Department of Health Behavior and Health Education, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Health Educ Res. 2011 Apr;26(2):361-71. doi: 10.1093/her/cyr013. Epub 2011 Mar 7.
Fidelity of program implementation under real-world conditions is a critical issue in the dissemination of evidence-based school substance use prevention curricula. Program effects are diminished when programs are implemented with poor fidelity. We assessed five domains of fidelity--adherence, exposure (dosage), quality of delivery, participant responsiveness and program differentiation (lack of contamination from other programs)--in a subset of respondents (N = 342) from a national random sample of public schools with middle school grades (N = 1721). Respondents taught 1 of 10 evidence-based universal substance use prevention programs as their primary program during the 2004-05 school year. Their responses to survey questions about their recent implementation practices indicated that fidelity was high for quality of delivery and participant responsiveness, low for program differentiation and modest for adherence and exposure--the two core domains of fidelity. Results suggest the need for continued emphasis on fidelity in program materials, trainings and on-going technical support. Particular attention should be paid to supporting use of interactive delivery strategies.
在现实条件下，计划执行的保真度是传播基于证据的学校物质使用预防课程的一个关键问题。当计划执行的保真度较差时，计划效果会降低。我们评估了五个保真度领域——依从性、暴露（剂量）、交付质量、参与者响应性和计划差异化（缺乏来自其他计划的污染）——在一个全国公立学校随机样本的一部分受访者（N=342）中，这些受访者在 2004-05 学年教授了 10 种基于证据的通用物质使用预防计划中的 1 种作为其主要计划。他们对最近实施实践的调查问题的回答表明，交付质量和参与者响应性的保真度很高，计划差异化的保真度较低，依从性和暴露（保真度的两个核心领域）的保真度适中。结果表明，需要继续强调计划材料、培训和持续技术支持中的保真度。特别应该注意支持使用互动式交付策略。
