Measuring Implementation Fidelity in a Community-Based Parenting Intervention

被引:103
|
作者
Breitenstein, Susan M. [1 ]
Fogg, Louis
Garvey, Christine
Hill, Carri [2 ]
Resnick, Barbara [3 ]
Gross, Deborah [4 ]
机构
[1] Rush Univ, Coll Nursing, Armour Acad Ctr, Chicago, IL 60612 USA
[2] Univ Illinois, Dept Psychiat, Inst Juvenile Res, Chicago, IL 60612 USA
[3] Univ Maryland, Baltimore, MD 21201 USA
[4] Johns Hopkins Univ, Baltimore, MD USA
关键词
fidelity; implementation; prevention; THERAPIST ADHERENCE; TREATMENT INTEGRITY; PREVENTION; FAMILY; BEHAVIOR; ISSUES; COMPETENCE; ALLIANCE; TRIAL; LEVEL;
D O I
10.1097/NNR.0b013e3181dbb2e2
中图分类号
R47 [护理学];
学科分类号
1011 ;
摘要
Background: Establishing the feasibility and validity of implementation fidelity monitoring strategies is an important methodological step in implementing evidence-based interventions on a large scale. Objectives: The objective of the study was to examine the reliability and validity of the Fidelity Checklist, a measure designed to assess group leader adherence and competence delivering a parent training intervention (the Chicago Parent Program) in child care centers serving low-income families. Method: The sample included 9 parent groups (12 group sessions each), 12 group leaders, and 103 parents. Independent raters reviewed 106 audiotaped parent group sessions and coded group leaders' fidelity on the Adherence and Competence Scales of the Fidelity Checklist. Group leaders completed self-report adherence checklists and a measure of parent engagement in the intervention. Parents completed measures of consumer satisfaction and child behavior. Results: High interrater agreement (Adherence Scale = 94%, Competence Scale = 85%) and adequate intraclass correlation coefficients (Adherence Scale =.69, Competence Scale =.91) were achieved for the Fidelity Checklist. Group leader adherence changed over time, but competence remained stable. Agreement between group leader self-report and independent ratings on the Adherence Scale was 85%; disagreements were more frequently due to positive bias in group leader self-report. Positive correlations were found between group leader adherence and parent attendance and engagement in the intervention and between group leader competence and parent satisfaction. Although child behavior problems improved, improvements were not related to fidelity. Discussion: The results suggest that the Fidelity Checklist is a feasible, reliable, and valid measure of group leader implementation fidelity in a group-based parenting intervention. Future research will be focused on testing the Fidelity Checklist with diverse and larger samples and generalizing to other group-based interventions using a similar intervention model.
引用
收藏
页码:158 / 165
页数:8
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