Limits...
What is the extent and quality of documentation and reporting of fidelity to implementation strategies: a scoping review.

Slaughter SE, Hill JN, Snelgrove-Clarke E - Implement Sci (2015)

Bottom Line: Researchers reported neither fidelity definitions nor conceptual frameworks for fidelity in any articles.We noted a statistically significant decline in fidelity scores over time.Careful reporting of details about fidelity of implementation strategies will make an important contribution to implementation science.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. susan.slaughter@ualberta.ca.

ABSTRACT

Background: Implementation fidelity is critical to the internal and external validity of implementation research. Much of what is written about implementation fidelity addresses fidelity of evidence-informed interventions rather than fidelity of implementation strategies. The documentation and reporting of fidelity to implementation strategies requires attention. Therefore, in this scoping review, we identify the extent and quality of documentation and reporting of fidelity of implementation strategies that were used to implement evidence-informed interventions.

Methods: A six-stage methodological framework for scoping studies guided our work. Studies were identified from the outputs of the Effective Practice and Organization of Care (EPOC) review group within the Cochrane Database of Systematic Reviews. EPOC's primary focus, implementation strategies influencing provider behavior change, optimized our ability to identify articles for inclusion. We organized the retrieved articles from the systematic reviews by journal and selected the three journals with the largest number of retrieved articles. Using a data extraction tool, we organized retrieved article data from these three journals. In addition, we summarized implementation strategies using the EPOC categories. Data extraction pertaining to the quality of reporting the fidelity of implementation strategies was facilitated with an "Implementation Strategy Fidelity Checklist" based on definitions adapted from Dusenbury et al. We conducted inter-rater reliability checks for all of the independently scored articles. Using linear regression, we assessed the fidelity scores in relation to the publication year.

Results: Seventy-two implementation articles were included in the final analysis. Researchers reported neither fidelity definitions nor conceptual frameworks for fidelity in any articles. The most frequently employed implementation strategies included distribution of education materials (n = 35), audit and feedback (n = 32), and educational meetings (n = 25). Fidelity of implementation strategies was documented in 51 (71 %) articles. Inter-rater reliability coefficients of the independent reviews for each component of fidelity were as follows: adherence = 0.85, dose = 0.89, and participant responsiveness = 0.96. The mean fidelity score was 2.6 (SD = 2.25). We noted a statistically significant decline in fidelity scores over time.

Conclusions: In addition to identifying the under-reporting of fidelity of implementation strategies in the health literature, we developed and tested a simple checklist to assess the reporting of fidelity of implementation strategies. More research is indicated to assess the definitions and scoring schema of this checklist. Careful reporting of details about fidelity of implementation strategies will make an important contribution to implementation science.

No MeSH data available.


Related in: MedlinePlus

Search and selection process
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4562107&req=5

Fig1: Search and selection process

Mentions: From the references included in the 47 systematic reviews, we identified 1158 articles published in 337 journals. The three journals including the most articles were the British Medical Journal (n = 54), Journal of the American Medical Association (n = 40), and Medical Care (n = 34). Thus, the initial search yielded 128 articles. With duplicates removed, there were 105 articles remaining. After reviewing the full articles for the 105 articles, it became apparent that there was no health provider behavior change for 33 of these. Thus, 72 articles were selected for inclusion in this scoping review. Figure 1 summarizes the search and retrieval process.Fig. 1


What is the extent and quality of documentation and reporting of fidelity to implementation strategies: a scoping review.

Slaughter SE, Hill JN, Snelgrove-Clarke E - Implement Sci (2015)

Search and selection process
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4562107&req=5

Fig1: Search and selection process
Mentions: From the references included in the 47 systematic reviews, we identified 1158 articles published in 337 journals. The three journals including the most articles were the British Medical Journal (n = 54), Journal of the American Medical Association (n = 40), and Medical Care (n = 34). Thus, the initial search yielded 128 articles. With duplicates removed, there were 105 articles remaining. After reviewing the full articles for the 105 articles, it became apparent that there was no health provider behavior change for 33 of these. Thus, 72 articles were selected for inclusion in this scoping review. Figure 1 summarizes the search and retrieval process.Fig. 1

Bottom Line: Researchers reported neither fidelity definitions nor conceptual frameworks for fidelity in any articles.We noted a statistically significant decline in fidelity scores over time.Careful reporting of details about fidelity of implementation strategies will make an important contribution to implementation science.

View Article: PubMed Central - PubMed

Affiliation: Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. susan.slaughter@ualberta.ca.

ABSTRACT

Background: Implementation fidelity is critical to the internal and external validity of implementation research. Much of what is written about implementation fidelity addresses fidelity of evidence-informed interventions rather than fidelity of implementation strategies. The documentation and reporting of fidelity to implementation strategies requires attention. Therefore, in this scoping review, we identify the extent and quality of documentation and reporting of fidelity of implementation strategies that were used to implement evidence-informed interventions.

Methods: A six-stage methodological framework for scoping studies guided our work. Studies were identified from the outputs of the Effective Practice and Organization of Care (EPOC) review group within the Cochrane Database of Systematic Reviews. EPOC's primary focus, implementation strategies influencing provider behavior change, optimized our ability to identify articles for inclusion. We organized the retrieved articles from the systematic reviews by journal and selected the three journals with the largest number of retrieved articles. Using a data extraction tool, we organized retrieved article data from these three journals. In addition, we summarized implementation strategies using the EPOC categories. Data extraction pertaining to the quality of reporting the fidelity of implementation strategies was facilitated with an "Implementation Strategy Fidelity Checklist" based on definitions adapted from Dusenbury et al. We conducted inter-rater reliability checks for all of the independently scored articles. Using linear regression, we assessed the fidelity scores in relation to the publication year.

Results: Seventy-two implementation articles were included in the final analysis. Researchers reported neither fidelity definitions nor conceptual frameworks for fidelity in any articles. The most frequently employed implementation strategies included distribution of education materials (n = 35), audit and feedback (n = 32), and educational meetings (n = 25). Fidelity of implementation strategies was documented in 51 (71 %) articles. Inter-rater reliability coefficients of the independent reviews for each component of fidelity were as follows: adherence = 0.85, dose = 0.89, and participant responsiveness = 0.96. The mean fidelity score was 2.6 (SD = 2.25). We noted a statistically significant decline in fidelity scores over time.

Conclusions: In addition to identifying the under-reporting of fidelity of implementation strategies in the health literature, we developed and tested a simple checklist to assess the reporting of fidelity of implementation strategies. More research is indicated to assess the definitions and scoring schema of this checklist. Careful reporting of details about fidelity of implementation strategies will make an important contribution to implementation science.

No MeSH data available.


Related in: MedlinePlus