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

TLDR

Evaluation of implementation processes and fidelity reveals the “black box” of interventions, yet standardized methods are lacking, resulting in few systematic studies in health service research. The study aims to systematically evaluate implementation fidelity and its influencing factors for complex interventions in health and social care. Using a modified Conceptual Framework for Implementation Fidelity that adds context and recruitment, the authors developed a systematic evaluation process and applied a multiple case study design with longitudinal quantitative and qualitative methods to empirically test the framework across three complex health service interventions. The study identifies key mechanisms and moderating factors that influence implementation fidelity of complex interventions. The trial is registered as NCT00960024.

Abstract

Evaluation 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.A 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.This 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.Supported Employment, SE, among people with severe mental illness -- a randomized controlled trial: NCT00960024.