What are the different approaches used in implementation fidelity assessments

Implementation Fidelity

• Implementation fidelity is the degree to which an intervention is delivered as it was designed or written.
• It encompasses five key elements: adherence, dosage or exposure, quality of delivery, participant responsiveness, and program differentiation.

Adherence

• Adherence refers to whether a program or intervention is being delivered as it was designed or written.
• It involves the delivery of all elements of the intervention as prescribed by its designers.

Dosage or Exposure

• Dosage or exposure refers to the amount of an intervention received by participants.
• It involves the frequency and duration of the intervention, and whether it is as full as prescribed by its designers.

Quality of Delivery

• Quality of delivery is the manner in which a program is delivered by a teacher, volunteer, or staff member.
• It can be evaluated using a benchmark, either within or beyond that stipulated by an intervention's designers.
• Quality of delivery may be viewed as a discrete aspect of fidelity or as a moderator of the relationship between an intervention and its fidelity.

Participant Responsiveness

• Participant responsiveness measures how far participants respond to, or are engaged by, an intervention.
• It involves judgments by participants or recipients about the outcomes and relevance of an intervention.

Program Differentiation

• Program differentiation is the identification of unique features of different components or programs.
• It involves identifying which elements of programs are essential for their intended effect.
• Program differentiation is more accurately described as the "Identification of an intervention's essential components".
• This element is distinct from fidelity and is concerned with determining the essential components of an intervention.

Measurement of Implementation Fidelity

• There are two distinct views on how to measure implementation fidelity:
  • One view is that each of the five elements represents an alternative way to measure fidelity.
  • The other view is that all five elements need to be measured to capture a comprehensive picture of implementation fidelity.