Health Education Research, Vol. 18, No. 2, 237-256,
April 2003
© 2003 Oxford University Press
A review of research on fidelity of implementation: implications for drug abuse prevention in school settings
Tanglewood Research, 7700 Albert Pick Road, Suite D, Greensboro, NC 27409 and 1 Drug Strategies, 1150 Connecticut Aveune, NW Suite 800, Washington, DC 20036, USA. E-mail: lindadusenbury{at}tanglewood.net
To help inform drug abuse prevention research in school settings about the issues surrounding implementation, we conducted a review of the fidelity of implementation research literature spanning a 25-year period. Fidelity has been measured in five ways: (1) adherence, (2) dose, (3) quality of program delivery, (4) participant responsiveness and (5) program differentiation. Definitions and measures of fidelity were found not to be consistent across studies, and new definitions are proposed. While there has been limited research on fidelity of implementation in the social sciences, research in drug abuse prevention provides evidence that poor implementation is likely to result in a loss of program effectiveness. Studies indicate that most teachers do not cover everything in a curriculum, they are likely to teach less over time and training alone is not sufficient to ensure fidelity of implementation. Key elements of high fidelity include teacher training, program characteristics, teacher characteristics and organizational characteristics. The review concludes with a discussion of the tension between fidelity and reinvention/adaptation, and ways of resolving this tension. Recommendations are made for developing a consistent methodology for measuring and analyzing fidelity of implementation. Further, researchers and providers should collaborate to develop ways of introducing flexibility into prevention programs.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  D. L. Fixsen, K. A. Blase, S. F. Naoom, and F. Wallace Core Implementation Components Research on Social Work Practice, September 1, 2009; 19(5): 531 - 540. [Abstract] [PDF]
|
|
|
|
 |
|
 A. K. Griffith, K. Duppong Hurley, and J. L. Hagaman Treatment Integrity of Literacy Interventions for Students With Emotional and/or Behavioral Disorders: A Review of Literature Remedial and Special Education, July 1, 2009; 30(4): 245 - 255. [Abstract] [PDF]
|
|
|
|
 |
|
 Z. Sloboda, P. Stephens, A. Pyakuryal, B. Teasdale, R. C. Stephens, R. D. Hawthorne, J. Marquette, and J. E. Williams Implementation fidelity: the experience of the Adolescent Substance Abuse Prevention Study Health Educ. Res., June 1, 2009; 24(3): 394 - 406. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Buckley and M. Sheehan A process evaluation of an injury prevention school-based programme for adolescents Health Educ. Res., June 1, 2009; 24(3): 507 - 519. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Zvoch Treatment Fidelity in Multisite Evaluation: A Multilevel Longitudinal Examination of Provider Adherence Status and Change American Journal of Evaluation, March 1, 2009; 30(1): 44 - 61. [Abstract] [PDF]
|
|
|
|
 |
|
 J. Holliday, S. Audrey, L. Moore, N. Parry-Langdon, and R. Campbell High fidelity? How should we consider variations in the delivery of school-based health promotion interventions? Health Education Journal, March 1, 2009; 68(1): 44 - 62. [Abstract] [PDF]
|
|
|
|
|
|
M. G. Wilson, T. B. Basta, B. H. Bynum, D. M. DeJoy, R. J. Vandenberg, and R. K. Dishman Do intervention fidelity and dose influence outcomes? Results from the Move to Improve worksite physical activity program Health Educ. Res., January 23, 2009; (2009) cyn065v1. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M Egan, C Bambra, M Petticrew, and M Whitehead Reviewing evidence on complex social interventions: appraising implementation in systematic reviews of the health effects of organisational-level workplace interventions J Epidemiol Community Health, January 1, 2009; 63(1): 4 - 11. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. K. Noonan and D. Gibbs Empowerment Evaluation With Programs Designed to Prevent First-Time Male Perpetration of Sexual Violence Health Promot Pract, January 1, 2009; 10(1_suppl): 5S - 10S. [Abstract] [PDF]
|
|
|
|
|
|
R. K. Noonan, J. G. Emshoff, A. Mooss, M. Armstrong, J. Weinberg, and B. Ball Adoption, Adaptation, and Fidelity of Implementation of Sexual Violence Prevention Programs Health Promot Pract, January 1, 2009; 10(1_suppl): 59S - 70S. [Abstract] [PDF]
|
|
|
|
 |
|
 M. L. Stein, M. Berends, D. Fuchs, K. McMaster, L. Saenz, L. Yen, L. S. Fuchs, and D. L. Compton Scaling Up an Early Reading Program: Relationships Among Teacher Support, Fidelity of Implementation, and Student Performance Across Different Sites and Years Educational Evaluation and Policy Analysis, December 1, 2008; 30(4): 368 - 388. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Self-Brown and D. J. Whitaker Parent-Focused Child Maltreatment Prevention: Improving Assessment, Intervention, and Dissemination With Technology Child Maltreat, November 1, 2008; 13(4): 400 - 416. [Abstract] [PDF]
|
|
|
|
|
|
P. R. Brandon, A. K. H. Taum, D. B. Young, F. M. Pottenger III, and T. W. Speitel The Complexity of Measuring the Quality of Program Implementation With Observations: The Case of Middle School Inquiry-Based Science American Journal of Evaluation, September 1, 2008; 29(3): 235 - 250. [Abstract] [PDF]
|
|
|
|
 |
|
 A. A. Fagan, K. Hanson, J. D. Hawkins, and M. W. Arthur Implementing Effective Community-Based Prevention Programs in the Community Youth Development Study Youth Violence and Juvenile Justice, July 1, 2008; 6(3): 256 - 278. [Abstract] [PDF]
|
|
|
|
 |
|
 K. L. Pence, L. M. Justice, and A. K. Wiggins Preschool Teachers' Fidelity in Implementing a Comprehensive Language-Rich Curriculum Lang Speech Hear Serv Sch, July 1, 2008; 39(3): 329 - 341. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Audrey, J. Holliday, and R. Campbell Commitment and compatibility: Teachers' perspectives on the implementation of an effective school-based, peer-led smoking intervention Health Education Journal, June 1, 2008; 67(2): 74 - 90. [Abstract] [PDF]
|
|
|
|
 |
|
 C. L. O'Donnell Defining, Conceptualizing, and Measuring Fidelity of Implementation and Its Relationship to Outcomes in K-12 Curriculum Intervention Research Review of Educational Research, March 1, 2008; 78(1): 33 - 84. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. C. Frank, C. P. Coviak, T. C. Healy, B. Belza, and B. L. Casado Addressing Fidelity in Evidence-Based Health Promotion Programs for Older Adults Journal of Applied Gerontology, February 1, 2008; 27(1): 4 - 33. [Abstract] [PDF]
|
|
|
|
|
|
S. Bisset and L. Potvin Expanding our conceptualization of program implementation: lessons from the genealogy of a school-based nutrition program Health Educ. Res., October 1, 2007; 22(5): 737 - 746. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. L. Plummer, D Wight, A. I. N. Obasi, J Wamoyi, G Mshana, J Todd, B. C. Mazige, M Makokha, R. J. Hayes, and D. A. Ross A process evaluation of a school-based adolescent sexual health intervention in rural Tanzania: the MEMA kwa Vijana programme Health Educ. Res., August 1, 2007; 22(4): 500 - 512. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. Mayo-Wilson Reporting Implementation in Randomized Trials: Proposed Additions to the Consolidated Standards of Reporting Trials Statement Am J Public Health, April 1, 2007; 97(4): 630 - 633. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. Sanchez, A. Steckler, P Nitirat, D Hallfors, H Cho, and P Brodish Fidelity of implementation in a treatment effectiveness trial of Reconnecting Youth Health Educ. Res., February 1, 2007; 22(1): 95 - 107. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Melde, F.-A. Esbensen, and K. Tusinski Addressing Program Fidelity Using Onsite Observations and Program Provider Descriptions of Program Delivery Eval Rev, December 1, 2006; 30(6): 714 - 740. [Abstract] [PDF]
|
|
|
|
|
|
D. Ward, R Saunders, G. Felton, E Williams, J. Epping, and R. Pate Implementation of a school environment intervention to increase physical activity in high school girls Health Educ. Res., December 1, 2006; 21(6): 896 - 910. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Rowling and V. Jeffreys Capturing complexity: integrating health and education research to inform health-promoting schools policy and practice Health Educ. Res., October 1, 2006; 21(5): 705 - 718. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Rohrbach, R. Grana, S. Sussman, and T. W. Valente Type II Translation: Transporting Prevention Interventions From Research to Real-World Settings Eval Health Prof, September 1, 2006; 29(3): 302 - 333. [Abstract] [PDF]
|
|
|
|
|
|
J. Solomon, J. J. Card, and R. M. Malow Adapting Efficacious Interventions: Advancing Translational Research in HIV Prevention Eval Health Prof, June 1, 2006; 29(2): 162 - 194. [Abstract] [PDF]
|
|
|
|
|
|
L. Dusenbury, R. Brannigan, W. B. Hansen, J. Walsh, and M. Falco Quality of implementation: developing measures crucial to understanding the diffusion of preventive interventions Health Educ. Res., June 1, 2005; 20(3): 308 - 313. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. P. Saunders, M. H. Evans, and P. Joshi Developing a Process-Evaluation Plan for Assessing Health Promotion Program Implementation: A How-To Guide Health Promot Pract, April 1, 2005; 6(2): 134 - 147. [Abstract] [PDF]
|
|
|
|
|
|
L. Faw, A. Hogue, and H. A. Liddle Multidimensional Implementation Evaluation of a Residential Treatment Program for Adolescent Substance Abuse American Journal of Evaluation, March 1, 2005; 26(1): 77 - 94. [Abstract] [PDF]
|
|
|
|
 |
|
 R. B. McNeal Jr., W. B. Hansen, N. G. Harrington, and S. M. Giles How all Stars Works: An Examination of Program Effects on Mediating Variables Health Educ Behav, April 1, 2004; 31(2): 165 - 178. [Abstract] [PDF]
|
|