Systematic evaluation of implementation fidelity of complex interventions in health and social care

Henna Hasson

doi:10.1186/1748-5908-5-67

Abstract

BackgroundEvaluation of an implementation process and its fidelity can give insight into the 'black box' of interventions. However, a lack of standardized methods for studying fidelity and implementation process have been reported, which might be one reason for the fact that few prior studies in the field of health service research have systematically evaluated interventions' implementation processes.The aim of this project is to systematically evaluate implementation fidelity and possible factors influencing fidelity of complex interventions in health and social care.MethodsA modified version of The Conceptual Framework for Implementation Fidelity will be used as a conceptual model for the evaluation. The modification implies two additional moderating factors: context and recruitment. A systematic evaluation process was developed. Multiple case study method is used to investigate implementation of three complex health service interventions. Each case will be investigated in depth and longitudinally, using both quantitative and qualitative methods.DiscussionThis study is the first attempt to empirically test The Conceptual Framework for Implementation Fidelity. The study can highlight mechanism and factors of importance when implementing complex interventions. Especially the role of the moderating factors on implementation fidelity can be clarified.Trial RegistrationSupported Employment, SE, among people with severe mental illness -- a randomized controlled trial: NCT00960024.

Highlights

Evaluation of an implementation process and its fidelity can give insight into the ‘black box’ of interventions
The theoretical framework for the study is that integrated care with a case manager creates networks of resources and services over time and between different healthcare providers, between health and social care
How were the participants engaged with the intervention services? How satisfied were the participants with the intervention services? How did the participants perceive the outcomes and relevance of the intervention?

Summary

Introduction

Evaluation of an implementation process and its fidelity can give insight into the ‘black box’ of interventions. A lack of standardized methods for studying fidelity and implementation process have been reported, which might be one reason for the fact that few prior studies in the field of health service research have systematically evaluated interventions’ implementation processes. The aim of this project is to systematically evaluate implementation fidelity and possible factors influencing fidelity of complex interventions in health and social care. Health service interventions consist of a number of components that might act both independently and inter-dependently This can challenge the evaluation of the program impact [2]. A classical study by Dobson and Cook [4] regarding a

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