Fidelity and Its Relationship to Implementation Effectiveness, Adaptation, and Dissemination
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. It represents the quality and integrity of the intervention as conceived by the developers.” This chapter discusses the importance of fidelity for D&I research, proposes a framework for considering factors that influence fidelity, and describes strategies for producing high fidelity in interventions. It presents an example of a community-based intervention and various attempts to assess fidelity, highlighting several key factors, processes, and challenges. The chapter concludes by summarizing implications of fidelity and adaptation issues on intervention dissemination for practitioners, researchers, and policymakers. The goal is to add conceptual clarity regarding fidelity across the study design spectrum.
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