From Conceptualization to Evaluation: A Practical Field Guide to Fidelity

Purpose: Essential in both practice and research, an intervention’s success or failure hinges on the fidelity of its implementation.  Despite consistent acknowledgement of the importance of measuring and maintaining fidelity during the testing and implementation of manualized interventions, little information is available to researchers specifically discussing how to do so.  Using the presenters’ newly developed Field Guide to Fidelity Model, attendees will walk through the five steps in the process of measuring and maintaining fidelity.

Overview:  This workshop will explain, discuss, and apply the five steps in the Field Guide to Fidelity Model: (1) Purpose and Scope, (2) Components of the intervention, (3) Development and Modification, (4) Monitoring, (5) Evaluation.  During the workshop, attendees will receive practical and detailed information about each step.  An interactive small group activity will be conducted and attendees will have an opportunity to ask questions.  Examples of this process will be provided throughout using materials developed during the fidelity monitoring of a federally funded prevention program, Pathways Triple P. 

Content: First, workshop participants will be involved in an orienting discussion of the importance of collecting fidelity data during an intervention.  Attendees will also learn how to determine the scale and scope of fidelity for their own study.  Practical decisions at this stage include deciding how to monitor, what content will be reviewed, who will review, and how interrater reliability will be established.  Second, researchers need to determine the essential components of the intervention.  Steps in this process include training and consultation in the model and reviewing the literature for any pre-existing fidelity measures.  Utilizing this knowledge and all manuals, researchers must define the essential content components of the intervention (content) and determine the manner (process) in which the intervention should be delivered.  Behavior which would violate fidelity, both by commission and omission, must be specified.  During the third step, the authors will discuss developing fidelity measures and assessing the quality and utility of pre-existing fidelity tools.  Key steps include the cyclical process of testing and making modifications until a valid and reliable fidelity tool is created.  Examples will be provided using materials developed for the Pathways Triple P intervention.  In small groups, attendees will evaluate and adapt a pre-existing fidelity measure after listening to examples of audiotaped sessions.  Fourth, monitoring fidelity during the intervention will be explored.  Authors will discuss the relationship between fidelity and clinical supervision with practitioners.  Finally, the authors will discuss the role of fidelity data in the final evaluation and statistical analysis of intervention outcomes. 

Significance: Fidelity is a key component of any intervention study yet comprehensive guides covering the full spectrum of the fidelity process do not exist.  The Field Guide to Fidelity Model lays a clear path for this process from conceptualization to evaluation.  Using this model, fidelity monitoring can be streamlined and standardized in both the practice and research settings.