Measuring the fidelity of implementation of a mental health program model.

Abstract

A fidelity index of program implementation for assertive community treatment (ACT) was developed. In Study 1, 20 experts rated the importance of 73 elements proposed as critical ACT ingredients, also indicating ideal model specifications for elements. Agreement among experts on ratings of importance was high (intraclass r = .98). In Study 2, a 17-item subset of the expert-identified critical ingredients was used to construct a fidelity index with three subscales: Staffing, Organization, and Service. Internal consistencies ranged from .50 to .72, with a .81 reliability for the total scale. Fidelity was linearly related to program "generations," suggesting "program drift." In 18 ACT programs, fidelity also was associated with measures of reduction in days in psychiatric hospitals. The correlation was significant for the total scale and for the Organization and Staffing subscales but not for the Service subscale.

Implementation of the Danish return-to-work program: process evaluation of a trial in 21 Danish municipalities

“…To assess fidelity (IC 5-13) and dose-delivered (IC 14-20), we developed a rating system inspired by McGrew et al (15). Two data sources were used to independently rate the degree of fidelity and dose-delivered: (i) group interviews with RTW team members in each municipality and (ii) field notes from process consultants (see the Appendix).…”

A Comparison of Phone-Based and On-Site Assessment of Fidelity for Assertive Community Treatment in Indiana

“…Poor implementation of evidence based practices (1, 2) and its toll on program outcomes are a critical concern for mental health services (3, 4). One accepted strategy to improve implementation is to verify program fidelity (5, 6).…”

Comparing the Costs and Acceptability of Three Fidelity Assessment Methods for Assertive Community Treatment

“…community treatment Fidelity to evidence-based models of care has been shown to predict better clinical outcomes for several types of practices (Cuddeback et al, 2013;Drake, Bond, & Essock, 2009;Latimer, 1999;J. H. McGrew, Bond, Dietzen, & Salyers, 1994;McGuire et al, in press; McHugo, Drake, Teague, & Xie, 1999;van Vugt et al, 2011).…”