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Implementation strategies are “deliberate and purposeful efforts to improve the uptake and sustainability of [evidence-based interventions (EBIs)],” to proximally affect implementation outcomes (e.g., adoption, appropriateness, feasibility, acceptability) that in turn distally affect service system and clinical outcomes through the successful implementation of an EBI .
- Conceptualisations of Implementation Fidelity and Their Limitations
- A Conceptual Framework: Background and Rationale
- Proposed Framework
- A Conceptual Framework: Elements and Relationships
A search was performed to identify literature on implementation fidelity, i.e., empirical research, reviews, or theoretical pieces. The following databases were searched with the terms "implementation fidelity" or "fidelity" within five words of "implement", "implementation", "implemented", etc.: Applied Social Sciences Index and Abstracts, Cumulat...
The concept of implementation fidelity is currently described and defined in the literature in terms of five elements that need to be measured [1, 2, 4]. These are: adherence to an intervention; exposure or dose; quality of delivery; participant responsiveness; and programme differentiation. There are certain overlaps here with the concept of proce...
All of the elements to evaluate implementation fidelity are listed in Table 1, and the relationships between them are shown in the framework depicted in Figure 1. The framework outlined in Figure 1 depicts the vital elements of implementation fidelity and their relationship to one another. The measurement of implementation fidelity is the measureme...
Adherence
Adherence is essentially the bottom-line measurement of implementation fidelity. If an implemented intervention adheres completely to the content, frequency, duration, and coverage prescribed by its designers, then fidelity can be said to be high. Measuring implementation fidelity means evaluating whether the result of the implementation process is an effective realisation of the intervention as planned by its designers. The content of the intervention may be seen as its 'active ingredients';...
Moderators
A high level of adherence or fidelity to an intervention, or its essential components, is not achieved easily. Several factors may influence or moderate the degree of fidelity with which an intervention is implemented. Each of the potential moderators of this relationship is now considered in turn.
Intervention complexity
The description of an intervention may be simple or complex, detailed or vague. Detailed or specific interventions have been found to be more likely to be implemented with high fidelity than ones that are vague. For example, a study of guidelines intended for General Practitioners (GPs) found that detailed and clear recommendations were almost twice as likely to be followed as vague and non-specific recommendations . The specificity of these guidelines was assessed by a group of researche...
- Christopher Carroll, Malcolm Patterson, Stephen Wood, Andrew Booth, Jo Rick, Shashi Balain
- 2007
Nov 23, 2017 · Although not always specified, fidelity may relate to the underlying theory of an intervention, or specific strategies to implement the EBI or both. 2 Careful measurement of fidelity allows researchers and program implementers to fully appreciate whether outcomes of an intervention are related to the quality or extent of implementation or whether some other factors—unrelated to the ...
Feb 9, 2023 · Background Implementation fidelity assesses the degree to which an intervention is delivered as it should be. Fidelity helps to determine if the outcome(s) of an intervention are attributed to the intervention itself or to a failure of its implementation. Little is known about how fidelity impacts the intended outcome(s) and what elements or moderators can affect the fidelity trajectory over ...
Effective dissemination and implementation (D&I) of evidence-based interventions (EBIs) assume that program strategies and methods will be conducted with “fidelity.” Fidelity has been defined as the “extent to which the intervention was delivered as planned.
May 13, 2023 · To highlight the importance of different implementation trajectories related to intervention fidelity, we will introduce a practical example from our own research, the FallDem study , perform a computer simulation quantifying the effect of different fidelity patterns on the outcome of a study in stepped-wedge and parallel cluster-randomized trials (CRT) and provide a tutorial of the performed ...
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Nov 30, 2007 · tion fidelity if the true effect of the intervention is to be. ... few studies measured later-stage implementation outcomes like fidelity, cost, or sustainability [61][62][63][64].
