From protocol to practice: Enhancing fidelity, supporting adaptation, and advancing science

Effective translation of evidence-based interventions (EBIs) into real-world settings hinges on the careful balance between fidelity and adaptation. Fidelity, the extent to which an intervention is delivered as intended, is essential for maintaining theoretical integrity and intervention effectiveness, yet rigid adherence often undermines contextual relevance.

This paper explores the importance of and barriers to measuring and reporting intervention fidelity and adaptation, emphasizing their implications for implementation success and scalability.

Drawing on implementation science frameworks and the Transitional Care Model (TCM) as a case study, we highlight the interplay between fidelity, adaptation, and context. Emphasis is placed on creating practical tools, fostering bidirectional learning, and establishing fidelity standards in intervention protocols.

We conclude with recommendations to improve training, reporting, and collaboration that will support equitable and effective implementation of EBIs in meaningful ways across diverse settings.