Fidelity and Its Relationship to Effectiveness, Adaptation, and Implementation
Rachel C. Shelton, Prajakta Adsul, Karen M. Emmons, Laura Linnan, Jennifer D. Allen
Abstract
Abstract There is substantial variability in the implementation of evidence-based interventions across the United States, which leads to inconsistent access to evidence-based prevention and treatment strategies at a population level. Increased dissemination and implementation of evidence-based interventions could result in significant public health gains and the potential to address persistent health inequities. While the availability of evidence-based interventions is increasing, study of implementation, adaptation, and dissemination has relatively recently gained attention in public health. To date, insufficient attention has been given to the issue of fidelity. Consideration of fidelity is necessary to balance the need for internal and external validity across the research continuum. There is also a need for a more robust literature to increase knowledge about factors that influence fidelity, strategies for maximizing fidelity, and methods for measuring and analyzing fidelity and learning from variation in implementation fidelity.