Terms

Fidelity refers to the degree to which a particular program follows the standards for an evidence-based practice.

A fidelity measure is a scale to assess the adequacy of implementation of an evidence-based practice.

Transcript

Now that the main principles of supported employment have been reviewed, let’s turn to the question of the role of monitoring fidelity of program implementation for evidence-based practices. In this section, I will explain why monitoring is a vital activity in all stages of implementation. First, let’s discuss a few basic definitions.

The term fidelity refers to the degree to which a particular program follows the standards for an evidence-based practice. In other words, a supported employment program can be characterized as “high fidelity,” meaning that it follows closely the evidence-based principles that we have just discussed. Or a program can be “low fidelity,” meaning that it does not attain the standards implied by these principles.

Having defined fidelity, the next logical question is, how is it measured? Any methodology that permits you to assess the level of fidelity is called a fidelity measure or fidelity scale. In other words, a fidelity scale is a tool to gauge the adequacy or degree of implementation of an evidence-based practice.

Monitoring fidelity is important, because programs that faithfully implement the evidence-based practices have better outcomes. That is, high fidelity programs have the benefits associated with the evidence-based practice. In the case of supported employment, high fidelity supported employment programs will generally have superior employment outcomes.

Conversely, programs that are low in fidelity are not likely to have the outcomes associated with the evidence-based practice. Just calling your program a certain type of program does not guarantee that it will be successful. This seems like a very obvious point, yet over the last 30 years, many programs seeking to implement a practice have failed to attend to fidelity.
There is another reason that fidelity is important. High fidelity programs also may reduce staff burnout, as found by Bond and his colleagues in a study of assertive community treatment programs. The interpretation is that in high fidelity programs, teams are more successful and success breeds success. Consequently, the program staff feel better about what they are doing and avoid the cynicism and discouragement that accompanies ineffective implementation.