Evaluating Fidelity to the National Extension Dining with Diabetes Program: Challenges and Opportunities

Abstract

The objective of this study was to evaluate fidelity to the Dining with Diabetes (DWD) program. Data were gathered cross-sectionally in 2019 using class profile forms (i.e., checklists) containing items reflecting the core components of DWD: delivery personnel, curriculum, hands-on cooking, and goal setting. Fidelity was calculated as the proportion of core components completed as intended. Educators (N = 9) completed class profile forms for 10 complete DWD programs (i.e., all four classes). Fidelity to components of completed DWD programs and individual DWD classes was high (over 70% in each category). Overall, fidelity was high, and adaptations reported likely did not detract from effectiveness (e.g., a 2-hour class lasted 2.5 hours). However, the response rate was low and may not reflect those who deliver with lower fidelity. Assessing fidelity should be incorporated as a standard part of community-based diabetes management program evaluation; these data can inform changes to programs to make them more effective in the “real world.”