Prevention and intervention research studies often fail to include an assessment of program integrity, and when they do, it is often examined in a limited way. Further, despite efforts to reform the intervention research process to include community stakeholders more actively in every phase of investigation, current practice generally employs a hierarchical model of integrity that fails to be responsive to community needs and priorities. In this article, we describe the traditional, hierarchical model of integrity and contrast this framework with a partnership model of treatment integrity. The limitations of the hierarchical model are illustrated through the description of two school-based prevention programs. Core features of the partnership model and steps for implementing this framework in research and practice are described. Although the partnership model has limitations when conducting efficacy research in clinical trials, it has clear advantages over the hierarchical model in conducting effectiveness research and research that is directly linked with practice.
The purpose of the present study was to evaluate differences in the social play of maltreated and nonmaltreated preschool children and the effectiveness of a resilient peer treatment (RPT) for socially withdrawn victims of physical abuse and neglect. RPT is a peer-mediated classroom intervention based on a developmental-ecological model. It involves pairing withdrawn children with resilient peers in the natural classroom under the supervision of a parent assistant. Forty-six Head Start children, of whom 22 were maltreated, were randomly assigned to RPT and control conditions. Outcome variables were observational categories of social play and standardized teacher ratings. Before treatment, maltreated children were significantly more isolated and less interactive in peer play than nonmaltreated children. RPT resulted in a significant increase in positive interactive peer play and a decrease in solitary play for maltreated and nonmaltreated, socially withdrawn children. Moreover, treatment gains in social interactions were validated 2 months following treatment. Findings are discussed in terms of a developmental-ecological model.
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