participant satisfaction was very high (M=3.90/4, SD=0.19).

Conclusions:

• High implementation fidelity of the PFR program is achievable in remote Native communities with appropriate training and support.
• The study demonstrates the successful adaptation and delivery of an evidence-based intervention by community members.
• The methods used for ensuring fidelity can serve as a model for evaluating other community-based programs.