Measuring the Fidelity of Implementation of a Mental Health Program Model

A fidelity index of program implementation for assertive community treatment (ACT) was developed. In Study 1,20 experts rated the importance of 73 elements proposed as critical ACT ingredients, also indicating ideal model specifications for elements. Agreement among experts on ratings of importance...

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Bibliographic Details
Published in:Journal of consulting and clinical psychology 1994-08, Vol.62 (4), p.670-678
Main Authors: McGrew, John H, Bond, Gary R, Dietzen, Laura, Salyers, Michelle
Format: Article
Language:English
Subjects:
Assertive Community Treatment
Community Mental Health Services - organization & administration
Community Mental Health Services - standards
Hospitalization
Hospitals, Psychiatric
Human
Length of Stay
Measurement
Measures
Mental Disorders - rehabilitation
Mental health
Mental Health Programs
Mental health services
Patient Admission
Psychological tests
Test Construction
Test Validity
Treatment
Workforce
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Summary:A fidelity index of program implementation for assertive community treatment (ACT) was developed. In Study 1,20 experts rated the importance of 73 elements proposed as critical ACT ingredients, also indicating ideal model specifications for elements. Agreement among experts on ratings of importance was high (intraclass r = .98). In Study 2, a 17-item subset of the expert-identified critical ingredients was used to construct a fidelity index with three subscales: Staffing, Organization, and Service. Internal consistencies ranged from .50 to .72, with a .81 reliability for the total scale. Fidelity was linearly related to program "generations," suggesting "program drift." In 18 ACT programs, fidelity also was associated with measures of reduction in days in psychiatric hospitals. The correlation was significant for the total scale and for the Organization and Staffing subscales but not for the Service subscale.
ISSN:0022-006X
1939-2117
DOI:10.1037/0022-006X.62.4.670