An Exploration of Fidelity of Implementation in Drug Abuse Prevention among Five Professional Groups

Dusenbury, Linda, Brannigan, Rosalind, Falco, Mathea, Lake, Antonia, Journal of Alcohol & Drug Education

Abstract

To explore the extent of awareness among practitioners of the importance of fidelity of implementation and the factors that inhibit or encourage it, interviews were conducted with nine individuals in each of the following groups: 1) researchers who have developed and evaluated prevention curricula; 2)publishers of drug abuse prevention curricula; 3) school administrators; 4) teachers; and 5) State Safe Drug Free Schools Coordinators. Interviews with leading researchers found there is inconsistency in definition as well as a lack of standard measures and methodology to investigate fidelity. All of the groups agreed that training was critically important to fidelity of implementation. Strategies for promoting fidelity of implementation are discussed.

INTRODUCTION

Fidelity of implementation refers to the degree to which teachers and other program providers implement programs as intended by the program developers. Unfortunately, as Berman and McLaughlin (1976) observe, while "the bridge between a promising idea and its impact on students is implementation," ... "innovations are seldom implemented as planned." (p.349).

In the field of drug abuse prevention, numerous research-based programs are delivered in schools by regular classroom teacher (Drug Strategies, 1999). However, there have been increasing reports that the quality of implementation of these programs is varied. In many studies, high fidelity of implementation has been associated with improved student outcomes (Abbot, et al., 1998; Battistich, Schaps, Watson, & Solomon, 1996; Botvin, Dusenbury, Tortu, & Botvin, 1990; Botvin, Baker, Dusenbury, Botvin, & Diaz, 1995). In the prevention literature, most researchers view any changes in a program as a potential threat to the integrity of the intervention, and most research has supported the expectation that the more completely a teacher implements a program, the less likely students will use drugs (Botvin, Baker, Dusenbury, Botvin, & Tortu, 1990; Rohrbach, Graham, & Hansen, 1993; Resnicow, Cross, & Wynder, 1993). The inverse also has been shown to be true: When programs are not implemented as intended, they are less likely to be effective. In addition, fidelity of implementation has been associated with changes in mediating variables believed to be responsible for outcomes (Hansen, Graham, Wolkenstein, & Rohrbach, 1991).

The few studies that have assessed fidelity of implementation find that it is seldom achieved. Good evaluations of drug abuse prevention programs have been done in the context of rigorous field trials, where there is considerable effort to get teachers to implement programs exactly as intended. However, even under these circumstances, research suggests that there is tremendous variability in how consistently different teachers present program material (Botvin, et al., 1990; Tortu & Botvin, 1989; Pentz, et al., 1990; Tappe, Galer-Unti, & Bailey, 1995).

To explore the extent of awareness among practitioners of the importance of fidelity of implementation and the factors that inhibit or encourage it, interviews were conducted with nine individuals in each of the following groups: 1) researchers who have developed and evaluated prevention curricula; 2) program developers/publishers of drug abuse prevention curricula; 3) school administrators who have selected and purchased prevention curricula; 4) teachers who have implemented prevention programs; and 5) State Safe and Drug Free Schools Coordinators who are responsible for overseeing the implementation of a wide range of programs in diverse settings.

Method

Telephone interviews were conducted with five separate professional groups: 1) nationally recognized researchers actively studying prevention programs effectiveness; 2) drug abuse prevention program developers; 3) school administrators involved in the selection and implementation of programs; 4) teachers responsible for delivering prevention programs; and 5) Safe and Drug Free School Coordinators in states with a wide dissemination of prevention programs. Up to nine individuals were interviewed in each professional group; none of those contacted refused to participate, though a few of those contacted could not be interviewed within the time frame of this study because of scheduling difficulties.

Selection of Researchers. Interviews were conducted with nine researchers who had published widely in the field of drug abuse prevention or prevention more broadly, and who had written or spoken extensively on the topic of fidelity of implementation. These individuals were identified through discussions with NIDA project staff, through the literature, and on recommendation by other researchers. The nine researchers interviewed for this project included:

* Dr. Richard Catalano, Associate Director & Professor, Social Development & Research Group, School of Social Work, University of Washington;

* Dr. Mark Greenberg, Director, Prevention Research Center, Human Development and Family Studies, Pennsylvania State University;

* Dr. William B. Hansen, President, Tanglewood Research;

* Dr. Mary Ann Pentz, Professor, Preventive Medicine (Division of Health Promotion), School of Medicine, University of Southern California;

* Dr. Cheryl Perry, Professor, Division of Epidemiology University of Minnesota/School of Public Health, University of Minnesota;

* Dr. Louise Ann Rohrbach, Research Assistant Professor, Institute For Prevention Research, University of Southern California;

* Dr. Richard Spoth, Senior Research Scientist and Project Director, Prevention Programming and Research, Institute for Social and Behavioral Research, Iowa State University;

* Dr. Abe Wandersman, Professor of Psychology, University of South Carolina; and

* Dr. Roger Weissberg, Professor of Psychology and Executive Director of the Collaborative for Academic, Social and Emotional Learning, University of Illinois in Chicago.

Selection of Program Developers, School Administrators and Teachers. The first step in selecting program developers, school administrators, and teachers, was to identify widely used prevention programs. Two …

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Publication information: Article title: An Exploration of Fidelity of Implementation in Drug Abuse Prevention among Five Professional Groups. Contributors: Dusenbury, Linda - Author, Brannigan, Rosalind - Author, Falco, Mathea - Author, Lake, Antonia - Author. Journal title: Journal of Alcohol & Drug Education. Volume: 47. Issue: 3 Publication date: March 2004. Page number: 4+. © 2009 American Alcohol & Drug Information Foundation. COPYRIGHT 2004 Gale Group.

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