Health Education Research Advance Access originally published online on November 2, 2004
Health Education Research 2005 20(3):308-313; doi:10.1093/her/cyg134
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Health Education Research Vol.20 no.3, © Oxford University Press 2004; All rights reserved
Quality of implementation: developing measures crucial to understanding the diffusion of preventive interventions
1 Tanglewood Research, 7017 Albert Pick Road, Suite D, Greensboro, NC 27409, 2 Drug Strategies, 1755 Massachusetts Avenue, Room 821, Washington, DC 20036 and 3 Washington Office on Latin America, 1630 Connecticut Avenue, NW Suite 200, Washington DC 20009, USA
4 Correspondence to: L. Dusenbury; E-mail: lindadusenbury{at}tanglewood.net
As prevention programs become disseminated, the most serious threat to effectiveness is maintaining the quality of implementation intended by the developers. This paper proposes a methodology for measuring quality of implementation in school settings and presents data from a pilot study designed to test several of the proposed components. These methods included assessments of adherence, quality of process, the positive or negative valence of adaptations, teachers' attitudes and teachers' understanding of program content. This study was conducted with 11 teachers who had varying degrees of experience who taught Life Skills Training. Observation and interview data were collected during visits to schools. Results suggest that quality of implementation can be measured through observation and interview. Teachers varied in adherence and quality of program delivery. All teachers made adaptations to the program. Experienced teachers were more likely to adhere to the curriculum, deliver it in a way that was more interactive and engaging to students, communicate the goals and objectives better, and make positive adaptations. The field can use these findings as the basis for exploring strategies for measuring and improving quality of implementation.
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