There is a growing awareness of the significance of developing and applying fidelity measures to evaluate the implementation of such programs ( 12, 14, 15). In the United States and Canada, the development and implementation of parenting programs to bolster healthy development of children has increased during the last 20 years ( 13). With increased demands for early intervention to be widely delivered by non-specialists, rigorous yet pragmatic strategies for maintaining program fidelity are needed. Attempts by program developers to assure adherence to their programs include the creation of training and protocol manuals, but these alone may not be sufficient to ensure fidelity of implementation ( 8, 12). However, defining and operationalizing program fidelity for parenting programs is difficult due to their interactive and dynamic nature ( 10, 11). Fidelity refers to the extent to which a healthcare program follows an explicit set of criteria specifically designed for its particular program model ( 7– 9). Despite recognizing the need to deliver vital parenting programs, monitoring fidelity has been historically ignored ( 5, 6). Nurses play an important role in intervening early to support parenting and promote healthy child development ( 3, 4).
Parents influence children's affective and cognitive development, with lifelong impacts ( 1, 2). In future, research should examine links between program fidelity and targeted outcomes to ascertain if increased fidelity scores yield more favorable effects of parenting programs. Development of checklists like the ATTACH™ fidelity assessment checklist enables the systematic evaluation of program delivery and identification of therapeutic components that enable targeted efforts at improvement. The overall quality index for program delivery varied between “very good” to “excellent,” with a mean of 4.3/5. This paper describes the step-by-step development and evaluation of a program fidelity measure, using the Attachment and Child Health (ATTACH™) parenting program as an exemplar. With increasing demands for early intervention programs to be delivered by non-specialists, rigorous yet pragmatic strategies for maintaining fidelity are needed. Fidelity refers to the degree to which healthcare programs follow a well-defined set of criteria specifically designed for a particular program model. Despite recognizing the need to deliver vital parenting programs, monitoring fidelity has largely been ignored. Nurses play an important role in promoting positive childhood development via early interventions intended to support parenting.
2Department of Pediatrics, Faculty of Nursing, University of Calgary, Calgary, AB, Canada.1Department of Pediatrics, Faculty of Nursing, Owerko Centre, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada.
0 kommentar(er)
