Measures of Facilitator Competent Adherence Used in Parenting Programs and Their Psychometric Properties: A Systematic Review

Abstract

Implementation fidelity is a critical component of intervention science, which aims to understand how interventions unfold in practice to improve outcomes. A key element of fidelity is facilitator competent adherence—the extent to which a program is delivered as prescribed with the specified level of quality. We conducted a two-part systematic review examining these aspects in parenting programs aiming to reduce child behavior problems and maltreatment. Part One reviews measures of facilitator competent adherence and Part Two examines the psychometric properties of the observational measures found. Searches identified 9153 articles from electronic databases, citation tracking, and expert input. After screening using pre-specified criteria, 156 (Part One) and 41 (Part Two) articles remained. In Part One, measure, facilitator, and intervention characteristics were extracted and synthesized from 65 measures. Most measures were observational, used by facilitators and researchers, and employed Likert-scale ratings. In Part Two, evidence on the reliability (internal consistency, inter-rater, intra-rater, test–retest) and validity (content, construct, convergent/divergent, criterion) of 30 observational measures identified from Part One was synthesized and evaluated. An adapted COSMIN checklist was used to assess study and measure quality. We found most studies to be of reasonably high quality. This is the first review to summarize and critically appraise measures of facilitator competent adherence used in the parenting program literature and establish their psychometric properties. The findings underscore the need to advance research on measures of facilitator competent adherence; reliable, valid, and high-quality implementation measures allow for evidence-based decisions regarding the delivery and scale-up of parenting programs. PROSPERO Registration Number: CRD42020167872.

Programa de parentalidade: Da evidência científica para a implementação em escala

“…Além disso, a implementação deve apresentar sustentabilidade que é fundamental para compreensão dos efeitos dos programas, a longo prazo (Bowman et al, 2008). Outro aspecto a ser considerado na implementação de programas é a fidelidade à proposta original que requer a avaliação da atuação dos facilitadores quanto à aderência ao programa e à competência dos facilitadores (Martin et al, 2021). Esses aspectos podem ser avaliados por meio da observação do comportamento por videogravação (Martin et al, 2021).…”

Iniciativas inovadoras e Primeira Infância: o desenvolvimento de programas

“…Relaciona-se à aderência, ao desenho e protocolos de determinado programa, o que se torna um elemento chave para qualquer disseminação e escalabilidade do programa. A fidelidade deve ser avaliada por meio da atuação dos facilitadores, por meio da observação do comportamento por videogravação ou autorrelato, a fim de identificar o grau de aderência ao conteúdo e estratégias do programa e a competência dos facilitadores (Martin et al, 2021). Certamente, o guia de implementação do programa ajuda na manutenção da fidelidade ao programa original durante sua implementação na prática.…”

The Reflective Fostering Programme fidelity rating scale: development and inter-rater reliability

“…Fidelity of an intervention can broadly be defined as “the intervention being delivered as intended by the program developers and consistent with the program model” (Breitenstein et al , 2010, p. 2). Some authors distinguish between adherence (the degree to which prescribed intervention activities and strategies are used) and competence (the skill and style with which the program is delivered; Martin et al , 2021). Assessing fidelity is important not only to support the training and development of practitioners (called “facilitators” in the RFP), but also as a way of assessing whether the intervention has been delivered in a way that is consistent with the core principles and techniques of the approach.…”

“…A recent systematic review of fidelity measures in parenting programmes (Martin et al , 2021) identified 65 such measures, none of which were specifically identified as exclusively targeted at assessing parenting programmes for foster carers. However, some of the identified programmes, such as the Triple P, Incredible Years and Parent Management Training Programme – Oregon Model interventions have been used with foster carer populations and evaluated for fidelity (Maaskant et al , 2016; Job et al , 2022; McDaniel et al , 2011).…”

“…However, some of the identified programmes, such as the Triple P, Incredible Years and Parent Management Training Programme – Oregon Model interventions have been used with foster carer populations and evaluated for fidelity (Maaskant et al , 2016; Job et al , 2022; McDaniel et al , 2011). For 30 of these measures, data regarding psychometric properties have been reported (Martin et al , 2021). This review found that there is significant variation both in the nature of fidelity measures used in parenting programmes and also the extent to which the psychometric properties, validity and reliability of these measures have been established.…”