Fidelity of implementation in a treatment effectiveness trial of Reconnecting Youth

Abstract

In 'a treatment effectiveness trial', a program is evaluated in a real-world setting, with an emphasis on achieving high implementation fidelity. Through fidelity assessment, the link between program implementation and outcomes is systematically evaluated and ultimately leads to a greater understanding of program success or failure. This paper reports the results of an implementation fidelity study of the 'Reconnecting Youth' (RY) prevention program. The research questions were (i) was the program implemented with fidelity? and (ii) did better fidelity predict better outcomes? RY is an indicated drug abuse prevention program for high school students that seeks to 'reconnect' high-risk youth to school before they drop out. The results reported here were part of a randomized controlled effectiveness trial of the RY prevention program conducted in two urban school districts in which 15 teachers taught 41 RY classes. Overall, implementation fidelity was high with an average 90% of core lessons being taught. Unexpectedly, increased quality of implementation predicted increased alcohol use and anger. Adherence (teaching more of the curriculum) predicted increased marijuana use, while exposure (student attendance) significantly increased bonding to high-risk peers, alcohol use and anger.

Implementation of Evidence-Based Practices for Treatment of Alcohol and Drug Disorders: The Role of the State Authority

“…This advocacy for EBPs in substance abuse treatment is key to successful adoption and fidelity. 48,49 Indeed, a particularly important barrier to the implementation of EBPs are unsupportive state, local, and federal mental health authority administrative practices and policies. 15 The most prevalent examples are lack of a long-term vision, lack of agreement on desired outcomes, lack of penalties for non-evidenced-based practices, short-term horizons for policy planning, political mandates on competing public-sector priorities, resource limitations, and uncertainty associated with change and untoward events.…”

Implementation of the Project P.A.T.H.S. in a school with a religious background: a case study

“…Mihalic et al (12) listed some barriers that have potential to affect the implementation quality, including failure to invest time and resources, hiring program implementers who lack the relevant skills to deliver the program, insuffi cient organizational and key leader support, poor motivation and buy-in of implementing staff, failure to provide continuing support and technical assistance, and lack of program monitoring. Sanchez et al (13) emphasized that incorporating the program into the school ' s formal curriculum with high program fi delity and a clear manpower deployment for program implementation is essential. Added to this, research studies indicated that the active involvement and support of school administrative personnel is another factor that enhances implementation success (14) .…”

Evaluación de proceso del programa escolar de prevención del consumo de cánnabis “xkpts.com” en adolescentes de Barcelona en 2006

“…No obstante, consideramos que una de las fortalezas del estudio es el tamaño de muestra, con la participación de 39 escuelas, muestra muy superior a la de otros estudios 11,14,16,17,39,40 .…”

“…En los últimos años un elevado número de estudios han señalado la importancia de evaluar la fidelidad de la implementación de las inter venciones preventivas escolares [13][14][15][16][17][18] . Su evaluación nos puede conducir a un mejor entendimiento del éxito o fracaso de un programa ya que la obtención de los resultados esperados está estrechamente vinculada a la intensidad y cualidad de la implementación 15,19 .…”