Berkel Cady, Murry Velma McBride, Roulston Kathryn J, Brody Gene H
Prevention Research Center, Arizona State University, Tempe, Arizona, USA.
Center for Research on Rural Families and Communities, Vanderbilt University, Nashville, Tennessee, USA.
Health Educ (Lond). 2013;113(4):297-323. doi: 10.1108/09654281311329240.
The purpose of this paper is to demonstrate the importance of considering both fidelity and adaptation in assessing the implementation of evidence-based programs.
DESIGN/METHODOLOGY/APPROACH: The current study employs a multi-method strategy to understand two dimensions of implementation (fidelity and adaptation) in the Strong African American Families (SAAF) program. Data were video recordings of program delivery and pre-test and post-test interviews from the efficacy trial. Multilevel regression in Mplus was used to assess the impact of fidelity to the manual, coded by independent observers, on racial socialization outcomes. One activity on racial socialization, a core component of the program, was selected for an in-depth examination using conversation analysis (a qualitative method of analyzing talk in interactions).
Results of the quantitative analyses demonstrated that fidelity of the selected activity was associated with increases in parent's use of racial socialization from pre-test to post-test, but only when participant attendance was included in the model. Results of the qualitative analyses demonstrated that facilitators were making adaptations to the session and that these adaptations appeared to be in line with cultural competence.
RESEARCH LIMITATIONS/IMPLICATIONS: The development of quantitative fidelity measures can be problematic, with many decision points to consider. The current study contributes to the evidence base to develop a quantitative measure of adaptation for family-based parenting programs.
ORIGINALITY/VALUE: Many researchers examining implementation of evidence-based programs consider fidelity and adaptation to be polar ends of a single spectrum. This paper provides evidence for the importance of examining each independently.
本文旨在证明在评估循证项目的实施情况时，兼顾保真度和适应性的重要性。
设计/方法/途径：本研究采用多方法策略，以了解“强大非裔美国家庭”（SAAF）项目实施的两个维度（保真度和适应性）。数据包括项目实施的视频记录以及疗效试验中的前测和后测访谈。使用Mplus中的多层回归来评估由独立观察员编码的手册保真度对种族社会化结果的影响。使用会话分析（一种分析互动中谈话的定性方法）对该项目的一个核心组成部分——一项关于种族社会化的活动进行深入研究。
定量分析结果表明，所选活动的保真度与从测试前到测试后父母对种族社会化的使用增加有关，但只有当模型中纳入参与者的出席情况时才成立。定性分析结果表明，主持人正在对课程进行调整，并且这些调整似乎符合文化能力要求。
研究局限性/启示：定量保真度测量的开发可能存在问题，有许多决策点需要考虑。本研究为基于家庭的育儿项目开发适应性的定量测量方法提供了证据基础。
原创性/价值：许多研究循证项目实施情况的研究人员认为保真度和适应性是单一范围的两极。本文为独立审视两者的重要性提供了证据。
