Assessing implementation fidelity in a child maltreatment pilot trial: Lessons for evaluating complex interventions

Area of Science:

• Child Welfare Research
• Intervention Science
• Implementation Science

Background:

• Child maltreatment remains a significant public health concern.
• Home-visiting interventions show promise in supporting families with complex needs.
• Effective implementation is key to intervention success.

Purpose of the Study:

• To evaluate the implementation fidelity of the Family Partner home-visiting intervention.
• To identify challenges and successes in delivering the intervention to families with complex support needs.
• To inform future evaluations of similar interventions.

Main Methods:

• Utilized self-reported routine data from 1657 intervention reports across 19 families.
• Conducted five in-depth qualitative interviews and two focus groups with practitioners.
• Employed descriptive analysis for quantitative data and thematic analysis for qualitative data.

Main Results:

• Most critical components of the Family Partner intervention were met.
• A key exception was the adherence to conducting three home visits within the first 10 days.
• Challenges in the quality and structure of practitioner-reported data impacted fidelity assessment.

Conclusions:

• Developing robust implementation fidelity measures early in pilot testing is essential.
• Predefined fidelity measures are necessary for strengthening the evaluation of complex interventions.
• Findings highlight the need for rigorous evaluation before scaling up interventions.