Implementing Sustainable Evidence-Based Interventions in the Community: A Fidelity-Focused Training Framework for the Savvy Caregiver Program

Evidence-based (EB) programs provide a tested means for addressing serious public health concerns. While establishing and maintaining fidelity to these programs is critical for high-quality outcomes, unfortunately, implementation reports rarely describe the strategies used to train and monitor fidelity in community-based implementations. Thus, an essential translational ingredient is a clearly articulated model for establishing a systemic, sustainable fidelity framework. This article provides a detailed description of the fidelity-focused framework developed for Michigan's statewide implementation of the Savvy Caregiver Program. This framework, titled Creating Confident Caregivers (R) (CCC), instilled conceptual understanding of fidelity, practice adherence, and competence via ongoing progressive practitioner training, peer observation, participant evaluation, and experiential assessments. Practitioners maintained very high evaluations from participants, and a select cadre of practitioners achieved master trainer status to monitor regional fidelity. This framework promotes sustainable fidelity to EB interventions and provides a replicable platform for other community-based implementations.