PreventionIdaho.Net Resources for substance abuse prevention providers in Idaho
5/6/2005 - Implementing Best Practice Prevention Programs With FIDELITY

Choosing a substance abuse prevention program that is a Best Practice is only one step in the process of successful prevention programming. Delivering a Best Practice program raises the likelihood for success in reducing youth problems related to substance use and supports the success of children and families -- when the program is implemented with fidelity. And that’s what really matters: not just having a Best Practice, but delivering it in such a way that it makes a positive change in people’s lives. Fidelity is the degree to which a program or curriculum is delivered according to the program guidelines. Assessing fidelity answers the question, “How well do the structure, program content, and method of delivery follow program developer guidelines?” Programs delivered faithfully to the Best Practice (i.e., with a high degree of fidelity) are more likely to achieve the proven outcomes. Programs with a low degree of fidelity are less likely to make a meaningful difference in the lives of the participants. Adaptation is how much a program is changed during implementation to fit a particular situation. In some instances adaptation may be necessary, and even desirable, but it must be done carefully. Balancing fidelity and adaptation to achieve desired outcomes is a process that requires thoughtful planning. It is an essential step for successful prevention program delivery. As a general rule, when in doubt – contact the program vendor. Research findings found in Science-Based Prevention Programs and Principles , published by the U.S. Department of Health and Human Services, have identified six guidelines to assist prevention programs with successfully maintaining the balance between fidelity and adaptation. 1. Understand the theory behind the program. A thorough study of curriculum material will yield this information. Underlying theory is also typically shared during training in preparation for program delivery. Understanding the theory will help you understand why the program is structured the way that it is, and that will help you keep adaptations faithful to the original design and goals. 2. Understand the core program elements. This information is usually provided during program training, in the program manual, or directly by the program developer. With in-depth understanding of the program, facilitators can usually determine essential program components for themselves. An adaptation that includes all of the core elements has a greater chance of having a similar impact as the original. 3. Thoughtfully assess fidelity and adaptation issues for the particular site where the program is being implemented. Think about the target population, funding level, available locations, potential facilitators, timing, or any community issues that might require adaptation in order for a program to be successfully implemented. But if too many of these elements require adaptation, you may be better off seeking a different program. It’s like a recipe – you can make a few substitutions, but if you make too many, it’s not the same dish anymore. 4. Consult with the program developer as needed. It’s always appropriate to contact program developers. They frequently have experience with different ways to deliver their program, both effectively and ineffectively, and may give you the names of others who have successfully dealt with similar adaptation issues. 5. Consult with the organization or community in which the program will be delivered. Talk with members of the group or community where the program will be delivered. This will build support for your program and increase program participation, besides providing valuable information. It will also help them understand why the program is designed to be delivered in a certain way. 6. Develop an implementation plan based on the information you have gathered. Taking time to gather the information you need will ensure that adaptations do not negatively impact program outcomes. We strongly encourage you to contact the program vendor if your implementation plan differs much from the original program. And finally, feel free to call your Benchmark Regional Manager. We’re here to help. In addition to helping us understand how well a particular Best Practice works in your community, and in Idaho, bringing things like fidelity questions to our attention may benefit others who are trying to address the same issue. It’s also our job to make certain that programs are effective as delivered so that they have the greatest possible impact on the people of our communities. We’ll work with you to find ways to enhance program effectiveness and be on the lookout for adaptations that might reduce or eliminate the value of the program in the lives of your participants.