Fidelity to and Adaptation of Evidence-based Interventions in the Social Work Literature: A Scoping Review

A common assumption is that evidence-based interventions (EBIs) should be used with high fidelity to yield good results, but sometimes they need to be adapted for use in a new setting. Research concerning these issues is published in various scientific journals, which makes it difficult to obtain an overview. This study explores how fidelity to and adaptation of EBIs are described in the social work literature. We searched for relevant articles in social work journals in five scientific databases and compiled information about how fidelity and adaptations were described in the articles. We found a relatively large variety of terms describing adaptations of EBIs; the range of terms describing fidelity was much smaller. Various methods to achieve and/or assess fidelity were identified, for example, training and supervision. Most of the adaptations were related to modification of the content (e.g. skipping parts of the original EBI or adding new content) and were planned before implementation. The interest in these issues is growing within the field of social work research. This study provides knowledge about how fidelity and adaptations have been described previously in the social work literature and provides guidance for future research. Using evidence-based interventions (EBIs) is one way to achieve good-quality social services. Adaptations of and efforts to maintain fidelity to EBIs are common. However, research addressing these issues is published across multiple journals. This scoping review aims to explore how fidelity to and adaptations of EBIs are described in the social work literature. We searched for peer-reviewed, English language articles addressing EBIs in social work journals in five databases. Data were extracted and analysed to address the aim of the study. Qualitative content analysis was used to analyse items containing more extensive information. The searches yielded 2,949 articles. The results of 236 articles are presented. Almost fifty different terms were found describing adaptations, and the variety of terms describing fidelity was significantly smaller. Various measures to achieve and/or assess fidelity were identified. The Framework for Reporting Adaptations and Modifications-Expanded was used to categorise information about adaptations. Most adaptations concerned modifications of content and were planned rather than unplanned. Thirty-eight frameworks for implementation of EBIs were identified, and fourteen dealt with fidelity and adaptations. Fidelity and adaptations are increasingly in focus in social work studies. This review contributes to increased knowledge about how fidelity and adaptations have been described in the social work literature.